WONCA endorses IAHPC Advocacy Note for Palliative Care in Pandemic Treaty

April, 2023

WONCA supports and endorses the Advocacy note by the International Association for Hospice & Palliative Care (IAHPC) for the inclusion of palliative care language in the response treaty.

The following suggestions are proposed to be added to the Zero Draft of the Pandemic Treaty:

I. General comments:

1) “Primary health care” is referenced twice, while UHC is mentioned 17 times.
a. We suggest reinserting PHC as per textual suggestions below and including the
WHO definition of PHC in the definitions Article.
2) The word “suffering” appears nowhere. We suggest where it can be inserted.
3) The word “rehabilitation” appears nowhere in the document
4) Treaty language with page numbers from the Zero Draft is copied and pasted below with suggested text changes highlighted in red.


28. Reiterating the need to work towards building and strengthening resilient health systems to advance universal health coverage, with primary health care as an integral component, as an essential foundation for effective pandemic prevention, preparedness, response and recovery of health systems, and to adopt an equitable approach to prevention, preparedness, response and recovery activities, including to mitigate the risk that pandemics exacerbate existing inequities in serious health-related suffering, particularly among vulnerable populations.
33. Deeply concerned by the gross inequities that hindered timely access to medical and other COVID-19 pandemic-related products, notably vaccines, oxygen supplies, personal protectiveequipment, diagnostics, therapeutics and internationally controlled essential medicines. P.6 (UNODC, WHO, INCB Joint Statements 2020 and 2021)
35. Emphasizing that, in order to make health for all a reality, individuals and communities need: equitable access to high quality health services, namely promotion, prevention, treatment, rehabilitation and palliative care, without financial hardship; well-trained, skilled health workers providing quality, people-centred care; and committed policy-makers with adequate investment in health to achieve universal health coverage, p. 7

III. Chapter I Definitions and use of terms Article 1. P.9
Suggestion: Define “primary health care” per WHO definition. "PHC is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment." Suggestion: Define “serious health-related suffering” per IAHPC definition “Suffering is health-related when it is associated with illness or injury of any kind. Health related suffering is serious when it cannot be relieved without medical intervention and when it compromises physical, social, spiritual and/or emotional functioning.” http://pallipedia.org/serious-health-related-suffering-shs/

2 Suggestion: Add definition of “health services”: encompasses promotion, prevention, curative, rehabilitation and palliative https://www.who.int/teams/integrated-health-services/about

IV. Operational paragraphs

Guiding Principles and Rights
Chapter II Article VI, P12
15. Universal health coverage – The WHO CA+ will be guided by the aim of achieving universal health coverage, for which strong and resilient health systems that integrate promotion, prevention, treatment, rehabilitation and palliative care, are of key importance, as a fundamental
aspect of achieving the Sustainable Development Goals through promoting health and well-being for all at all ages.

Chapter III Article VI P.13 Article 6 2. The WHO Global Pandemic Supply Chain and Logistics Network (the “Network”) is hereby established. Controlled essential medicines in all routinely used formularies must be included in planning and execution per UNODC, WHO, INCB Joint Statements 2020 and 2021
Chapter IV, Article 11. P.19

4 (a) continued provision of quality routine and essential health services during pandemics, including clinical and mental health care and immunization, with a focus on primary health care and community-level interventions, and management of the backlog of and waiting lists for the
diagnosis and treatment of, and interventions for, other illnesses, including rehabilitation, palliative care and care for patients with long-term effects from the pandemic disease.

Chapter V, Article 16. Whole of Government Approach p. 22
The Parties recognize that pandemics begin and end in communities and are encouraged to adopt a whole-of-government and whole-of-society, primary health care approach, including to empower and ensure communities’ ownership of, and contribution to, community readiness and resilience for pandemic prevention, preparedness, response and recovery of health systems

Chapter VI, Article 19, Financing P25 (b) plan and provide adequate financial support in line with its national fiscal capacities for: (i) strengthening pandemic prevention, preparedness, response and recovery of health systems; (ii) implementing its national plans, programmes and priorities; and (iii) strengthening health systems and progressive realization of universal health coverage, minimising out of pocket spending for patients and families.

Find more information at the IAHPC website.