Publications
APS Bulletin • Volume 13, Number 2, 2003
Palliative Care
Arthur G. Lipman, PharmD, Department Editor
International Palliative Care: Initiatives of the International Association for Hospice and Palliative Care
Liliana DeLima, MPH
Department Editor’s Note: The World Health Organization has defined palliative care as the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social, and spiritual problems is paramount.
In the United States, the National Cancer Institute funded the demonstration project for hospice/palliative care between 1974 and 1977. In less than a quarter of a century, the number of programs in this country has grown from one to more than 3,000. Most of those are home care programs. We are now seeing a massive increase in palliative care programs within hospitals and health systems. Among them is an excellent palliative care program at the Clinical Center of the National Institutes of Health that serves patients with a range of advanced illnesses.
Many palliative care programs report fewer than half of their patients have cancer. While cancers are still the most common illnesses for many hospice patients, neurological, cardiac, renal, endocrine, bronchopulmonary, and other diseases, as well as AIDS and end-stage organ failure, are among the admitting diagnoses of the majority of U.S. palliative care patients. Nearly all palliative care patients require pain management.
Modern palliative care began in the 1900s in Ireland and England, and was refined and exemplified at St. Christopher’s Hospice in London in 1967. Internationally, interest in palliative care has grown remarkably in the past two decades.
The International Association for Hospice and Palliative Care (IAHPC) is an organization dedicated to the development and improvement of palliative care worldwide. Its board of directors is chaired by Eduardo Bruera, MD, and comprises 24 members from 16 countries. IAHPC is a non-profit, non-political organization without religious affiliation.
IAHPC’s mission is to increase the availability of and access to high-quality hospice and palliative care for patients and their families throughout the world. IAHPC aims to work with associations and agencies, as well as with individuals, to improve communication and access to resources and foster opportunities in education and training. IAHPC collaborates with other professional and lay organizations such as APS and the American Academy of Hospice and Palliative Medicine to promote the development of hospice and palliative care. IAHPS participates in joint publications and panel presentations and by serving as a bridge to other regional and international organizations.
IAHPC Initiatives
The following are among the IAHPC’s initiatives:
- IAHPC Traveling Fellows Program—This program supports the travel expense of an individual who is willing to travel to and spend at least two weeks in a developing country and teach palliative care. The goal is to help host programs and organizations develop their own models of palliative care. Since 1999, 14 fellowships have been awarded to countries in Asia, Africa, and Latin America.
- The IAHPC Traveling Scholarship Program—This program provides financial assistance to palliative care leaders from developing countries so they can speak at the IAHPC Annual Meeting and attend the international palliative care congress, with which our meetings are associated. Scholarships have been awarded to individuals from Ukraine, Poland, Korea, India, Romania, Saudi Arabia, and Uganda.
- Annual IAHPC Recognition Awards—This award promotes the development of palliative care around the world by increasing the profile of programs and individuals who have made outstanding contributions to palliative care. The winners of the 2001 IAHPC annual awards were Anne Merriman, MD (Individual) from Uganda, and Clinica Familia–Programa de Cuidados Paliativos in Chile (Institutional).
- Endorsement of Seminars and Teaching Programs—IAHPC endorses teaching programs, seminars, and scientific meetings to recognize initiatives that can make a difference in the care of patients in developing countries. These programs include the Continuing Medical Education Program of the School of Training and Updating in Palliative Care, National Cancer Institute, Milan, Italy; VII Latin American Palliative Care Meeting, Guadalajara, Mexico; Samara Hospice Project, Samara, Russia; Medical School and University of Namibia, Namibia, Africa.
- Web site—The IAHPC Web site at www.hospicecare.com provides worldwide access to palliative care information. Serving as an information and communication tool with more than 25,000 hits per week, it has become one of the more visited Web sites in the field. Some of the free resources available at the Web site are fact sheets by Derek Doyle, MD; an electronic newsletter edited by William Farr, MD; the Manual of Palliative Care by Doctors Derek Doyle and Roger Woodruff; an “article of the month” by Dr. Carla Ripamonti, a palliative care book shop, an ethics article, an international directory, and a future events and meetings calendar.
- Clearing House Program—This program was established in 2001. Those who work on it locate donors of palliative care journals and publications less than 5 years old and match them with institutions and programs in developing countries that need those publications. Beneficiaries of the 2001 Clearing House Program include programs and institutions in Argentina, Colombia, South Africa, Venezuela, Mexico, Bosnia and Herzegovina, Brazil, and the Philippines.
Conclusion
IAHPC is an organization that has served the palliative care community, healthcare professionals, and institutions worldwide. The success of our programs indicates we are helping to meet the needs of people establishing hospice and palliative care programs in developing countries.
Liliana DeLima, MPH, is executive director of the International Association for Hospice and Palliative Care. She can be reached at ldelima@iahpc.com.