We have the pleasure to share with you, new WHO guides on Integrating palliative care into health care for planners, implementers and managers, which are available on our WHO website bellow

The objective of these guides is to provide practical guidance on integrating palliative care and symptom relief into health care systems. It is intended, to assist anyone involved with planning, implementing, managing palliative care and symptom control. With this guide, WHO reiterates its commitment to answering the needs and expectations of all people, especially the most vulnerable, providing equitable access to quality and safe care across disease and age groups.

*         Integrating palliative care and symptom relief into primary health care

Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is “an ethical responsibility of health systems”(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).

*         Integrating palliative care and symptom relief into paediatrics

People younger than 20 years comprise 35% of the global population and 40% of the global population of least-developed nations (1). The number of children – neonates, infants, children, and adolescents up to 19 years of age – who need pediatric palliative care (PPC) each year may be as high as 21 million (2). Another study found that almost 2.5 million children die each year with serious health related suffering and that more than 98% of these children are in low- and middle-income countries (LMICs) (3). While estimates differ, there is no doubt that there is an enormous need for prevention and relief of suffering among children – for PPC. In response to the large-scale unnecessary suffering of children, the 2014 World Health Assembly resolution WHA67.19 on Strengthening of palliative care as a component of comprehensive care throughout the life course emphasizes that access to palliative care for children is an “ethical responsibility of health systems” (Annex 4) (4). Remarkably, however, PPC has not been seen as a priority around the world. A 2011 study found no PPC services in 65.6% of countries (5). Where services do exist in LMICs, they typically are available in only one or a few institutions and are not integrated into health care systems. A review of PPC in sub-Saharan African countries found that less than 1% of children needing palliative care in Kenya had access to it and less than 5% in South Africa and Zimbabwe (6).

*         Integrating palliative care and symptom relief into responses to humanitarian emergencies and crises

Humanitarian emergencies and crises (Humanitarian emergencies and crises) are large-scale events that may result in the breakdown of health care systems and society, forced displacement, death, and physical, psychological, social and spiritual suffering on a massive scale. Current responses to Humanitarian emergencies and crises rightfully focus on saving lives, but for both ethical and medical reasons, the prevention and relief of pain, as well as other physical and psychological symptoms, social and spiritual distress, also are imperative. Therefore, palliative care, should be integrated into responses to Humanitarian emergencies and crises. The principles of humanitarianism and impartiality require that all patients receive care and should never be abandoned for any reason, even if they are dying. Thus, there is significant overlap in the principles and mission of palliative care and humanitarianism: relief of suffering; respect for the dignity of all people; support for basic needs; and accompaniment during the most difficult of times.

Please, don’t hesitate to share and publicize these new WHO guides through your respective networks and any relevant target audience.

All my best regards.

Isabelle Wachsmuth
Service Delivery and Safety Department
Health Systems and Innovation
World Health Organization
Geneva, Switzerland