The following are the areas of work that were identified as priorities during the pre-congress session:

Access to Medications
   1. To ensure availability in the country, and access, to all palliative care essential medicines (or a close substitutes) on the IAHPC list
   2. To have more than 2 potent oral opioids available in at least an immediate onset and a modified release form plus have a parenteral (subcutaneous) medication form
   3. To increase the rational use of opioids as reported in consumption reports provided to the International Narcotics Control Board and to encourage an annual increase in use of, and consumption of, these agents to the target date of 2009.

Policy
  1. To produce a report on the state of development and the necessary next steps that will be presented to the national authorities (provide information when and how the report shall be presented)
   2. To produce guidelines for basic palliative care that is endorsed by the national associations (provide details on the scope of the guidelines)
   3. To establish the right of employees to have access to compassionate care leave for those wishing to care for an ill relative
   4. To have palliative care included in the national cancer and HIV/AIDS programs

Education
   1. To have palliative care inserted in the curriculum for medical/nursing students (and other professionals)
   2. To have medical boards recognize and certify palliative care as a specialty/subspecialty
   3. To implement specialist training for nurses
   4. To implement academic training
   5. To establish a certification process that recognizes palliative care competence
 
Quality
   1. To define standards of care (provide detailed standards and a standard development process)
   2. To introduce a standard documentation system for palliative care services (provide information about the implementation process)
   3. To establish a quality assurance project, using benchmarking or audit-cycles
   4. To define high quality palliat! ive care

Research
   1. To incorporate the proposals presented in the Venice Declaration to support the development of research in palliative care
   2. To initiate a research forum, or a working group, on research as a platform for future projects and training of researchers
   3. To produce a national agenda on palliative care research
   4. To establish funding, or an award, to promote research activities in the country
   5. To increase the publishing of papers in peer reviewed journals on issues of palliative care

It was agreed that the WPCA, the EAPC and the IAHPC would work together to help the associations develop and achieve their commitments. The IAHPC looks forward to helping in this process.

The EAPC Congress was a great success as evidenced by the number of people who participated and also the quality of the presentations and posters. The Congress was inaugurated by the President of the Hungarian Republic and a special prize was given to Mr. George Soros, Director of Open Society Institute (OSI), in recognition of his influence on the development of palliative care in Hungary and Eastern Europe. Dr. Foley, who is also Director of the International Palliative Care Initiative of OSI, received the award on behalf of Mr. Soros. Congratulations are due Mr. Soros for receiving this recognition award and to the EAPC and the Congress organizers for putting together a magnificent event. We were delighted to hear in Budapest of the many things going on in palliative care’s global movement. Budapest provided a great opportunity to meet old friends and make new ones and to witness how a large network is developing a! round the world.

As we announced in our previous edition, the IAHPC supported several participants from developing countries to attend the EAPC Congress in Budapest, including Dr. Faith Mwangi-Powell, director of the African Palliative Care Association (APCA), who gave the opening plenary address. This edition includes reports by individuals who also received grants from the IAHPC to attend the Congress as well as from scholars who received our grants to other seminars. Also, included are some pictures taken at the IAHPC booth. We extend our thanks to all those who stopped by our booth to say hello, and to those who inquired about our programs and ways in which we can collaborate together to help improve palliative care in the world.

The journal Anesthesia and Analgesia has dedicated their current issue to topics on pain and palliative care, especially on the access to pain relief as a fundamental human right. The papers can be accessed for free from the journal’s website at http://www.anesthesia-analgesia.org/

We are happy to announce that the IAHPC has granted a Traveling Scholarship to Dr. Mateja Lopuh, head of the palliative care department at Jesenice General Hospital, in Lesce, Slovenia to attend a training seminar on palliative care at Christophorus Akademie in Munich. We are delighted to be able to support her travel and look forward to her report.  

Until next month,

Kathy Foley, MD
Chair, Board of Directors

Liliana De Lima, MHA
Executive Director

Photo:  (from L to R)
Ms. Carolina Monti from the ALCP; Jose Armando Espinosa from the PC program in ICO, Spain; Liliana De Lima, Ana Restrepo from IAHPC; and Dr. Patricia Bonilla, from the NCI in Caracas Venezuela.
Click here to view.

Photo: Ms Ana Restrepo from IAHPC with Ana Towers, from the University of McGill (Canada) at the IAHPC booth.
Click here to view.      

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IAHPC’s Traveling Scholars’ Reports

This month we highlight the reports of three IAHPC traveling scholars to the 10th Congress of the European Association of Palliative Care (EAPC) held in Budapest from the 7th to the 9th of June, 2007. In each report, the scholar reflects on how the knowledge learned at the Congress has influenced them and what it might mean for their programs as they return home. Please click on the following link to read their reports: www.hospicecare.com/news/07-07/travelsch.html

The IAHPC Scholars are:

Harmala Gupta
President, CanSupport
New Delhi, India

Ms. Carolina Monti, BA
Administrative Manager
Latin American Association for Palliative Care

Dr. Maria Fidelis Manalo, MS
IAHPC 2007 Traveling Scholar
Department of Community & Family Medicine, Far Eastern University-NRMF Medical Center, Quezon City, Philippines

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IAHPC PALLIATIVE CARE FACULTY DEVELOPMENT PROGRAM

This report by Dr. Msemo B. Diwani covers an update on the IAHPC Development Program that was started in December, 2004 at the Muhimbili University College of Health Sciences in Tanzania. During the report period (March-May, 2007) they offered courses to clinicians, postgraduate students and pharmacists as a response to the great need for palliative care knowledge and skills in their community. Read how they used the political process to further their cause and how they hope to develop a research effort in the future. To view the report click on the following URL: 
www.hospicecare.com/news/07-07/faculty.html

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IAHPC Traveling Fellow’s Report   

Dr. Guzman is a IAHPC Traveling Fellow who was a clinical visitor in the Department of Palliative and Rehabilitative Medicine at the MD Anderson Cancer Center, Houston (April 30 - May 1, 2007).

She states, “The hospital visit was very helpful to me because it made me aware of the clinical practices of hospice and palliative care in a leading cancer center such as MD Anderson. Although our setting in the Philippines, could never mimic, or equal, the setting I observed in Houston, at least I now have a standard of practice to which we can compare our delivery of hospice and palliative care….. Read more about her experiences at MD Anderson at the following URL: 
www.hospicecare.com/news/07-07/travelfel.html

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Palliative Care Book of the Month

Dr. Roger Woodruff reviews five books this month and chooses one as the Palliative Care Book of the month.

RESEARCH METHODS IN PALLIATIVE CARE

Julia Addington-Hall, Eduardo Burera, Irene Higginson and Sheila Payne (Eds)
Oxford University Press, 2007
315 pp
ISBN 978-0-19-853025-1
RRP £29.95 $US57.50

Here is the A-Z and ‘how to’ book on palliative care research brought to you by the First Team – a click on PubMed shows they have over 850 citations between them.

The first section of the book concerns clinical trails and includes a discussion of ethical and practical issues in designing and conducting clinical trials in palliative care. The second section concerns survey research and all the pitfalls to avoid. Section three is about epidemiological research methods and the chapter on systematic reviews is excellent. The fourth section is on qualitative research methods. The last section consists of five chapters titled ‘How to…’ that includes everything from developing a research question to publication.

The book is well set out, with a useful system of headings that allows you to scan the material in a chapter. There is an enormous amount of information and detail, although it is presented in a manner that could be easily understood by somebody not familiar with the research process. As such, I think this book will be a useful reference for those experienced in research and an invaluable guide for those embarking upon it for the first time.

Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia
(June 2007)

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The Following 4 Book Reviews may be read at our website:
www.hospicecare.com/news/07-07/reviews.html#br

CANCER PAIN. Pharmacological, Interventional and Palliative Care Approaches.

Oscar A. de Leon-Casasola (Ed)

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THE FUTURE OF ASSISTED SUICIDE AND EUTHANASIA

Neil M Gorsuch

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MEDICAL CARE AT THE END OF LIFE
A Catholic Perspective

David F. Kelly

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COMPLEMENTARY AND ALTERNATIVE MEDICINE
Ethics, the Patient, and the Physician

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Regional Reports

Advancing drug availability in West Africa

By Dr Henry Ddungu, MBChB MMed and Richard A. Powell, BA MA MSc

“In May 2006 the 59th United Nations (UN) World Health Assembly adopted resolution 58.22, thereby recognizing the importance of improving pain relief treatment using opioid analgesics and calling upon member states to remove barriers to their medical use and availability…

Many challenges remain, they are:

- “inadequate funding to mobilize and provide authorized pain relief;

- the protracted nature of policy change;

- continued ‘criminalization’ of pain relief; and

- inadequate in-service training to address the ‘opiophobia’ that restricts health professionals’ prescribing and dispensing practices…”

Read their entire report on how they used an innovative and interactive workshop format to promote the use and availability of opioid analgesics in West Africa.
www.hospicecare.com/news/07-07/regional.html

Zimbabwe:  Multidisciplinary Teamwork Award
“Valerie Maasdorp of Island Hospice and Bereavement Service, Harare, Zimbabwe   received the Multidisciplinary Teamwork Award for 2007 at the Third International Journal of Palliative Nursing (IJPN) awards ceremony, held at the Savoy Hotel, London, United Kingdom on 23 March 2007…” 
www.hospicecare.com/news/07-07/regional.html

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Announcements

Education for Physicians in Palliative and End-of-life Care – Oncology (EPEC-Oncology)
The final version of the Education for Physicians in Palliative and End-of-life Care – Oncology (EPEC-Oncology) Curriculum is now available as a CD-ROM / DVD combination. You can order it at   http://www.cancer.gov/aboutnci/epeco
This curriculum is eligible for continuing education credit for physicians and nurses who complete the requirements.
AND
The EPEC-Oncology module “Last Hours of Living” is available on Medscape with Continuing Education Credits. See http://www.medscape.com/viewprogram/5808.

Please share this with other colleagues.

Thanks, Frank
Frank D. Ferris, MD
Medical Director, Palliative Care Standards / Outcome Measures
San Diego Hospice & Palliative Care