Strategic donor support is critical

Given that donor support for palliative care is not sustainable in the long term, donors need to take a strategic approach and work towards embedding palliative care into government health policy and practice. How can they best go about this?

Palliative care is important for everybody with a life-threatening illness. In countries experiencing an HIV/AIDS pandemic, palliative care must not be seen as a luxury at the end of life but as an essential part of the continuum of care for people with HIV/AIDS or any other life-limiting illness. Donors therefore need to be involved in promoting changes in attitude among health professionals, care providers and governments as well as in more traditional grant-giving.

Sustained support for organisations providing palliative care is essential. It is these organisations that provide the services, demonstrate the practicality and effectiveness of palliative care and advocate for more palliative care in their own countries.

It is not enough, however, to fund islands of excellence. Funded organisations need to demonstrate that they are actively involved in the scaling up of palliative care and in its integration into health policy and the continuum of care. Donors need to ensure that organisational funding goes together with other funding support and advocacy at local, country, regional and international levels.

Donors could help fund:

• the development of education curricula for palliative care
• training courses for health professionals and carers
• local research to provide an evidence base for effective palliative care.

At country level donors could work with local partners to advocate for:

• the provision of opioids and other medicines that relieve pain and symptoms, and potentially back changes to the national laws if necessary
• the full integration of palliative care into HIV/AIDS treatment and care
• palliative care to be part of the training for all health professionals.

International donors could advocate for:

• recognition of the vital importance of palliative care
• more resources from a wider range of donors.

It is likely that palliative care in under-resourced health systems will, for the foreseeable future, require external donors and it is essential that donors cooperate with the existing health system. They should not set up unsustainable parallel systems of care. To have the most impact with limited resources, the small numbers of donors with a special interest in palliative care need to work together.

Palliative care focuses on the individual and their family with a holistic approach to meeting their needs. Yet it is only by thinking and acting strategically that donors can help ensure that palliative care is available to every individual that needs it.

Olivia Dix
Palliative Care Initiative, Diana Princess of Wales Memorial Fund, County Hall, Westminster Bridge Road, London SE1 7PB, UK
palliativecare@memfund.org.uk

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