Western Pacific Palliative Care Advocacy Network 

The importance of advocacy to improve access has been tragically revealed during the COVID-19 pandemic with global supply chains and capacity broken under the weight of new and increased demand for controlled medications. Even before the impact of COVID-19, 83% of the global population, mostly but not exclusively in low-and-middle-income countries (LIMCs), had inadequate access, a true opioid crisis of global proportions.

The third WPPCAN virtual workshop, held on 19 May 2021, focused on improving access to controlled medicines. There were 28 participants from the Philippines, Hong Kong, Fiji, New Zealand and Australia. While most of the participants had attended the previous workshops, it was good to welcome new members and to see awareness of the Network growing.

The first speaker was Elizabeth Mattfeld, Global Program Manager for Increasing Access to and Availability of Controlled Medicines and Palliative Care from the UN Office of Drugs and Crime (UNODC). In her talk, she reviewed the importance of the foundation documents of the International Narcotics Board (INCB), WHO and UNODC, the formation of the Joint Global Program between UNODC, WHO and the Union for International Cancer Control (UICC), and the highly influential UNGASS 2016 joint commitment to effectively address and counter the world drug problem (link below).

Despite these efforts, we know that gross imbalance remains and that the dominant international narrative continues to be about avoiding opioid misuse and harm. The drama of COVID-19 vaccination inequity mirrors the international crisis of opioid access in LIMCs. Elizabeth stressed the concepts of rational use of opioids, namely for the right patient, the right drug, at the right dose, by the right route and for the right period of time.

In the second part of her talk, she reviewed the UNODC technical guidance document (link below), and the three core areas which are critical for improvement: Systems strengthening and integration, Supply chain management and Education and awareness. For each core area, measures have been developed to guide strategic actions by countries as they work towards improving availability of controlled medications.

Elizabeth reminded us that while COVID-19 has led to some short-term policy changes including in access to medicines, our challenge is to work toward strengthening our health systems with a well-trained workforce who have access to the tools they need, including medicines, as further crises are to be expected in the future. 

Elizabeth’s talk was inspiring and encouraging of our efforts to build a network with which to engage in these international efforts and to advocate directly for colleagues and patients who are directly experiencing the effects of inadequate access on a daily basis.

Rachel Coghlan