Integrating Compassionate End-of-life Care into Health Systems Across Africa
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Throughout Africa, more than 2.5 million people die of AIDS-related illnesses each year. For an overwhelming majority of these individuals, their final days are filled with fear, loneliness, and agonizing pain. The unendurable suffering they face—and the anguish felt by family and friends who are forced to watch their loved ones die in misery—is compounded by the fact that it is so unnecessary. While access to life-extending treatment in low-resource countries around the world may be limited because it remains too expensive to be made widely available, access to compassionate end-of-life care should never be.
APCA’s mission is to facilitate the scale-up of palliative care services across Africa. (Photo: Courtesy of Donna Anderson)
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The HIV/AIDS Twinning Center is supporting the African Palliative Care Association (APCA) in its efforts to serve as a catalyst for scaling up end-of-life care in countries across Africa. With funding from the President’s Emergency Plan for AIDS Relief, APCA—which is based in Kampala, Uganda—is championing palliative care by encouraging government backing of appropriate and affordable end-of-life support programs, advocating for the availability of medications necessary for pain and symptom management, promoting the development of national palliative care associations, and establishing standard guidelines for training and the provision of care.
Palliative care is simple, cost-effective, and can easily be integrated into the day-to-day routine of physicians, nurses, allied care providers, and even patients’ families. Recognizing that the needs of a dying person are not only physical, but mental, emotional, and spiritual as well, the underlying purpose of palliative care is to promote acceptance of the fact that death and bereavement are realities of life and provide a network of compassionate support that improves the quality of what life remains for people with terminal illnesses.
Initially, APCA will target four countries—Kenya, Tanzania, Uganda, and Zambia—working with local associations and other partners such as NGOs and faith-based groups to ensure the integration of palliative care within the overall framework of healthcare provision in these nations.
“HIV/AIDS has made medicine understand that if it is only focused on cure and ignores suffering it is not doing its job. It has made the call for what palliative care is all about imperative, and the role of palliative care in fighting HIV/AIDS inevitable. The amount of suffering is simply too great, and the promise of a cure, for many, too distant." —Joseph F. O’Neill, MD, MS, MPH, former Deputy Coordinator and Medical Director of the US Department of State’s Office of the Global AIDS Coordinator (from Palliative Care in Sub-Saharan Africa: An Appraisal 2004, published by King’s College London and the Diana, Princess of Wales Memorial Fund)
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