ࡱ> egd%` 0bjbj 4X̟̟$ ^^^@08d"46bxxxxggg56767676767676$8h:;[6gg[6xxp6t!t!t!xx56t!56t!t!24xV H,.3!66063;*;(4;4pg1t!t5Qggg[6[6!Xggg6 Joint Declaration and Statement of Commitment on Pain Relief and Palliative Care as Human Rights We, as representatives of international, regional and national pain and palliative care organizations as well as members of civil society, declare Whereas The Universal Declaration of Human Rights recognizes the rights of everyone to life to freedom from torture and cruel, inhuman or degrading treatment (Art. 5), and to a standard of living adequate for health and well-being (Art 25); The Human Rights Committee has interpreted the right to life broadly and as requiring States to take positive measures to increase life expectancy; The International Covenant on Economic, Social, and Cultural Rights (ICESCR), the State parties recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (Art. 12), specifying among other measures the prevention, treatment, and control of epidemic, endemic, occupational, and other diseases and creating the conditions which would assure to all medical service and medical attention in the event of sickness and that the right to health is articulated in several other international covenants; The Committee overseeing the ICESCR issued a General Comment on the right to health, stating what it saw as the core obligations of all signatory nations, irrespective of resources and including the provision of access to essential medicines among the core obligations of states;  The United Nations Committee on Economic, Social and Cultural Rights specifically states that parties are under the obligation to respect the right to health by, inter alia, refraining from denying or limiting equal access for all persons . . . to preventive, curative and palliative health services; The Committee on Economic, Social and Cultural Rights affirmed the importance of attention and care for chronically and terminally ill persons, sparing them avoidable pain and enabling them to die with dignity; The Committee on Economic, Social and Cultural Rights indicated that access to essential drugs, as defined by the WHO Action Programme on Drugs is part of the minimum core content of the right to health and that fourteen medications listed in the IAHPC List of Essential Documents for Palliative Care are currently on the WHO Essential Medicines Model List; A right to palliative care and access to pain medication is further protected by the right to freedom from cruel, inhuman and degrading treatment; The Declaration on the Promotion of Patients Rights in Europe asserts: Patients have the right to relief of their suffering according to the current state of knowledge and Patients have the right to humane terminal care and to die in dignity; The International Guidelines on HIV/AIDS and Human Rights state that States should take measures necessary to ensure for all persons, on a sustained and equal basis, the availability and accessibility of preventive, curative and palliative care .; Recognizing That these commitments oblige governments to create and /or use every rightful mechanism to guarantee access to all components that contribute to the full exercise of the right to health; That palliative care and pain relief are such components, That access to palliative care and pain relief include access to appropriate treatment and services and access to essential medicines needed for the relief of suffering; That a national pain relief and palliative care plan also requires a focus on education for physicians and nurses and other related disciplines; That access to palliative care and pain relief can only be achieved when governments adopt and implement a national public health strategy which includes the above mentioned components; That several individuals, organizations and alliances have formulated the need to recognize pain relief and palliative care as fundamental human rights for several years and in several publications and forums (see  HYPERLINK "http://www.hospicecare.com/resources/pain_pallcare_hr/" http://www.hospicecare.com/resources/pain_pallcare_hr/) Alarmed That of the more than 1 million people who die each week, only a minority of those in need receive palliative care resulting in widespread unnecessary suffering; That in spite of the great advances in the treatment of pain, opioids are still not available to the majority of the population in need; As representatives of pain relief and palliative care alliances, federations, associations, organizations and as members of civil society hereby agree to work and collaborate together to: Identify, develop and implement strategies for the recognition of pain relief and palliative care as fundamental human rights. Work with governments and policy makers to adopt the necessary changes in legislation to ensure appropriate care of patients with life limiting conditions. Work with policy makers and regulators to identify and eliminate regulatory and legal barriers which interfere with the rational use of controlled medications. Advocate for improvements in access to and availability of opioids and other medications required for the effective treatment of pain and other symptoms common in palliative care including special formulations and appropriate medications for children with pain and other symptoms. Advocate so that adequate resources be made available to support the implementation of pain relief and palliative care services and providers where needed. Advocate for academic institutions, teaching hospital and universities to adopt the necessary practices and changes needed to ensure that pain and palliative care positions, resources, personnel, infrastructures, review boards and systems are created and sustained. Encourage and enlist other international and national professional organizations, pain and palliative care organizations and other interested parties to join this global campaign for the recognition of pain relief and palliative care as human rights. In witness hereof the representatives of the following organizations have signed this Joint Declaration: List Name of Organization/Individual Signing on to this Declaration Categories International Organizations Regional Organizations National Organizations Individuals Appendix A Suggested organizations to approach International Organizations Childrens Hospice International (CHI) International AIDS Society (IAS) International Association for Hospice and Palliative Care (IAHPC) International Association for the Study of Pain (IASP) International Brain Tumor Alliance (IBTA) International Childrens Palliative Care Network (ICPCN) International Observatory in End of Life Care (IOEL) International Palliative Care Initiative - Open Society Institute International Psycho Oncology Society (IPOS) Multinational Association for Supportive Care in Cancer (MASCC) The International Network for Cancer Treatment and Research (INCTR) World Institute of Pain (WIP) World Psychiatric Association (WPA) Worldwide Palliative Care Alliance (WPCA) Regional Organizations African Association for the Study of Pain African Association for Palliative Care (APCA) Asia Pacific Hospice Palliative Care Network (APHN) Asociacin Latinoamericana de Cuidados Paliativos (ALCP) Foundation for Sub-Saharan Hospices in Africa (FSSHA) Eastern and Central Europe Palliative Care Task Force (ECEPT) European Association of Palliative Care (EAPC) European Federation of IASP Chapters (EAFIC) European Society of Medical Oncology (ESMO) Federacin de Dolor Latinoamericanas (FEDELAT) National Organizations Include list of WPCA National Association Members Individuals Solicited at key events starting with the World AIDS Conference, Mexico City Appendix B Draft Dissemination and Communication Strategy Purpose: The purpose of this Declaration is to draw attention to the issue of Pain Relief and Palliative Care as a Human Right. Endorsements: We are seeking endorsement generally via computer sign-on from a number of different levels including: International Organizations including Hospice, Palliative care and pain groups Regional Organizations/Bodies including hospice, palliative care and pain groups National Non-governmental Organizations (NGOs) including WPCA National Association Members and other civil society members Individuals - Solicited at key events starting with the World AIDS Conference, Mexico City Implementation: The implementaton of this Declaration will have two distinct phases of work associated with it. The sign on phase that will be from August 1, 2008 and ending on World Hospice Palliative Care Day October 11, 2008. Followed by active advocacy phase starting in October 2008 where associations/networks/alliances/groups will be encouraged to use this Declaration as an advocacy tool. Who is this Declaration for: This advocacy tool will be used by civil society/Non-governmental Organizations (NGOs) when approaching various levels of organizations and governments including: International bodies like the World Health Organization (WHO), UNAIDS, Global Fund on HIV/AIDS, TB and Malaria Regional bodies like the European Union National Governments To what end: Representatives of pain relief and palliative care alliances, federations, associations, organizations and as members of civil society hereby agree to work and collaborate together to achieve the seven goals laid out in the Declaration.  United National. Universal Declaration of Human Rights. UN, Adopted and proclaimed by General Assembly resolution 217 A (III) of 10 December 1948.  Human Rights Committee, General Comment No. 6 on the Right to Life.  International Covenant on Economic, Social and Cultural Rights (1966).  Committee on Economic, Social and Cultural Rights. 22nd Session April May 2000 E/C 12/2000/4, para 43.  Gen Comment 14. The right to the highest attainable standard of health (article 12 of the International Covenant on Economic, Social and Cultural Rights) CESCR Twenty-second session Geneva, 25 April-12 May 2000, para. 34.  Gen Comment 14 para 25.  Gen Comment 12, para 12.  International Covenant on Civil and Political Rights, article 7.  WHO. Declaration on the promotion of patients rights in Europe, Articles 5.10 and 5.11, 1994.  UN Office of the High Commissioner for Human Rights and the Joint Program on HIV/AIDS. International Guidelines on HIV/AIDS and Human Rights; Guideline 6; 2006.     01AQ`abhiq{|? 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