INCTR

INCTR Palliative Access (PAX) Program

Palliative Care sensitization workshop for nursing students, Scheer Memorial Hospital, Nepal

INCTR established this program to address the challenges related to the delivery of palliative care in developing countries in which such care can be hindered by limited access to opioids and other symptom-relieving medications, rural dislocation of a population, competing health priorities, war or political instability, and limited access to health care services.

The goal of the PAX Program is to assist developing countries to initiate and sustain effective palliative care programs suitable for their countries in order to provide an improved quality of life for all patients with cancer, especially for those in whom cure is not possible.

The three main strategies of the PAX Program are:

To help set up Regional Palliative Care Centers in collaboration with regional and international agencies and by using the existing INCTR network. These centers will provide specialist palliative care for adults and children with advanced cancer and other illnesses such as AIDS, TB and malaria as well as training for a broad range of health care specialists and sensitization to the community and policy makers with respect to the importance of palliative care.
To provide consulting services to national or regional governments in the assessment of palliative care needs, including improving opioid availability and planning services to improve access to care.
To promote the provision of palliative care by oncologists and other health care professionals not specialized in palliative care.

Virginia LeBaron, Nurse Consultant, PAX Program with recent graduates of a 6 week palliative care certificate course in Hyderabad, India.

The PAX Program is concentrating on developing services in Kathmandu, Nepal; Hyderabad, India; and Dar es Salaam, Tanzania. Initial planning for a similar project is underway at the Santa Marcelina Hospital, Sao Paulo, Brazil. INCTR has agreed to be the primary partner, along with WHO, in helping to enhance palliative care in Nicaragua, one of the IAEA PACT model countries. The PAX team actively collaborates with the Middle East Cancer Consortium program of education in palliative care and has agreed to participate in the European School of Oncology's Black Sea project.

Consulting services have been provided to Tanzania, Yemen and Nicaragua under the auspices of IAEA PACT. The main goals are the integration of palliative care services into national cancer control programs, the addition of palliative care education to medical, nursing and paramedical curricula, and interaction with narcotic regulators to improve opioid availability.

The team provides a number of lectures and seminars at oncology conferences and symposia with the goal of educating oncologists and other health professionals in palliative care.

Clinical Guidelines for Palliative Care, developed by the INCTR PAX team, are currently available in both an on line version (http://www.inctr.org/projects/palliative.shtml) and a pocket-sized companion book. The guidelines provide a quick and practical reference for health care professionals providing palliative care within resource-constrained health care systems. A new edition is about to be published.

Partial support for the production and distribution of the guidelines has been provided by Eli Lilly and the Office of International Affairs, NCI.