Pallium India was privileged to be a part of their meeting in London on 20 July 2019, chaired by Dr Parvathi Nair. The meeting discussed the current status of healthcare in India and how palliative care could bring in compassion into it. This group has been supporting palliative care in Kulasekharam for many years now.
While sharing this optimism, let us also warn of a potential implementation gap. In our country, not always does policy translate to action and reality. We will need sustained and systematic action to ensure that the competency mentioned in the curriculum is actually achieved by the students.
(Image: Dr Satendra Singh at the Disability Pride Parade in Chicago.)
Palliative care organizations around the world felt that the withdrawal was a knee-jerk reaction, and that it should have followed consultations with experts. The WHO has released a statement in essence explaining the principle of balance, with which we would all agree. The Principle of Balance states that we have a dual responsibility – to make opioids available for pain relief, while at the same time preventing their diversion to inappropriate or non-medical use.
We hope the new guidelines will bring opioids back to their rightful place so that people are not left in agony of pain.
We have one concern, though. The new guidelines are going to be evidence-based. We hope any expert committee which goes into creation of these guidelines will take into consideration the fact that for some things as subjective as pain, the quality of evidence is bound to be of relatively poorer quality.
Secondly, the weight of evidence may turn greatly in favour of the more expensive medicines. This is inevitable because at least 80% of all scientific research is funded by the pharma industry directly or indirectly. Very little research actually happens globally regarding inexpensive medicines, which, we believe, are systematically pushed out of the market.
The Indian experience with Dextropropoxyphene is a case in point. Globally, everyone would frown at the name Dextropropoxyphene. Experts, otherwise led by reason and research, have been heard to claim that it is a ‘dirty drug’. We hope that those who have gone into the depths can recount a different story.
We hope the new evidence-based guidelines will not have a negative effect on people in pain, globally. Their numbers are unbelievably large. More than 80 million people globally die with untreated, excruciating pain.
In an elegant function at the House of Commons of the British Parliament on 19th July 2019, Dr M. R. Rajagopal received the Bharat Gaurav award instituted by Sanskriti Yuva Sanstha, from the Member of Parliament, Dr Virendra Sharma. Our deepest gratitude to all involved, for this recognition.
The person with the disease may get some attention; but the silent caregiver is seldom acknowledged. We are glad that Caregiver Saathi is giving some attention to it.
Please read the article by Shwetha Sivaraman on the Caregiver Saathi blog. Role of a Caregiver in early stage Parkinson’s