Stjernswärd Jan
WHO, Svedala, Sweden.
J Public Health Policy. 2007;28(1):42-55. doi: 10.1057/palgrave.jphp.3200115.
There is the knowledge to improve the Quality of Life, Dying and Death of cancer sufferers, other patients dying of chronic diseases, HIV/AIDS and the children and elderly terminally ill and their caring family members, an estimated 100 million people globally, if palliative care and pain relief would be available. Tragically however, palliative care is only reaching a lucky few. Two third of those in need of palliative care are in the low or middle income countries. The World Health Organization (WHO) has pioneered a public health strategy to integrate palliative care into existing healthcare systems as this offers the best approach for translating new knowledge and skills into evidence-based, cost-effective interventions that can reach everyone in the population, when incorporated by governments into all levels of their healthcare systems and owned by the community. The WHO Strategy starts by establishing four foundation measures, key components that are: 1) appropriate policies, 2) adequate drug availability, 3) education of the public, policymakers and the public and 4) implementation. The WHO Model has shown that it provides an effective strategy for countries to establish palliative care. The Open Society Institute has actively supported countries to establish National Palliative Care Programs according to these principles. Combined with a community strategy that involves the society through collective and social action"Palliative Care for All" indeed could become a reality.
如果能提供姑息治疗和疼痛缓解,就有知识可以改善癌症患者、其他慢性病临终患者、艾滋病毒/艾滋病患者以及绝症儿童和老年人及其关爱他们的家庭成员的生活质量、临终状态和死亡状况,全球估计有1亿人。然而,可悲的是,只有少数幸运儿能得到姑息治疗。三分之二需要姑息治疗的人在低收入或中等收入国家。世界卫生组织(WHO)率先提出了一项公共卫生战略,将姑息治疗纳入现有的医疗保健系统,因为当政府将其纳入各级医疗保健系统并由社区主导时,这是将新知识和技能转化为基于证据、具有成本效益的干预措施从而惠及全体民众的最佳途径。WHO的战略首先确立了四项基础措施,即关键要素:1)适当的政策,2)充足的药物供应,3)对公众、政策制定者及大众的教育,4)实施。WHO的模式表明,它为各国建立姑息治疗提供了一项有效战略。开放社会研究所积极支持各国按照这些原则建立国家姑息治疗项目。结合一项通过集体和社会行动让社会参与进来的社区战略,“全民姑息治疗”确实可以成为现实。