Challenges/barriers for moving forward

Ernesto JaramilloWHO/Stop TB Department

Palliative Care and M/XDR-TB

18-19 November, 2010Geneve, Switzerland

Non-exhaustive list of challenges

• Awareness

• Advocacy

• Assessment of need

• Policy-guidelines

• Financing

• Human resources

• Models for palliative care in M/XDR-TB

• Needs for technical assistance

• Monitoring and evaluation (indicators, targets, goals)

• Drug management in palliative care for TB

AWARENESSWhat else apart from anti-TB drugs are

patients in need of?

ADVOCACYHealth care workers and health care systems not only have

the ethical duty but CAN deliver effective palliative care

Universal access to palliative care must match

universal access to diagnosis and treatment of M/XDR-TB

Policy-guidelines…in need of updating

FinancingWhat and hw to budget and fund palliative

care in M/XDR-TB?

Models for palliative care in M/XDR-TB

Human resources

Needs of technical assistance

Monitoring and evaluation (indicators, targets, goals)

How to measure coverage,

quality, and impact of

palliative care in the response to M/XDR-TB?

Drug management in palliative care for TB

Which are the challenges in the health systems for scaling up palliative care?

  Health System Building Blocks

BottlenecksService delivery

Health workforce Information

Medical products

and technologies

Health financing

Leadership and

governance

Still major gaps in TB control            

Extremely weak M/XDR-TB management and care            

Health workforce crisis            

Inadequate laboratories            

Quality of anti-TB drugs not assured            

Limited access to drugs for pain relief            

Absent infection control            

Insufficient body of evidence on PC in TB            

Major financial gaps            

What means a patient-centred approach in TB care and control

without palliative care?