Within weeks of completing the Newcastle University Policy Academy‘s foundation workshops, an email landed in my inbox too sweet and too timely to ignore. “Advocacy opportunity!” the International Association for Hospice and Palliative Care (IAHPC), of which I am a member, shouted. IAHPC is a global, not-for-profit organization dedicated to increasing access to and optimizing the practice of palliative care and the invitation was to represent them at the 72nd session of WHO Europe in Tel Aviv. In this post I will share my experiences of this baptism of fire for the benefit of anyone else who aspires to advocate and/ or shape policy on a global scale.
My desire to advocate for universal access to palliative care services and essential medicines comes directly from teaching Newcastle University’s online MSc Palliative Care. Here my students share stories from the patient bedside that testify of global inequality, despite the fact that palliative care is a recognised part of universal health coverage. Advocacy – the support of a particular cause or policy – runs hand-in-hand with education, research and, of course, policymaking. This was my chance to put learning into action.
My first piece of advice is prepared to put in a lot of hard work. Weeks before the event you will review provisional agenda items and associated documents for relevance to the cause you are advocating for. In our case the agenda items related to palliative care for persons with disabilities, non-communicable disease and cervical cancer. Katherine Pettus, IAHPC’s senior advocacy officer, and I drafted statements in response to these documents, respectfully yet forcefully making our point. Good academic writing skills are invaluable here as you reference legislation and research to present compelling, evidence-based arguments within a set word-limit. These written statements – and sometimes video recordings – were uploaded to the WHO Europe website, but first we had to garner support.
The IAHPC is a Non-State Actor in Official Relations with the WHO (NSA for short) and, as such has the opportunity to make oral statements (“take the floor”) at the event after member states have made their responses to agenda items under discussion. This isn’t a to-and-fro discussion – it’s a precisely orchestrated dance of procedure and protocol, following a predefined hierarchy and conforming to rules. NSAs must join forces to be heard and that means endorsement. In the weeks leading up to the event, written statements are circulated around the NSAs for endorsement, a process involving feedback (an opportunity to get your message before policymakers), amendment and logo-sharing. Statements were landing in my email inbox at a bewildering rate that was challenging to keep on top of, but this proved to be a good way to network prior to arriving in Tel Aviv.
The most important connection you must make before big international events such as WHO regional sessions, Conferences of the Parties (COP) or meetings of UN committees, is with your country’s official delegation (ministers, civil servants and/ or chief medical, nursing or scientific officers). This was easier said than done in the middle of a prime ministerial hand-over and following the death of a monarch. Even emails to an ally in the House of Lords bore no fruit but if all else fails, you can strike up a conversation on the airport transport or at a 6am Pilates session (yes, we did this).
In the run-up to the session an experienced colleague gave me two excellent pieces of advice: keep on message and find the free coffee. Both proved invaluable. I met some great people and I learnt a lot about the future direction of healthcare in Europe and about myself. Our efforts resulted in small changes – the addition of a few words to policy-informing documents – but the impact could be huge. Sixty five percent of people in Europe currently have no access to palliative care. Perhaps my baptism of fire will make it accessible to more people and that is why, after feeling exhausted (hence the coffee) and often out of my depth, I will definitely do it again.
Read the IAHPC’s draft statement, written by Dr Victoria Hewitt and Dr Katherine Pettus in response to “The WHO European framework for action to achieve the highest attainable standard of health for persons with disabilities 2022–2030” by clicking on this link