International Pain Policy Fellowship

 About the IPPF

Established in 2006, the International Pain Policy Fellowship (IPPF) empowers emerging leaders from low- and middle-income countries to identify and overcome barriers to the use of opioids for pain control or palliative care in their countries.

 booklet about the IPPF:

  • Describes the Fellowship program
  • Lists the 30 Fellows that have participated in the program since its inception
  • Highlights Fellowship successes

2006 Cohort Training Workshop Madison, WI

Why a Fellowship?

Pain relief is a fundamental part of palliative care. Toward this end, access to opioid analgesic medicines is essential. Because opioid medicines also have a potential for non-medical use, they are controlled by international treaties and national laws. Very limited access to opioid medicines in some countries results, at least in part, from unduly strict national drug control and healthcare regulatory policies.

Although the incidence of cancer is increasing globally, the disease burden falls disproportionately on low- and middle-income countries.  Many patients in these countries lack access to the opioid medicines that the World Health Organization designates as essential medicines. This International Pain Policy Fellowship (IPPF) program, led by some of the world’s experts in opioid availability, can empower motivated health professionals and policy makers to evaluate and improve their country’s regulatory environment without sacrificing the security of the existing drug control system.

The Fellows

The IPPF is intended for health professionals (e.g., physicians, pharmacists), healthcare administrators, policy experts, social workers, or lawyers from low- and middle-income countries who have an interest in improving availability of opioid medicines for pain relief and palliative care. 

Fellows are chosen through a rigorous application process that includes a review of their curriculum vitae, experience in research, potential for successful change in the country, and support from their employer.  Fellows are encouraged to identify a government representative from the Ministry of Health (or its equivalent) to support their IPPF activities and attend the initial training workshop.  Fellows are provided a modest stipend to commit a portion of their professional time to IPPF activities. 

To date, there have been four cohorts of Fellows, comprising 30 individuals from 25 countries.

2006 Cohort
Supported by the Open Society Foundations (OSF), the IPPF began in 2006 with an inaugural class of Fellows from 8 countries:

ARGENTINA (Jorge Eisenchlas) SERBIA (Snezana Bosnjak)
COLOMBIA (Marta Leon) SIERRA LEONE (Gabriel Madiye)
NIGERIA (Daisy Amanor-Boadu) UGANDA (Henry Ddungu)
PANAMA (Rosa Buitrago) VIETNAM (Nguyen Thi Phuong Cham)

2008 Cohort
A second class of Fellows was initiated in 2008, including 8 fellows from 6 countries:

ARMENIA (Hrant Karapetyan, Irina Kazaryan) JAMAICA (Magaret (Dingle) Spence, Verna Walker-Edwards)
GEORGIA (Pati Dzotsenidze) KENYA (Zipporah Ali)
GUATEMALA (Eva Rossina Duarte) NEPAL (Bishnu Dutta Paudel)

Selected Fellows continued their fellowship activities with grant support from LIVESTRONG and the OSF. 

2012 Cohort
Together, LIVESTRONG, OSF, and the US Cancer Pain Relief Committee supported the PPSG to continue the IPPF, with the launch of a third class of Fellows in the summer of 2012.  This class consisted of 10 Fellows from 6 countries:

ALBANIA (Kristo Huta) KYRGYZSTAN (Taaliagul Sabyrbekova),
BANGLADESH (Rumana Dowla, Farzana Khan) SRI LANKA (Nadarajah Jeyakumaran, Suraj Perera)
INDIA (Priyadarshini Kulkarni, Shalini Vallabhan, Nandini Vallath) UKRAINE (Nataliia Datsiuk)

2014 Cohort
With support from the US National Cancer Institute (National Institutes of Health), PPSG partnered with the African Palliative Care Association to administer a regionally-based fourth cohort of the IPPF, the African Pain Policy Fellowship. The class consisted of 5 Fellows from 5 countries:

ETHIOPIA (Abraham Endeshaw Mengistu) SUDAN (Nahla Gafer)
GHANA (Mawuli Gyakobo) ZAMBIA (Lewis Banda)
RWANDA (Christian Ntizimira)  

The Fellowship's four components

[1] Training Program: At the beginning of the Fellowship program, PPSG conducts an intensive training workshop to provide Fellows foundational information about the roles and function of the international drug control system and how to become a strategic change-agent for opioid availability in their country. PPSG staff and expert mentors assist the Fellows in identifying barriers in their country’s policies and systems governing the use of controlled medicines.  Fellows then develop an Action Plan to define three to five barriers to opioid availability in their countries and detail the objectives, activities, and resources necessary for eliminating each barrier.

[2] In-Country Project using the Action Plan: Each Fellow is responsible for implementing the Action Plan during the remainder of the IPPF.

[3] Mentorship: Throughout the IPPF, PPSG staff and international expert mentors are in frequent contact with each Fellow to provide technical assistance related to their in-country project to ensure progress in meeting the Action Plan objectives.

[4] Update & Review Meeting: At the mid-point of the IPPF program, an Update & Review meeting is held to provide Fellows an opportunity to network and develop strategies to overcome outstanding challenges as well as to share approaches that have led to success.