Introduction

IMPROVING CANCER PAIN RELIEF
IN THE WORLD

REPORT FOR 2001

World Health Organization
Collaborating Center for Policy and
Communications in Cancer Care

Sponsored by

The Pain & Policy Studies Group
University of Wisconsin Comprehensive Cancer Center
The Medical School
Madison, Wisconsin USA
www.medsch.wisc.edu/painpolicy

September 2002

Table of Contents

Executive Summary The Center and its WHO Terms of Reference Staff Members Acknowledgements

Executive Summary

This report summarizes the work of the World Health Organization Collaborating Center (the Center) for Policy and Communications in Cancer Care. The Center is designated by the Pan American Health Organization (PAHO) and sponsored by the Pain & Policy Studies Group, University of Wisconsin Comprehensive Cancer Center, Medical School in Madison, Wisconsin, U.S.A.

In 2001, the Center collaborated extensively with WHO Headquarters programs in Essential Drugs and Medicines, Cancer, HIV/AIDS, and Long-Term Care, and WHO Regional Offices in the Americas, Europe, and South-East Asia.

In July 2001, the Center met with the WHO Regional Office for Europe (EURO) and the Open Society Institute to plan a regional workshop on opioid availability for six countries in Eastern Europe.

In August 2001, the Center met with PAHO to review follow-up work needed subsequent to the December 2000 PAHO/Center 6-country workshop on opioid availability for palliative care held in Quito, Ecuador.

In December 2001, the Center participated in the “WHO Research Partners Meeting” to increase collaboration between WHO and external partners on non-communicable disease research priorities.

In 2001, the Center continued its cooperation with the International Narcotics Control Board (INCB) regarding global opioid availability. The Center uses INCB statistics on consumption of opioids to monitor global and national trends in availability and medical use of opioid analgesics.

In 2001, the Center and a key collaborator in India published an article in Lancet that reported outcomes from a WHO Demonstration Project in Calicut, India (designated by the Center) to make opioids available for the relief of pain in terminally ill patients living at home, without diversion and abuse. In 2001, the Center and the Demonstration Project sponsored additional workshops on morphine availability for palliative care and simplification of state regulations in India.

The Center accomplishes its policy work through a program of research, development, demonstration, monitoring, evaluation, and communications. The Center develops methods, procedures and models that can be used to identify barriers to opioid availability, diagnose regulatory problems, make changes in national and state policy, and monitor outcomes.

The Center accomplishes its communications work through the publication of Cancer Pain Release, a quarterly WHO newsletter that provides health professionals, policy makers, and regulators throughout the world with updates on issues and developments in the field. Cancer Pain Release is disseminated to approximately 50,000 health-care professionals in 173 countries and is inserted in national and international pain and palliative medicine journals.

The Center participates in international and national conferences and strategy meetings for health professionals and government officials, and provides technical assistance to government and non-government organizations. The Center maintains policy and communications websites and promotes better understanding of the principle of balance that should guide national narcotics control policy to ensure availability of opioid pain medications under adequate control to prevent diversion.

Madison, Wisconsin, USA September 17, 2002

David E. Joranson Director