Award trains palliative care champions

With a new $200,000 grant from the National Cancer Center, Dr. James Cleary, director of the Pain and Policy Studies Group at the University of Wisconsin Carbone Cancer Center, will collaborate with the African Palliative Care Association to train in-country champions who will improve access to medications needed to relieve cancer pain.

Cleary is principal investigator for “An African Pain Policy Fellowship: A Pilot Regional Collaboration to Improve Opioid Availability for the Treatment of Cancer Pain.” An international leader in palliative care and the use of opiates such as morphine to provide pain relief, Cleary also is director of the Collaborating Center for Pain Policy and Palliative Care at the World Health Organization (WHO), a special advisor on non-communicable diseases at the UW-Madison Global Health Institute and founding member of the African Palliative Care Association.

The project is designed to allow health care practitioners in low and middle income countries to have better access to cancer pain medicine. Working together, the UW Pain and Policy Studies Group and the African Palliative Care Association will bring International Pain Policy Fellowship (IPPF) training, usually offered in the United States, to Africa. For the pilot, the African group will identify five practitioners who will be trained in the knowledge and skills to improve access to opioid analgesics through distance learning and in person workshops.

Most of the world’s population lacks access to palliative care and, with that, access to morphine, which WHO defines as an essential medicine, Cleary says. The Pain and Policy Studies Group promotes the appropriate medical use of opiates through the concept of “balance” in national drug policy. A balanced policy, in essence, ensures adequate availability of the medications while implementing appropriate measures to prevent their diversion and abuse.

The IPPF, which has been offered at the Carbone Cancer Center since 2006, has improved opioid availability throughout many low and middle income countries. The program has trained and mentored 27 fellows from 21 countries, including Kenya, Bangladesh, Ukraine and Colombia. The fellows have been instrumental in effecting change in local and national laws and policies, clinician education, public awareness, advocacy and patient care.

The in-country approach will draw on local knowledge about traditions, beliefs, cultures and political situations and how they might affect the availability of needed medications and palliative care. UW- Madison faculty and staff will provide policy and technical expertise to identify solutions that are most feasible in each situation.

Fellows will share common experiences related to medications and face similar challenges, Cleary says. The collaboration among U.S., African and international experts will make finding solutions to common challenges easier and give fellows a sense of ownership for their accomplishments. “Being surrounded by others with a shared mission will serve to elevate the enthusiasm and commitment as the fellows approach their defined goals.” Cleary says. “Their efforts in the future will benefit from knowing more colleagues who are addressing the same opioid availability issues.”

By establishing regional training partnerships, Cleary says education will be more accessible to more practitioners who will become change-agents for improving palliative care throughout the world.

The Global Health Institute (GHI), supported by public and private funds, is dedicated to improving health today and tomorrow by addressing the multi-layered causes of disease. GHI fosters collaborations that strengthen health care and health systems and encourage the sustainable use of global resources, restore and conserve the ecosystem and address and reverse the causes of climate change. For more information or to learn how you can become part of the GHI community, visit

Ann Grauvogl/ 2/21/2014