abstract: 'Evidence-based advocacy underpins the sustainable delivery of quality,

  publicly guaranteed, and universally available palliative care. More

  than 60 million people in low- and middle-income countries (LMICs) have

  no or extremely limited access to either palliative care services or

  essential palliative care medicines (e.g., opioids) on the World Health

  Organization Model List. Indeed, only 12\% of the global palliative care

  need is currently being met. Palliative care advocacy works to bring

  this global public health inequity to light. Despite their expertise,

  palliative care practitioners in LMICs are rarely invited to health

  policymaking tables - even in their own countries - and are

  underrepresented in the academic literature produced largely in the

  high-income world. In this paper, palliative care experts from

  Bangladesh, Colombia, Egypt, Sudan, Uganda, and Zambia affiliated with

  the International Association for Hospice \& Palliative Care Advocacy

  Focal Point Program articulate the urgent need for evidence-based

  advocacy, focusing on significant barriers such as urban/rural divides,

  cancer-centeredness, service delivery gaps, opioid formulary

  limitations, public policy, and education deficits. Their advocacy is

  situated in the context of an emerging global health narrative that

  stipulates palliative care provision as an ethical obligation of all

  health systems. To support advocacy efforts, palliative care evaluation

  and indicator data should assess the extent to which LMIC practitioners

  lead and participate in global and regional advocacy. This goal entails

  investment in transnational advocacy initiatives, research investments

  in palliative care access and cost-effective models in LMICs, and

  capacity building for a global community of practice to capture the

  attention of policymakers at all levels of health system governance. (c)

  2022 American Academy of Hospice and Palliative Medicine. Published by

  Elsevier Inc. All rights reserved.'
affiliation: 'Rosa, WE (Corresponding Author), Mem Sloan Kettering Canc Ctr, Dept
  Psychiat \& Behav Sci, 641 Lexington Ave,7th Floor, New York, NY 10022 USA.

  Rosa, William E., Mem Sloan Kettering Canc Ctr, Dept Psychiat \& Behav Sci, New
  York, NY USA.

  Rosa, William E.; Knaul, Felicia Marie, Univ Miami, Inst Adv Study Amer, Coral Gables,
  FL USA.

  Ahmed, Ebtesam, St Johns Univ, Dept Clin Hlth Profess, Coll Pharm \& Hlth Sci, Queens,
  NY USA.

  Ahmed, Ebtesam, MJHS Inst Innovat Palliat Care, New York, NY USA.

  Chaila, Mwate Joseph, Catholic Relief Serv, Lusaka, Zambia.

  Chansa, Abidan, Minist Hlth, Natl Palliat Care Program, Lusaka, Zambia.

  Adelaida Cordoba, Maria, Fdn Hosp Pediat La Misericordia, Pediat Palliat Sect, Bogota,
  Colombia.

  Adelaida Cordoba, Maria, Hosp Univ Fdn Santa Fe Bogota, Dept Pediat, Bogota, Colombia.

  Dowla, Rumana, United Hosp, Palliat Med Canc Care Ctr, Dhaka, Bangladesh.

  Gafer, Nahla, Khartoum Oncol Hosp, Integrated Palliat \& Oncol Unit, Khartoum, Sudan.

  Khan, Farzana, Fasiuddin Khan Res Fdn, Dhaka, Bangladesh.

  Khan, Farzana, Univ Edinburgh, Global Hlth Acad, Edinburgh, Midlothian, Scotland.

  Namisango, Eve, African Palliat Care Assoc, Kampala, Uganda.

  Namisango, Eve, Kings Coll London, Cicely Saunders Inst, Dept Palliat Care \& Rehabil,
  London, England.

  Rodriguez, Luisa, Univ La Sabana, Dept Anesthesia Pain \& Palliat Med, Chia, Colombia.

  Rodriguez, Luisa, Asociac Colombiana Cuidados Paliat, Bogota, Colombia.

  Knaul, Felicia Marie, Univ Miami, Miller Sch Med, Dept Publ Hlth Sci, Miami, FL
  USA.

  Knaul, Felicia Marie, Tomatelo Pecho, Mexico City, DF, Mexico.

  Knaul, Felicia Marie, Fdn Mexicana Salud, Mexico City, DF, Mexico.

  Pettus, Katherine I., Int Assoc Hosp \& Palliat Care, Houston, TX USA.'
author: Rosa, William E. and Ahmed, Ebtesam and Chaila, Mwate Joseph and Chansa, Abidan
  and Adelaida Cordoba, Maria and Dowla, Rumana and Gafer, Nahla and Khan, Farzana
  and Namisango, Eve and Rodriguez, Luisa and Knaul, Felicia Marie and Pettus, Katherine
  I.
author-email: rosaw@mskcc.org
author_list:
- family: Rosa
  given: William E.
- family: Ahmed
  given: Ebtesam
- family: Chaila
  given: Mwate Joseph
- family: Chansa
  given: Abidan
- family: Adelaida Cordoba
  given: Maria
- family: Dowla
  given: Rumana
- family: Gafer
  given: Nahla
- family: Khan
  given: Farzana
- family: Namisango
  given: Eve
- family: Rodriguez
  given: Luisa
- family: Knaul
  given: Felicia Marie
- family: Pettus
  given: Katherine I.
da: '2023-09-28'
doi: 10.1016/j.jpainsymman.2022.07.004
eissn: 1873-6513
files: []
issn: 0885-3924
journal: JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
keywords: 'Palliative care; hospice; global health; social justice; advocacy;

  policy; opioids; essential medicines; partnerships'
keywords-plus: PARTNERSHIPS
language: English
month: OCT
number: '4'
number-of-cited-references: '48'
orcid-numbers: 'Rodriguez Campos, Luisa Fernanda/0000-0002-0649-9119

  Cordoba Nunez, Maria Adelaida/0000-0001-8130-5647

  Gafer, Nahla/0000-0001-6291-093X'
pages: E217-E226
papis_id: 642069a816583718b9d81b85fc284dea
ref: Rosa2022canyou
times-cited: '3'
title: Can You Hear Us Now? Equity in Global Advocacy for Palliative Care
type: article
unique-id: WOS:000888866900005
usage-count-last-180-days: '8'
usage-count-since-2013: '10'
volume: '64'
web-of-science-categories: 'Health Care Sciences \& Services; Medicine, General \&
  Internal;

  Clinical Neurology'
year: '2022'