Africa: The African Palliative Care Association (February 2006)

Supporting indigenous organizations in building their capacity is a key element of PEPFAR's focus on sustainability. Three months after its 2004 inaugural meeting in Arusha, Tanzania, the African Palliative Care Association (APCA) received $250,000 in Emergency Plan funding to support the expansion of palliative care for PLWHA in African focus countries. At that time, APCA was a nascent, indigenous pan-African association in the formative stages of organizational development. APCA aims to support the expansion of affordable and culturally-appropriate palliative care, helping to realize the Emergency Plan vision of a holistic approach to relieve physical, emotional and practical suffering of people living with HIV/AIDS (PLWHA). With PEPFAR support, APCA established headquarters in Kampala, Uganda and supported scale-up of local and national palliative care associations and programs across Africa. APCA mobilized its Advisory Committees to provide technical assistance and training in various countries.

The Emergency Plan supported APCA in providing institutional development to national palliative care associations in Zambia, Tanzania and Kenya. The Palliative Care Association of Zambia (PCAZ), for example, entered into a twinning partnership with APCA through PEPFAR's HIV/AIDS Twinning Center. Through the partnership's work, PCAZ established its office and work plan, and put plans in motion to hold a national stakeholders meeting and train-the-trainer program to advance Zambian palliative care goals.

For over three years the Government of Botswana sought training from palliative care experts in other African countries to integrate palliative approaches (such as pain and symptom management, holistic care, antiretroviral treatment (ART) support, and bereavement care) into their national community home-based care training program. With Emergency Plan support, APCA developed the training program in partnership with the government, and almost 200 health professionals and community home-based care coordinators were trained in palliative care in 2005. The Honorable Minister of Health, Professor Sheila Dinotshue Tlou, launched the training event.

In April 2005, APCA brought together African stakeholders and health providers from 10 of the 12 African focus countries to develop a strategy that would build donor relations and develop key palliative care policies across Africa. The workshop emphasized priorities set forth by the World Health Organization to advance palliative care, including expanded palliative care drug access, policy development, and training and education. With this support, African stakeholders and providers are now able to more effectively leverage other support and address key policy gaps in their countries. This includes appropriate symptom management for PLWHA who are on ART and pain management for PLWHA during the end-of-life stage of the disease.

Finally, as a direct result of the initial Emergency Fund support to build APCA's indigenous infrastructure, APCA has successfully leveraged $1.2 million in funding from other international partners, helping to ensure the sustainability of its valuable work.

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