Advocating for Dignity: PACAM’s Campaign for Liquid Morphine in Malawi - part 1 of 3

For many people in rural Malawi who suffer from AIDS, cancer, or other progressive diseases, palliative care is often the best option for improving their quality of life, according to the Palliative Care Association of Malawi (PACAM).

PACAM recommends morphine as the best treatment for managing severe chronic pain that these HIV/AIDS and Cancer patients experience. Yet until May 2009, morphine – a controlled substance in Malawi, with distribution restrictions – was only available in tablet form at Central, District and private hospitals, in urban areas, not at the community level where many patients receive home based care.

PACAM’s mission is to support, develop, and promote affordable and culturally appropriate palliative care in Malawi. Pact Malawi began partnering with PACAM in December 2007 to provide capacity building assistance and administer a grant from the United States (U.S.) President’s Emergency Plan for AIDS Relief (PEPFAR), through the U.S. Agency for International Development. As part of its 2007 – 2009 partnership with Pact, PACAM launched a national advocacy campaign in January 2008 with the aim of encouraging the Government in procuring liquid oral morphine for palliative care patients in Malawi. Liquid morphine was procured by a non government hospital which was shared to some CHAM hospitals. Liguid Morphine is preferable to tablet morphine for these patients, PACAM says, because it is less expensive and more effective in rapid pain control. Through its strategic advocacy campaign, PACAM forged relationships with key actors and government officials, drawing them in as allies in an effort to influence policy and provide palliative care patients with a drug that can ease their suffering and restore their dignity.

Traveling to Uganda on a Drug availability conference at Entebbe organized by African Palliative care Association in June 2006, Lameck Thambo had learned firsthand from the country’s palliative care system that liquid morphine can be effectively distributed as a treatment at the community level.