In Central and Eastern Europe (CEE) and the former Soviet Union (fSU), public health experts are increasingly aware that an aging population, a growing incidence of cancer, and an emerging HIV/AIDS epidemic creates enormous medical and economic challenges, and that the quality of care for patients and families must be seen as an international public health issue. In Africa, the HIV/AIDS pandemic has created an urgent, immediate need for high-quality hospice and palliative care.

The goal of the OSI International Palliative Care Initiative is to improve end-of-life care for patients and their families, with a special focus on vulnerable populations including the elderly, children, and patients with cancer or HIV/AIDS. The initiative has four objectives:

• to increase public awareness about end-of-life care issues;
• to provide palliative care education to health care professionals and support the integration of palliative care into medical and nursing school curricula;
• to make essential drugs for pain and symptom management easily available;
• to integrate palliative care into national health care plans, policies, and systems of care.

In January 2000, the Open Society Institute announced the International Palliative Care Initiative for CEE and fSU, a $500,000/year initiative to enhance hospice and palliative care in those regions. Funding supports governmental and professional organizations, individuals, and foundations to expand the capacity of local programs to improve care of the dying. The initiative has made nearly 200 grants in the region to individuals, nongovernmental organizations, national and international professional associations, and the World Health Organization. The initiative’s main funding strategy has been to map the wide range of existing palliative care services and to support their capacity for development and sustainability. The initiative has also supported efforts to improve governmental health policies that affect the delivery of palliative care services.

In 2002, OSI expanded its International Palliative Care Initiative to South Africa with a $1-million, three-year matching funds initiative. The South Africa initiative acted as a catalyst to advance programs in palliative care education, training, and service delivery, and advocated for their full integration into national HIV/AIDS prevention, care, and treatment programs. Professional and public education is a major focus of these programs, because these efforts will help build a workforce of community health volunteers and professionals who treat and care for patients with HIV/AIDS. Community-based, nongovernmental organizations are far ahead of the government in addressing the palliative care needs of dying HIV/AIDS patients and their families, especially at a grassroots level. In 2005, the International Palliative Care Initiative further widened its geographic scope, giving grants to hospice organizations in Kenya, Nigeria, Tanzania, Uganda, and Zimbabwe.

The International Palliative Care Initiative serves as a resource to establish an international network of individuals and organizations committed to improving care for patients with life-limiting illness and their families. In the coming years, the initiative will expand its reach to additional countries, and previously funded programs will continue to receive technical assistance.

For more information see the International Palliative Care Initiative grants section.