33 Advocating for accessibility and strengthening the availability of essential palliative care medicines for children and adults experiencing serious health related suffering in Uganda

<h3>Introduction</h3> Untreated pain negatively impacts the quality of life of those experiencing health related suffering. Uganda was the first African country to have palliative care described as an essential clinical service and included in the Health Sector Strategic Plan and its HIV/AIDS National Strategic Framework (in 2000 and 2004). Furthermore, it was the first nation to amend its legislation allowing palliative care specially trained nurses and clinical officers to prescribe certain oral narcotic medicines for pain and symptom management. There is widespread palliative care services and local manufacturing of oral liquid morphine. However, unequitable access and availability to controlled medications like oral liquid morphine remains. The World Health Organization (WHO) emphasizes access to opioids and other appropriate pain management medicines and the Palliative Care Association of Uganda (PCAU) works with relevant stakeholders to achieve this important goal. We aimed to raise awareness among policymakers, healthcare providers, and the public about the necessity for improved availability of oral morphine. <h3>Methods</h3> Existing literature and policies were reviewed, performed stakeholder mapping, and held meetings and capacity-building sessions with the different stakeholders. Held three morphine partner meetings with the relevant stakeholders, two sensitization meetings for pharmacists, and training sessions for nurses and doctors. <h3>Results</h3> In 2023, PCAU, beneficiaries of palliative care, and other stakeholders involved in patient care and advocacy presented a position paper to the Committee on Health at the Parliament of Uganda on the Narcotic Drugs and Psychotropic Substances (Control) Bill 2023 resulting in its amendment from the recommendations. In 2023, there were no morphine stockouts. <h3>Conclusions</h3> PCAU’s multifaceted approach encompassed addressing regulatory barriers, strengthening medical education on pain management, fostering collaboration between stakeholders, and building evidence through supporting research. Advocacy by civil society has ensured sustainable supply of oral morphine for children and adults who need it when they need it.