The UK is committed to the development of health services that respond to the broad health needs of the population, and palliative care clearly has a vital place in this. DFID support is largely directed at countries where the health spend is less than $10 per person per year and often far less. The public spend in the Congo is $2, in Ethiopia $1.50 and in Burundi $0.70. Clearly these countries are not able to deliver the range of services that they would wish and realistically are unlikely to invest significant public budgets in palliative care. We support countries to deliver their health programmes and the priority interventions defined in their national health plan. Increasingly we provide resources through various forms of flexible budget support.
DFID officials have met staff from the hospice community on a number of occasions, most recently during a public consultation on a revised DFID health strategy. Many committed groups lobby DFID to make greater efforts on what they see as neglected areas in the international health response. Recent communications have challenged DFID to do more on palliative care, cancer services, neglected tropical diseases, blindness, disability, malnutrition and non-communicable diseases. DFID accepts that palliative care services need to be better reflected in national health plans and budgets and that realistically support needs to be provided through home-based rather than institutional settings.