International Pain Policy Fellowship

Why the International Pain Policy Fellowship?

Pain relief is a fundamental part of palliative care. Toward this end, access to opioid analgesic medicines is essential. Because opioid medicines also have a potential for non-medical use, they are controlled by international treaties and national laws. Very limited access to opioid medicines in some countries results, at least in part, from unduly strict national drug control and healthcare regulatory policies. 

Although the incidence of cancer is increasing globally, the disease burden falls disproportionately on low- and middle-income countries. Many patients in these countries lack access to the opioid medicines that the World Health Organization designates as essential medicines. This International Pain Policy Fellowship (IPPF) program, led by some of the world's experts in opioid availability, can empower motivated health professionals and policy makers to evaluate and improve their country's regulatory environment without sacrificing the security of the existing drug control system. 

"The faculty has created a curriculum on opioid accessibility that is both comprehensive and understandable and that provides a simple but powerful method to overcome barriers to access. The IPPF equips its Fellows with all the tools they need to be able to make opioids available and accessible in their countries."

Eric Krakauer, MD, International Expert Committee member 

The Fellows

The IPPF is intended for health professionals (e.g., physicians, pharmacists), healthcare administrators, policy experts, social workers, or lawyers from low- and middle-income countries who have an interest in improving availability of opioid medicines for pain relief and palliative care. 

Fellows are chosen through a rigorous application process that includes a review of their curriculum vitae, experience in research, potential for successful change in the country, and support from their employer. Fellows are encouraged to identify a government representative from the Ministry of Health (or its equivalent) to support their IPPF activities and attend the initial training workshops. Fellows are provided a modest stipend to commit a portion of their professional time to IPPF activities. 

There have been four cohorts of Fellows, comprising 30 individuals from 25 countries.

The Fellowship's Four Components

At the beginning of the Fellowship program, IPPF conducts an intensive training workship to provide Fellows foundational information about the roles and function of the international drug control system and how to become a strategic change-agent for opioid availability in their country. Staff and expert mentors assist the Fellows in identifying barriers in their country's policies and systems governing the use of controlled medicines. Fellows then develop an Action Plan to define three to five barriers to opioid availability in their countries and detail the objectives, activities, and resources necessary for eliminating each barrier. 

Each Fellow is responsible for implementing the Action Plan during the remainder of the IPPF.

Throughout the IPPF, staff and international expert mentors are in frequent contact with each Fellow to provide technical assistance related to their in-country project to ensure progress in meeting the Action Plan objectives. 


Examples of Technical Assistance

  • Review and comment on national policies
  • Analyze opioid supply systems to identify barriers and suggest solutions
  • Write strategic letters of support to key government officials or decision-makers
  • Assist in organizing and presenting at national workshops or high-level meetings with Ministry of Health officials to provide international expert opinion or to facilitate government action regarding opioid availability
  • Act as a liaison between the Fellow and the World Health Organization of the International Narcotics Control Board
  • Problem-solve and strategize when road blocks arise
  • Facilitate communication and sharing of strategies and resources between Fellows and other experts in various fields (pharmacy, nursing, education, etc.)

At the mid-point of the IPPF program, an Update & Review meeting is held to provide Fellows an opportunity to network and develop strategies to overcome outstanding challenges as well as to share approaches that have led to success. 

Read about the International Pain Policy Fellowship's Successes

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After the Fellowship

After completing the IPPF, several Fellows have become members of the IPPF International Expert Committee, a select group of professionals with expertise in opioid availability. In that capacity, they have served as mentors to subsequent Fellows.

Within their home countries, many of the Fellows developed a reputation as champions for access to opioid medicines, have published articles about their work, attended international meetings on forming policy, and successfully advocated for positive changes in the laws and regulations in their countries.

Fellows have described the knowledge and experience gained through the IPPF as career-changing and many have continued to pursue their work to address barriers to opioid availability, long after their formal program involvement had ended. 

"The knowledge and experience I gained in the fellowship are engrained in me for the rest of my life. Since the Fellowship ended, I've continued working with that knowledge and have tried to learn more as I encounter new challenges. I'm fortunate to be a part of the IPPF world network of people working hard to support one another as we work to improve the availability of opioids."

Marta Leon, Colombia, 2006 Cohort Fellow

Walther Center in Global Palliative Care & Supportive Oncology

IU School of Medicine & IU Simon Comprehensive Cancer Center

540 Barnhill Drive
CL 370 H INTM
Indianapolis, IN 46202
Phone: +1-(317) 278-4006