The essential package of palliative care for people affected by TB consists of a set of medicines, simple equipment, social supports and human resources (Table 6). Adapted from the WHO essential package of palliative care for primary care (95), it is designed to be safe and effective for preventing and relieving all types of suffering associated with TB (Box 6). The package includes only inexpensive and readily available medicines and equipment, and its use requires only basic palliative care training (30–40 hours). Consequently, this package can and should be made accessible everywhere, including for the rural poor. The medicines include: at least one non-opioid analgesic, opioid analgesic, anti-pyretic, anti-emetic, anxiolytic, antidepressant, antihistamine, anticholinergic, antifungal, and antidiarrhoeal agent; as well as a bronchodilator, corticosteroid, diuretic, expectorant, laxative, neuroleptic and proton pump inhibitor.
Table 6. Essential package of palliative care for people affected by TB (91, 105)
* Based on WHO Model List of Essential Medicines, 2019. In parentheses () are acceptable substitutes where the primary recommended medication is not available or is expensive.
** For patients who qualify on the basis of financial need.
*** Staffing will vary depending on the level of the health-care system (referral hospital, provincial hospital, district hospital, community health centre, or home). Staff members of palliative care centres or wards may provide palliative care full-time. Others may provide relief of suffering combined with TB treatment most of the time and may provide end-of-life care only when needed. All staff members should be trained to practise and teach infection control.