The WHO CC may be approached by countries, palliative care programmes or services in need of support for developing or improving palliative care in several ways, as follows:

I. “Formal” WHO designation mechanism for countries wanted to implement national public health palliative care programmes

Candidate countries should be suggested by either the WHO central office or the WHO Headquarters through the corresponding regional office. Countries should always contact the WHO for their designation, and a Biennial Collaborative Agreement (BCA) should be signed up between the WHO and the candidate country.

Once the BCA has been signed, the WHO will put the designated country in contact with the WHO CC to initiate the process of support and collaboration. Designated countries will be guided throughout the process of implementing public health palliative care programmes (PHPCP) at a national, regional or local level.  A standardized and comparable way for collecting information and assessing progress across regions will be applied. An entry pathway for country support has been suggested.

The successful completion of the entry pathway constitutes the first part of a plan for the progressive implementation of a palliative care programme. An action plan should be agreed between the WHO CC and the designated country. Countries should show commitment to develop palliative care by means of undertaking a series of activities as well as demonstrating results as part of the support process.

Requisites

In order to be supported, countries should demonstrate commitment to establish, or further develop palliative care, and/or a comprehensive cancer and/or geriatric and/or AIDS control programme with a perspective on public health. Key elements are:

	committed leaders (“in-country” champions) actively involved in the process of implementation, including leaders at the Ministry of Health (or equivalent), national, regional and local health care managers and health professionals leaders. Leaders should be clearly identifiable, easily reachable and willing to be supported in their own development.
	an “in country” WHO representative, who will act as the link between the WHO CC and the country leaders. The WHO representative will also be actively involved in the process of implementing palliative care in the country
	political support, from national, regional and/or local health authorities
	capacity building, by means of financial support to guarantee reimbursement for palliative care for initially five years
	commitment to evaluation. Palliative care initiatives should commit themselves to systematically evaluate their own achievements, progresses and outcomes
	commitment to benchmarking, by means of acting as pilot projects in their regions to share their experiences with neighbour countries and with other palliative care initiatives worldwide
	commitment to education, training and evidence-based practice in palliative care
All countries interested in being involved in the implementation of public palliative care should follow the steps described in this section. II. “Direct cooperation” of the Collaborating Centre with public health palliative care programmes and/or services wanted to improve the delivery of palliative care Palliative care programmes and services in need of support for further developing or improving whichever aspect of the delivery of palliative care may contact either the WHO regional office or the WHO CC directly. Linkage will be adapted to the needs and demands of the programmes and services. Basic Requisites Criteria for services and programmes to be supported include:
	Clear leadership from interested professionals and defined objectives
	Institutional commitment from Public Health Institutions or Organisations (including Health Ministries, Public Hospitals or other health organisations, Academic or research entities , or other similar or equivalent organizations)
	Capacity to guarantee the allocation of resources to support the programmes.
	Commitment to evaluation. Palliative care initiatives should commit themselves to systematically evaluate their own achievements, progresses and outcomes
	Commitment to benchmarking, by means of acting as pilot projects in their regions to share their experiences with neighbour countries and with other palliative care initiatives worldwide
	Commitment to education, training and evidence-based practice in palliative care
	Normativa