Palliative care has only 1% access in India because doctors don’t consider palliative care even when a patient is terminally ill and caregivers just aren’t aware. Hence, both audiences are critical. Among doctors, any doctor involved in the treatment of terminally ill patients in any way became our target audience.

In India, prescription drugs can only be promoted to doctors. This communication is governed under the Drugs and Cosmetics Act and a self-controlled body – ASCI . Doctor-patient communication is also governed by the MCI's ethics policy, which prevents the endorsement of brands but allows unbranded medical information or diagnosis.

We unearthed the insight: Surprisingly, most last words are heard by nurses, not families. This happens because doctors keep even terminally ill patients in ICUs where they do receive the best medical care but also stay isolated from their families.

The creative idea: Could these dying last words – so far unheard by families – bring alive the need for palliative care? We interviewed more than 200 nurses across India and the most heart-rending last words they heard became the heart of our campaign – the film.

The campaign used these real last words to start conversations on palliative care and got doctors to the website that provided detailed information. Doctors were encouraged to make the decision of offering palliative care through online pledges.

200 nurses were interviewed across India and the most heart-rending last words they heard became our film. The film was launched by the Human Rights Commissioner, with hundreds of doctors pledging to offer palliative care to their patients.

Social media became our launch vehicle digitally to reach the 100,000 socially active Indian doctors, giving the campaign scale and initiating conversations. The clickable video got doctors to the website where they could learn more about palliative care and pledge.

Palliative care associations across the world were approached to share the campaign with their network and mailing lists.

The doctor campaign was complemented by a consumer campaign that eventually spanned digital media, along with PR.

All consumers who pledged got downloadable support kits with stickers for their medical files, letting their doctors know, “I’d like access to palliative care” – thus, reiterating the message to doctors.

The real last words resonated with doctors and consumers, each sharing personal stories. The campaign even served as a catharsis, with thousands confessing to have missed hearing the last words of their loved ones. Many doctors committed to offer palliative care to their patients, while one even promised to start a palliative care hospital.

The campaign reached a confirmed 50,000+ doctors online. In addition, a majority of Indian doctors were probably reached through the consumer campaign based on the same film. The consumer campaign achieved 100 million impressions and 8 million rupees of unpaid media, even trending at no. 3 on Twitter.

But real success was achieved when international palliative care associations adopted the campaign, as did members of parliament.

The last words are finally being heard.

This campaign was focused on changing the cultural thinking and behaviour of doctors so they would consider palliative care for terminally ill patients. To achieve this, the campaign had to cover multiple but related objectives, reaching multiple target audiences across geographies and across media as below:

1. Reaching both doctors and consumers to establish the need for palliative care

2. Initiating conversations through influencers, unpaid media and peers

3. Creating platforms providing more information on palliative care

4. Ensuring continued doctor consideration over time

This campaign was focused on changing doctor behaviour to consider palliative care for terminally ill patients.

But for this, the doctor and caregivers first need to accept that the patient’s death is imminent. This created the need to reach both doctors and consumers to establish the need for palliative care through our film.

In India, talking about death is taboo. Achieving cultural change required initiation of conversations through influencers, unpaid media and peers. Hence, social media and PR became core platforms.

While having family around at the time of death does drive this need, palliative care includes several other support areas. This required platforms providing detailed information.

In addition to establishing the need for palliative care, it was also critical to ensure that doctors considered it when they came across a terminally ill patient. Hence, we needed constant, non-intrusive reminders.

Palliative care provides comfort and dignity in death. However, even though the Indian Association of Palliative Care (IAPC) has helped establish infrastructure to provide palliative care over the last decade, only 1% of the 6 million eligible Indian patients have access. This happens for two key reasons: One, the Indian medical system focuses on keeping patients alive, even at the cost of pain and suffering. So, even when patients are terminally ill, doctors don’t consider palliative care. Two, consumers just aren’t aware.

Hence, the campaign needed to include doctor and consumer communication with different communication objectives. However, with limited budgets, the concept/execution needed to be similar.

With doctors, driving behaviour change is challenging – they do what they think is best for the terminally ill patient but the campaign had to help them understand how patients are suffering because of lack of access to palliative care.