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 online video.

This clickable video used the 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.

Doctors and consumers needed to hear the real last words of patients to bring alive the need for palliative care. So, 200 nurses– with 2,000+ years of nursing service – 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 and promoted on social and digital platforms, with an aim to reach the 90-95% digitally active Indian doctors. This included the 100,000 registered doctors on Facebook, and many more doctors through their social network.The clickable video got doctors to the website where they could learn more about palliative care and pledge to offer palliative care.

Palliative care associations across the world adopted the film. As did members of parliament.

The doctor campaign was complemented by a consumer campaign using an edit of the same online video, eventually covering social and digital media, along with PR.

Palliative care is a category where multiple doctors are involved with multiple opinions. Hence, to achieve significant impact, a majority of the 300,000+ practicing doctors in India had to be reached.

Using a field force to reach doctors was considered, but doctors were uncomfortable discussing palliative care with medical representatives since it has legal, medical and ethical perspectives.

Hence, the online video became the core of the campaign, allowing us to touch doctors through real last words, and reach the estimated 90-95% of Indian doctors who are digitally active.

The video was made clickable with a call-to-action to learn more about palliative care on the website, as well as a pledge to offer palliative care to patients.

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.