This report, published in The Lancet on 12 0ctober 2017, provides the first worldwide estimates of serious, health-related suffering and the resultant need for palliative care and pain relief… 

Furthermore, the number of people who experience serious health-related suffering is much higher, with an additional 35,5 million people requiring pain relief outside of end-of-life care. More than 80% of these cases are in low- and middle-income countries, where access to immediate-release morphine, an essential and inexpensive medicine to alleviate pain, as well any other type of palliative care, is severely lacking.

Inequity in access

“Inequity in access to essential pain relief for palliative care and pain relief is one of the world’s most striking injustices. The world suffers a deplorable pain crisis: little to no access to morphine for tens of millions of adults and children in poor countries who live and die in horrendous and preventable pain,” says Professor Felicia Knaul, co-Chair of the Commission from the University of Miami, USA.

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Global need for palliative care

The most common symptoms of suffering were pain, depressed mood, anxiety, fatigue and weakness. The Commissioners propose an essential package for palliative care as the minimum standard any health system should make available as a core component of Universal Health Coverage.

Designed to be low-cost and covering medicines, basic equipment and human resources, one of the minimum requirements is the availability of oral or injectable morphine.

Global need for morphine in palliative care unmet

In some of the world’s poorest countries, such as Haiti, Afghanistan and many countries in Africa, oral morphine in palliative care is virtually non-existent. 

Professor Paul Farmer, co-chair of the Commission, Harvard Medical School, USA, adds: “One shouldn’t have to live through an earthquake in Haiti, or be struck by a car, to understand the importance of trauma care. Nor should it be necessary to be diagnosed with cancer to understand the importance of chemotherapy.

“All too often, however, we forget that access to life-saving medical care should always be accompanied by life-affirming palliative care,” concludes Professor Farmer. 

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