Global State of Pain Treatment: Access to Medicines and Palliative Care

May 26, 2011
This 128-page report details the failure of many governments to take even basic steps to ensure that people with severe pain due to cancer, HIV, and other serious illnesses have access to palliative care, a health service that seeks to improve quality of life. As a result, millions of patients live and die in great agony that could easily be prevented.
  • WHO (2009) estimates that tens of millions of people each year suffer untreated moderate to severe pain, including 5.5 million terminal cancer patients and 1 million patients in the last phases of HIV/AIDS.
  • The president of the INCB has stated that access to morphine and other strong pain medicines is "virtually non-existent in over 150 countries."
  • Barriers to care can be divided into three areas: lack of health policies in support of palliative care development; lack of relevant training for healthcare workers; and poor availability of essential palliative care drugs.
  • With regard to the availability of pain medications, there are a number of different common barriers, including the failure of states to put in place functioning drug supply systems, existence of unnecessarily restrictive drug control regulations and practices, fear among healthcare workers of legal sanctions for legitimate prescribing of opioid medications, and the unnecessarily high cost of pain medications.
  • In most low and middle-income countries, an assessment of barriers to access to morphine and the development of a plan of action must be the first step in a comprehensive effort to address those barriers. To be successful, reforms must address both supply and demand for morphine simultaneously.
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