Study shows access to palliative care limited to a few patients

Palliative Care pain management physical suffering psychological suffering Palliative Care and Pain Relief WHO HIV cancers heart disease dementia indian express health news

Palliative Care pain management physical suffering psychological suffering Palliative Care and Pain Relief WHO HIV cancers heart disease dementia indian express health news

Almost 26 million people around the world die each year with serious suffering in part because of a huge gap in pain relief: The U.S. may be awash in opioid painkillers, but they're rare or unavailable in dozens of poor countries, says a new report.

"At least 35.5 million people who did not die also experienced serious health-related suffering [in 2015], meaning that the total number of people needing palliative care per year was over 61 million, including 5.3 million children", Dr M R Rajagopal, co-author of the Lancet study on Global Access to Palliative Care and Pain Relief told The Indian Express.

The challenge is to improve palliative care in low-income countries while avoiding mistakes that led to the USA addiction crisis.

In some places, even children dying of cancer or children in treatment for cancer can't get pain relief, said University of Miami professor Felicia Knaul. "For India it is estimated that at least 10 million people are likely to require palliative care every year", said Dr Rajagopal, chairman of Pallium India, and director of the Trivandrum Institute of Palliative Sciences (WHO Collaborating Centre for Training and Policy on Access to Pain Relief).

Researchers reported that out of the few hundred tons of morphine and opioids distributed around the world, less than 4 percent goes to low- and middle-income countries. Knaul spent three years studying the disparity.

The 2010 natural disaster in Haiti highlighted the scarcity, as doctors lacked opioids for people who were severely injured or needed surgery, the commission noted. Yet a basic palliative care package, which includes key medications and personal care, is not expensive, costing about US$2.40 per capita per year in low income countries and US$0.75 in lower-middle income countries.

The report calls for new methods to measure health progress that include suffering, and for the inclusion of palliative care as part of the universal health insurance governments offer their citizens. Providing pain relief for all those with medical need could cost as little as $145 million.

-Countries should use cheap, immediate-release oral and injectable morphine for severe pain.

-Closely monitor morphine supply, and train health workers in proper pain treatment. Poor countries throughout the rest of the world have an entirely different story. "People with advanced illness and pain are weakened by disease and they have no voice", said Dr. Rajagopal.

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