World Health Organisation Palliative Care
This report discusses the key facts and barriers (including no access to pain relief) behind palliative care.7 Aug 2015
- Palliative care improves the quality of life of patients and their families who are facing problems associated with life-threatening illness, whether physical, psychosocial or spiritual.
- Each year, an estimated 40 million people are in need of palliative care, 78% of them people live in low- and middle-income countries.
- Worldwide, only about 14% of people who need palliative care currently receive it.
- Overly restrictive regulations for morphine and other essential controlled palliative medicines deny access to adequate pain relief and palliative care.
- Lack of training and awareness of palliative care among health professionals is a major barrier to improving access.
- The global need for palliative care will continue to grow as a result of the rising burden of noncommunicable diseases and ageing populations.
- Early palliative care reduces unnecessary hospital admissions and the use of health services.
Worldwide, a number of significant barriers must be overcome to address the unmet need for palliative care:
- national health policies and systems do not often include palliative care at all
- training on palliative care for health professionals is often limited or non-existent
- population access to opioid pain relief is inadequate and fails to meet international conventions on access to essential medicines.
- lack of awareness among policy-makers, health professionals and the public about what palliative care is, and the benefits it can offer patients and health systems
- cultural and social barriers, such as beliefs about death and dying
- misconceptions about palliative care, such as that it is only for patients with cancer, or for the last weeks of life
- misconceptions that improving access to opioid analgesia will lead to increased substance abuse.
What can countries do?
National health systems are responsible for including palliative care in the continuum of care for people with chronic and life-threatening conditions, linking it to prevention, early detection and treatment programmes. This includes, as a minimum, the following components:
- Health system policies that integrate palliative care services into the structure and financing of national health-care systems at all levels of care.
- Policies for strengthening and expanding human resources, including training of existing health professionals, embedding palliative care into the core curricula of all new health professionals, as well as educating volunteers and the public.
- A medicines policy which ensures the availability of essential medicines for managing symptoms, in particular opioid analgesics for the relief of pain and respiratory distress.
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