Tuesday, June 03, 2014

The Price and Pain of Dying

18 million people - mainly in developing countries - died in unnecessary pain in 2012. In Ethiopia, there are reports of cancer patients throwing themselves in front of trucks to escape pain.

Part of the problem is the refusal of governments to give patients access to painkillers such as morphine because of exaggerated fears about the risk of addiction. Other developing countries have very limited supplies. Some countries, such as Afghanistan and Libya, provide no palliative care, including pain relief.

In Pakistan, more than 350,000 people needed this type of care in 2012, but only around 300 people received any. There are only two palliative care services in the entire country. The single service in Mozambique served 153 out of the 100,000 people who needed palliative care in 2012, and in Morocco, 153 people out of 80,000 accessed the country's only service.

Morphine is cheap. It's made from raw opium found in the poppy fields of Afghanistan. It is an internationally controlled drug which means countries have to order their yearly supply from the International Narcotics Control Board. But many countries are simply not ordering enough.

Dr Edward Kelly, from WHO, says "Many countries are already struggling with the fact they don't have enough money to finance their health systems, so the questions is how will they justify launching new programmes on palliative care for people at the end of life?"

Concerns that while people living in developing countries have very limited access to these drugs, powerful painkillers are being over-used in some higher-income countries. "Prescription drug abuse is now becoming a major cause of death in the United States," says Dr Lochan Naidoo, president of the International Narcotics Control Board.

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