Global Palliative Care

Palliative care has been recognised as an important part of healthcare since it became prominent in the 1970s and 80s.  However, the need for relief of suffering for those with advancing disease approaching the end of their life has always been with us.  Whether people are suffering from cancer, infectious diseases, progressive organ failure or effects of severe disability, the needs are similar and the physical, emotional social and spiritual suffering can be enormous.

Across the world the development of palliative care support and services has been variable.  In North America, Europe and Australasia there is almost complete coverage, whereas in many of the developing parts of the world the provision of palliative care is patchy or non existent.

Around 78% of people needing palliative care are in developing countries. This means that the majority of people struggling with life threatening progressive and terminal illnesses lack support and relief of symptoms at the time when they need it most.  In many countries there is no access to essential medicines such as morphine for pain control. In other areas the stretched health care services are focussed on preventative and curative treatments and, even in places where the need is recognised, those trying to provide good palliative care lack the skills and the opportunities for training.  In some countries and cultures there is a tremendous stigma around death and dying, or some specific illnesses such as HIV/AIDS, and these act as huge barriers to the implementation of good palliative and end of life care. Health systems are often weak which exacerbates the many problems.

The global need is estimated at 20 million people per year simply based on those approaching death and 100 million if we include family members. The need is much greater when we consider that many will have years struggling before death  In the developing world the age spectrum of people needing care is much younger with a significant proportion of those with life threatening illnesses being children. Most of the world (estimated 5.5 billion) do not have any access to pain medication.

The WHO has recognised the problem and together with a ground breaking resoltuion at the World Health Assembly in 2014 and UNGASS in 2016 there is a significant international imperative. Palliative care has also been agreed as a basic human right.  These imperatives need to be implemented in order to address the needs to include country and regional policy development with integration into health systems supported by good education, access to basic medication and equipment and the local leadership to ensure implementation. This also forms part of the global imperative for universal health coverage.

Cairdeas seeks to address these issues. Most of the obvious impact is where we provide educational support to local services who are developing. However, there is also much being done in terms of developing policy both at regional and national levels, working to develop health systems strengthening, campaigning for access to essential resources and training and mentoring those local leaders who are working to implement services.

For more detailed information on the need see the Essential resources section. In particular the WHO infographic, World Health Assembly Resolution and Global Atlas of Palliative Care.