Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report

  title={Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report},
  author={Felicia Marie Knaul and Paul Farmer and Eric L Krakauer and Liliana de Lima and Afsan Bhadelia and Xiaoxiao Jiang Kwete and H{\'e}ctor Arreola-Ornelas and Octavio G{\'o}mez-Dant{\'e}s and Natalia M. Rodriguez and George A. O. Alleyne and Stephen R Connor and David J. Hunter and Diederik Lohman and Lukas Radbruch and Mar{\'i}a del Roc{\'i}o S{\'a}enz Madrigal and Rifat A. Atun and Kathleen M. Foley and Julio Frenk and Dean T Jamison and M R Rajagopal and Huda Abu-Saad Huijer and Agnes Binagwaho and Sne{\vz}ana M. Bo{\vs}njak and David Clark and James F. Cleary and J. R. Diaz and Cynthia Ruth Goh and Pascal J. Goldschmidt-Clermont and Mary Gospodarowicz and Liz Gwyther and Irene J. Higginson and Thomas Hughes-Hallett and Emmanuel B K Luyirika and Maria-Elena Medina Mora and Faith N. Mwangi-Powell and Sania Nishtar and Megan E O'Brien and K. Srinath Reddy and Judith A. Salerno and Silvia Allende and Nahid Bhadelia and Mariana Rosales Calder{\'o}n and Victoria Y. Fan and Jorge Jimenez and Christian R. Ntizimira and Pedro Emilio Perez-Cruz and Isa{\'i}as Salas-Herrera and Dingle Spence and Mark R. Steedman and St{\'e}phane Verguet and Julia Downing and Bishnu Datta Paudel and Maia Elsner and James A. Gillespie and Karen J Hofman and Quach Thanh Khanh and Karl A Lorenz and Oscar M{\'e}ndez Carniado and Rachel A Nugent and Emily B Wroe and Camilla Zimmerman},
  journal={The Lancet},

Latin American Pain Federation position paper on appropriate opioid use in pain management

Latin American Pain Federation position paper on appropriate opioid use in pain management João Batista Santos Garcia*, Maria Patricia Gomez Lopez, Guilherme Antonio Moreira Barros, Héctor

Historical aspects in pain management in palliative care in an oncological reference unit.

The actions implemented for pain management in palliative care oncology and the contribution of Hospital do Câncer IV, as a reference unit at the National Cancer Institute are described and analyzed.

Access to pain relief and essential opioids in the WHO South-East Asia Region: challenges in implementing drug reforms

There is an urgent need for well-formulated drug policies to increase access to opioid medications, coupled with capacity-building and comprehensive public health systems incorporating palliative care in South-East Asia.

Restoring balance to cancer pain management

There was a major and steady rise in the misuse and diversion of opioids with a significant increase in deaths associated with opioids, especially when they were taken with alcohol and/or benzodiazepines, in the United States.

Education in pain and palliative care in the low- and middle-income countries of the Asia Pacific region.

Ongoing efforts to improve education in pain management and palliative care in LMIC in the Asia Pacific region to improve access to pain relief and pallingative care are reported on.

From Tramadol to Methadone: Opioids in the Treatment of Pain and Dyspnea in Pediatric Palliative Care

Tramadol appears to play a key role in treating episodes of inconsolability in children with progressive neurologic, metabolic, or chromosomally based condition with impairment of the central nervous system, and therefore puts children at risk for unrelieved pain or increased respiratory depression.

Sustainable access to appropriate opioids for palliative care patients in Australia-preventing the need for crisis management

  • K. Reed
  • Medicine
    Journal of pain & palliative care pharmacotherapy
  • 2019
The recent history and current issues of the ‘opioid crisis’ are considered, providing recommendations to which regulatory and peak bodies can work with the Australian government, ensuring consistent adherence to WHO guidelines maintaining access to evidence based opioid management for palliative care patients.

One Step Closer to Effective Pain Management Around the World?

The essential pain management (EPM) course is described and how EPM originated in response to a request by anesthesia providers in PNG for help with pain management is described, which offers a powerful tool for pain education and advocacy around the world.

Cancer pain management in Mexico

The history and current status of cancer pain management in Mexico is reviewed to identify existing barriers to proper, effective opioid use, as well as provide practical recommendations for improvement.



Pain Control in the African Context: the Ugandan introduction of affordable morphine to relieve suffering at the end of life

An example of a highly effective and cost efficient model of care that has transformed the ability to humanely manage the problems of those with terminal illness, and to offer a culturally appropriate "good death" is offered, to complete the ethical circle of care in resource poor circumstances.

An evaluation of a morphine public health programme for cancer and AIDS pain relief in Sub-Saharan Africa

The Ugandan programme for roll-out has proved a useful model to expand opioid availability as the first step in improving patient care, and may prove a useful template for other Sub-Saharan African countries.

Palliative care conundrums in an Ebola treatment centre

The issues around declaring a patient palliative in a low resource environment while dealing with a largely unknown entity, Ebola viral disease, make this an important discussion-stimulating case.

Improving the availability and accessibility of opioids for the treatment of pain: The International Pain Policy Fellowship

The fellows from each country were successful at initiating collaboration with relevant governmental bodies, national authorities, and professional societies, which resulted in a new supply of oral opioids in Sierra Leone and Serbia, and improvements in the distribution of already available opioids in Colombia.

Connecting the Dots: A Comparative Global Multi-Institutional Study of Prohibitive Factors Affecting Cancer Pain Management

There are significant differences in perceived barriers and degree of prohibitive factors to cancer pain management among trainee physicians in low- vs high-resource environments.