Global Key Message

  • Access to hospice and palliative care in all countries is a human right. The continuum of universal health coverage includes palliative care and any health system without palliative care is incomplete.
  • Palliative care includes physical, psychological, social, and spiritual care for patients and their families with life threatening illnesses including cancer, progressive non-malignant disease, HIV and TB.
  • Access to essential palliative care medications, including opioids for pain relief, is required as is national policy and inclusion of palliative care training in all health professional education.

The Facts

  • Over 40 million people need palliative care annually including 20 million at the end of life. Most are older (69% 60+) but at least 6% are children.
  • 78% live in low and middle income countries. Only 14% of the need for palliative care is being met at the end of life, less than 10% of the overall need WHPCA/WHO, 2014)
  • 75% of the world population lives without access to proper pain relief treatment (INCB, 2016)
  • Each year 18 million people die in pain without access to essential medicines (WHPCA, 2014)
  • Only 20 countries have palliative care well integrated into the health care system (WHPA/WHO, 2014).

Meeting the Challenge

All governments need to implement policies establishing palliative care as part of their health care system, adding palliative care as a recognized specialization, and providing human and financial resources to deliver palliative care services to those in need.

Country example

The Neighbourhood Network in Palliative Care (NNPC), a community owned programme in Kerala (India), is a project evolved out of a series of needs-based experiments in the community. In this programme, initiated in the year 2000, volunteers from the local community are trained to identify problems of the chronically ill in their area and to intervene effectively, with active support from a network of trained professionals. Essentially, NNPC aims to empower local communities to look after the chronically ill and dying patients in the community. Within 10 years, the initiative has grown into a vast network of more than 500 community-owned palliative care programmes looking after more than 15,000 patients at any one time. It has a workforce of over 15,000 trained community volunteers, 50 palliative care physicians, and 100 palliative care nurses.