World Health Assembly Resolution 67.19 states that universal access to palliative care – the prevention and relief of suffering due to serious or life-threatening health problems or their treatment – is an ethical imperative: “it is the ethical duty of health care professionals to alleviate pain and suffering, whether physical, psychosocial or spiritual, irrespective of whether the disease or condition can be cured … ”, and “palliative care is an ethical responsibility of health systems … ” (1). The Health Assembly also asserted that integration of palliative care into public health care systems is essential for achievement of Sustainable Development Goal (SDG) 3.8 (universal health coverage, UHC) and that this integration is especially important “at the primary care level”. How can this ethically imperative integration be achieved? What changes are needed? And what will it cost?