Report Finds Huge Unmet Need for Palliative Care Worldwide

Megan Brooks

January 28, 2014

Globally, only 1 in 10 people who need palliative care get it, according to the first-ever Global Atlas of Palliative Care at the End of Life, published jointly today by the World Health Organization (WHO) and the Worldwide Palliative Care Alliance (WPCA).

"The atlas shows that the great majority of the global need of end-of-life care is associated with noncommunicable diseases such as cancer, heart disease, stroke and lung diseases," Oleg Chestnov, MD, WHO assistant director-general for noncommunicable diseases and mental health, said in a statement.

"While we strengthen efforts to reduce the burden of the biggest killers in the world today, we must also alleviate the suffering of those with progressive illness who do not respond to curative treatment," he added.

About one third of those needing palliative care have cancer. Those with progressive illnesses affecting their heart, lung, liver, kidney, or brain or with chronic life-threatening diseases such as HIV and drug-resistant tuberculosis also have an often unmet need for it.

Palliative care addresses the physical, psychosocial, and emotional needs of patients with serious advanced illnesses and supports family members providing care to a loved one.

Each year, more than 20 million patients need palliative care at the end of life, the WHO and WPCA say. Some 6% of these patients are children. The number of people requiring palliative care rises to at least 40 million if all those who could benefit from palliative care at an earlier stage of their illness are included.

The WHO and WPCA estimate that in 2011, roughly 3 million patients received palliative care, the vast majority at the end of their life. Most palliative care is provided in high-income countries, yet almost 80% of the global need for palliative care is in low- and middle-income countries, the report notes.

Only 20 countries worldwide have palliative care well integrated into their healthcare systems.

The atlas calls on all countries to include palliative care as an essential component to every modern healthcare system.

This means addressing key barriers to palliative care, including lack of policies recognizing palliative care and the need for care both at the end of life and during progressive illnesses; lack of resources to implement services, including access to essential medicines, especially pain relievers; and lack of knowledge of healthcare professionals, community volunteers, and members of the public about the benefits of palliative care.

"Our efforts to expand palliative care need to focus on bringing relief of suffering and the benefits of palliative care to those with the least resources," David Praill, cochair of the WPCA, said in a statement. "This will take courage and creativity as we learn from each other how to integrate palliative care into existing but very limited healthcare systems."

Last week, the executive board of the WHO called on countries to strengthen palliative care and to integrate it into their healthcare systems, a subject expected to be discussed in Geneva this spring during the 67th World Health Assembly.

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