Palliative care not available for majority in developing countries: WHO

Only 20 countries across the world have palliative care well integrated into their health-care systems, says report

By Kundan Pandey
Published: Friday 31 January 2014

Only 1 in 10 people who need palliative care, or medical care to relieve the pain, symptoms and stress of serious illness, are currently receiving it,” says a recent report released by World Health Organization (WHO).
Published jointly by WHO and Worldwide Palliative Care Alliance (WPCA), the global atlas has highlighted that availability of palliative care is a challenge for the world.
According to WHO, in 2001, over 29 million people across the world died from diseases which required palliative care. The present estimated number of people in need of palliative care, at the end of life, is 20.4 million.

Among those who need palliative care, total 94 per cent are adults of whom 69 per cent are over 60 years old and 25 per cent are 15 to 59 years old. As per the WHO, six per cent of those who need such care are children.


Contrary to the common belief that only cancer needs such assistance, WHO has emphasised on many other diseases where people need palliative care. To ascertain this, the world health agency has examined prevalence of pain in specific diseases to find out whether they need the facility or not.

Diseases that demand palliative care

For adults, the international body has named these diseases as requiring palliative care: Alzheimer’s and other dementias, cancer, cardiovascular diseases (excluding sudden deaths), cirrhosis of the liver, diabetes, HIV/AIDS, kidney failure, multiple sclerosis, Parkinson’s disease, drug-resistant tuberculosis (TB).


Among children, those afflicted with cancer, cardiovascular diseases, cirrhosis of the liver, congenital anomalies (excluding heart abnormalities), blood and immune disorders, HIV/AIDS, meningitis, kidney diseases, neurological disorders and neonatal conditions need such care.

The greatest number of children in need of palliative care died from congenital anomalies, followed by neonatal conditions, protein energy malnutrition, meningitis, HIV/AIDS and cardiovascular diseases.


The atlas has also talked about income groups which need care the most. According to the report, in 2011, approximately three million patients received palliative care, the vast majority at the end of their life. Although maximum palliative care is being provided in high-income countries, almost 80 per cent of the need for palliative care is in low and middle-income countries.

“Only 20 countries across the world have palliative care well integrated into their health-care systems, says the report. It further adds that the great majority, 78 per cent of adults in need of palliative care at the end of life, belong to low and middle-income countries where it has not got sufficient attention from local government.


However, the highest rate of people (per every 100,000 adults), in need of palliative care, is found in the higher income groups.


WHO, in its report, has insisted that palliative care refers to the approach that takes care and improves the quality of life of patients and their families facing problems associated with life-threatening illness.


Global atlas of palliative care at the end of life

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