Palliative care is more than just pain relief.
It includes addressing the physical, psychosocial and emotional suffering of
patients with serious advanced illnesses and supporting family members
providing care to a loved one.
About one third of those needing palliative
care suffer from cancer. Others have progressive illnesses affecting their heart,
lung, liver, kidney, brain, or chronic, life-threatening diseases including HIV
and drug-resistant tuberculosis.
It is estimated that every year more than 20
million patients need palliative care at the end of life. Some 6% of these are
children. The number of people requiring this care rises to at least 40 million
if all those that could benefit from palliative care at an earlier stage of
their illness are included. Hospice and palliative care often encompasses some
support to family members, which would more than double care needs.
In 2011, approximately 3 million patients
received palliative care, the vast majority at the end of their life. Although most palliative care is provided in
high-income countries, almost 80% of the global need for palliative care is in
low- and middle-income countries. Only 20 countries worldwide
have palliative care well integrated into their healthcare systems[1].
“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,” says Dr Oleg Chestnov,
WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. “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.”
The Atlas
calls on all countries to include palliative care as an essential component
to every modern healthcare system in their moves towards universal health
coverage. This means addressing barriers such as:
1) lack of policies recognizing palliative care
and the need for care both at the end of life and during progressive illnesses;
2) lack of resources to implement services,
including access to essential medicines, especially pain relievers;
3) lack of knowledge of health care
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,” adds David Praill, Co-Chair of the WPCA. “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 WHO called on
countries to strengthen palliative care and to integrate it into their
healthcare systems. It is expected that the 67th World Health Assembly will discuss
the subject in May 2014.
The importance of palliative care is being
emphasized by the WHO Global Action Plan for the Prevention and Control of
Noncommunicable Diseases 2013–2020 and the most recent WHO essential medicines
list that includes a specific section on medicines for palliative care.
* * *
Download the Global Atlas for Palliative Care at the End of Life (PDF); or visit the WPCA website at http://www.thewpca.org/resources
Global Action Plan for the Prevention and Control of NCDs
2013-2020: http://www.who.int/nmh/events/ncd_action_plan/en/
[1] Australia, Austria, Belgium, Canada,
France, Germany, Hong Kong Special Administrative Region, Iceland, Ireland,
Italy, Japan, Norway, Poland, Romania, Singapore, Sweden, Switzerland, Uganda,
United Kingdom, United States of America
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