Confronting global inequities in palliative care

Abstract

The number of people dying with preventable, serious health-related suffering is rapidly increasing, and international calls for the expansion of palliative care services have been made, such as the World Health Assembly Resolution 67.19, which named palliative care as an essential component of Universal Health Coverage. Despite this, only about 14% of all palliative care need globally is met today, and health systems around the world are unprepared to meet the growing need. Palliative care has been shown to improve patient, caregiver and health-system outcomes and reduce costs for many populations and contexts. Geographic, social, cultural and health-literacy related inequities in access to and quality of palliative care services persist. We provide evidence-based recommendations which require immediate, coordinated action to improve progress towards achieving equitable access to high-quality palliative care for all. These include but are not limited to ensuring every country has palliative care codified into national health policy; providing evidence-based, basic palliative care education and training for all non-specialist healthcare workers; empowering and facilitating community action in research and service development; and ensuring that all essential palliative care medicines are available for those who need them. Unless urgent, evidence-based, coordinated action is taken, countries, health systems, and communities will fail to meet the growing palliative care demand, and millions of people around the world will experience preventable suffering.

Keywords: Global Health; Health economics; Health policy; Public Health.

Figure 1. Palliative care development by country and World Bank income level in 2017.