The Lack of Palliative Care

In many poor and middle income countries untold millions are in pain due to illnesses like cancer and are not able to receive needed relief.  A chief reason is the opioid epidemic in the US. These countries are afraid that if the opioids needed to alleviate pain were made available more freely, that they too would end up with an epidemic.  While the US has 31 times the amount of drugs it needs, the result of this fear and avoidance is that Haiti has about 0.2% of what it requires and Nigeria even less. India and Indonesia each supply about 4% of their need, Russia 8% and China 16%, just a little bit less than what Uganda has. Uganda has actually  innovated palliative care delivery. They provide diluted liquid morphine in pint sizes free through the government but funded by a charity. Even if it fares better than many other countries, that is obviously not nearly enough. Pharmaceutical companies could produce cheap morphine, but there is not enough profit in it for them to do that. What strikes one’s conscience is how little it would take to supply the needs of those in pain, those dying of cancer or other painful diseases. A Lancet report found that it would take $145 million (not billion) a year to supply enough morphine for all those in the world who are in pain, need it and can’t have it. And if one wanted to take away the pain of the word’s children under 15 suffering from severe burns, surgery, car accidents, cancerous tumors, pain from sickle cell and the like it would be one million dollar a year—a paltry sum to an increasing number.

There are any number of billionaires trying to make a name for themselves in philanthropy, perhaps following in Bill Gates footsteps. Jeff Bezos the richest man in the world still has no known philanthropy to his name. Would alleviating the pain of children and the dying qualify? — I would think it ought to at least tug at the heart of anyone with a developed social conscience and the means to do it. For the rest of us perhaps it suffices to know about this inequality and remember how easy it is for us to alleviate our own pain when we experience it.

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