At least 2.4 million people died in 2012 of cancer or HIV in moderate or severe pain without treatment. Opioid analgesics, including morphine, are considered essential medicines by the World Health Organization but access to them is severely limited in most low- and middle-income countries, where 85% of the world’s population consumes just 7% of the medicinal opioids.
There is no more striking example of the global disparity in access to health care than cancer. Cancer patients in low- and middle-income countries lack access to basic diagnostic services and cancer awareness is low, so about 80% of cancer cases are in advanced stages of disease when they are diagnosed. For example, Uganda, with a population of 33 million, has one cancer center. Among the 22,000 new patients seen each year, 91% die within a year. With a prevalence of about 80% among people with advanced cancer, untreated moderate to severe pain that grows worse each day is a consistent feature of cancer care in resource-limited settings.
Improved access to essential pain medicines is not the only thing that cancer patients in low- and middle-income countries need, but it is arguably the easiest and least expensive need to meet, would do the most to relieve suffering, and recent data suggest it may also extend survival.
In the search for practical, meaningful, and attainable objectives in the fight to improve care for cancer patients in resource-limited settings, securing access to essential pain medicines is a first-priority to ensure that cancer patients like Saidat, pictured here, don't have to suffer unnecessarily.