In 2014 the World Health Assembly (governing body of WHO) passed the first stand-alone resolution on palliative care. This unanimous resolution calls on all countries to strengthen palliative care as a component of comprehensive care throughout the life course. This obligates WHO to include support for palliative care development in its global programme of work. Palliative care is also now recognised as an essential part of the continuum of health care services under the United Nation Sustainable Development Goals. To achieve goal three for good health and well-being countries are moving toward universal health coverage (UHC). In 2017 the continuum of services needed for UHC was described as “Promotion, Prevention, Treatment, Rehabilitation and Palliative Care”. Therefore, without palliative care it could be argued that health care is not universal.
Worldwide, the global need for palliative care has recently increased (in 2021, an estimated 73.5 million people worldwide would benefit from palliative care. Most of this need is concentrated in low- and middle-income countries (LMICs), which account for roughly 80% of the global burden. Even more, projections indicate that the global need for palliative care will continue to rise sharply and that by 2060 with fastest growth in need, unsurprisingly, expected in low-income countries.
Given this situation, tracking the growth of global palliative care is a critical element in advancing the hospice and palliative care movement alongside measurement of the growing need for palliative care. While there is no global registry of those receiving palliative care, the number of specialised palliative care services serves as a surrogate measure for estimating the number of patients and families receiving services. In this and a 2021 paper estimating the number of patients served in 2017, we have drawn on multiple efforts to measure levels of palliative care development to track the number of services operating worldwide. This article draws specifically on data from the ATLANTES Global Survey on Palliative Care Development, a standardised study conducted in 201 countries.
This measurement process provides an opportunity to track the analysis of trends in palliative care growth on a global, regional, and national level against the growing need for palliative care. In parallel to this work, analysis of the need for palliative care has been updated by the Lancet Commission on Palliative Care and Pain Relief. Both research efforts then form the basis for a rough analysis of the gap between need for palliative care and capacity to deliver services. And this, in turn helps paint a picture of the unmet need for services that informs efforts to advocate for resources needed to close the gap. One of the main resources used to advocate for palliative care is the Global Atlas of Palliative Care, a recurring publication of the Worldwide Hospice Palliative Care Alliance (WHPCA) done in cooperation with the World Health Organization (WHO) approximately every five to six years. This Atlas highlights the gap in access to services and helps provide evidence for palliative care advocacy.
The recently launched paper will provide an analysis of the growth of specialised palliative care for each of the six WHO regions and by the four World Bank income groups against the need for palliative care in each of these categories. For more information, download the PDF available HERE.
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