Harvard hosts international workshop to address global pain inequity

Categories: Policy.

The event has been taking place for two days (16 and 17 April) and will address the global pain divide and start to devise a roadmap to advocacy and policy change at national and global levels.

Access to adequate chronic pain management is limited to the most affluent areas of the world and those with the most resources within those areas. Currently, only 20 countries have fully integrated palliative care into their health systems, and more than 2.7 million people die in untreated pain each year without the basic human right of palliative care. Including family members and carers, over 100 million people each year need hospice and palliative care services.

The UN monitoring indicator ‘Morphine equivalent opioid consumption per death from HIV & cancer pain’ starkly highlighted these disparities, with the poorest 10% of the world’s countries reporting 54mg, while the 10% richest countries consumed 97 400mg.

Palliative care is an integral part of universal health care, as defined by the World Health Organization. Participants unanimously called for this definition to be put into practice. 

Speakers introduced the global inequalities in access to pain relief and initiated discussions around innovative approaches to better pain control worldwide. 

Participants heard from palliative care leaders from Rwanda, Uganda, Jordan and Mexico, among others, on access to pain relief in their countries. 

Eric Krakauer, Director of International Programs, Harvard Medical School Center for Palliative Care, called the lack of access to pain control and palliative care “a morally outrageous problem,” and “a major issue to closing the pain divide.” He told the group: “Every day I wonder: why are medications that are so cheap, not able to be accessed by all?”

Felicia Knaul, Associate Professor at Harvard Medical School and Director of Harvard Global Equity, questioned the global focus on disease burden and cost-effectiveness metrics, pointing out that these fail to measure pain control and palliation and skew global health priority setting. This was supported by comments from Julio Frenk, Faculty Dean of Harvard School of Public Health, calling for separate accounting for pain and metrics for pain related disability. 

The discussions will continue today. Follow on the Twitter hashtag #ClosethePainDivide