WHO report on access to morphine for medical use

Categories: Featured and Policy.

On 16 June 2023, The World Health Organization (WHO) published a report on access to morphine for medical use, titled Left behind in pain: Extent and causes of global variations in access to morphine for medical use and actions to improve safe access. Morphine is an essential medicine used for relieving acute or chronic, moderate to severe pain, triggered by causes such as major trauma, surgery, heart attack, and cancer. Pain relief is felt almost immediately when an adequate dose of morphine is injected, or within 30 minutes when taken orally. Like other medicines and other opioids, morphine use is associated with side effects, including constipation, drowsiness, and less often confusion, dry mouth, nausea, and vomiting. Clinical guidance in managing these common side effects is well established.

Pain is a major public health problem globally. Poorly controlled pain is disabling; it causes physical, psychological, social, and spiritual suffering. Each year, people across the world live with physical and psychological serious health-related suffering associated with a need for palliative care and pain relief. About one in two deaths every year worldwide is estimated to be associated with serious health-related suffering. Among these deaths 2.5 million are children, 98% of whom live in low- and middle-income countries.

Striking a balance between maximizing the medical benefits of opioids, such as morphine, and minimizing the potential harms of use or misuse, has been a long-standing policy goal both at international and national levels. At the international level, the United Nations (UN) Single Convention on Narcotic Drugs, 1961 (as amended by the 1972 Protocol) and Convention on Psychotropic Substances, 1971 are the two main legal instruments for facilitating global cooperation on controlling the production and distribution of narcotic and psychoactive substances, which include morphine and other opioids.

WHO is committed to improving safe access to essential opioids for medical use, in accord with its mandates conferred by the World Health Assembly through various resolutions, particularly resolution WHA67.19 Strengthening of palliative care as a component of comprehensive care throughout the life course and resolution WHA67.22 Access to essential medicines. WHO is also bound to promote and protect human rights and to pursue primary care and universal health coverage according to covenants, resolutions, and principles endorsed by the United Nations Human Rights Council and the United Nations General Assembly.

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