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FACT SHEET: GLOBAL LACK OF ACCESS TO MORPHINE, AN ESSENTIAL MEDICINE

!The problem. According to the World Health Organisation, more than 5.5 billion people, living in more than 150 countries, (83% of the worlds population) have low to no access to controlled essential medicines such as morphine for pain relief, palliative care, other health acute health conditions. 1The Single Convention on Narcotic Drugs classifies certain medicines, including essential opioid analgesics such as morphine, into schedules. All member states must impose the specific levels of control mandated by the treaties. Many impose more stringent controls than necessary, resulting in unavailability for patients and providers. Source: International Narcotics Control Board 2010

Although aggregate global morphine consumption has increased exponentially over the last two decades, regional inequalities in access to pain relief are stark. Ninety per cent of the global consumption of morphine and other opioids occurs in Australia, Canada, New Zealand, the United States and several European countries.

The World Health Organisation classifies morphine for pain control, as an essential medicine. Essential medicines satisfy the priority healthcare needs of a population and must be available, accessible, and affordable. The need for 2inexpensive oral morphine is particularly acute in resource poor countries where most patients only seek medical attention when disease has advanced beyond the possibility of cure and is causing severe pain. The prevalence of untreated pain

he World Health Organization Briefing Note-February 2009. Access to Controlled Medications 1Programme: Improving access to medications controlled under international drug conventions. Available from: http://www.who.int/medicines/areas/quality_ safety/ACMP_BrNoteGenr-l_EN_Feb09.pdf

Hogerzeil GV The concept of essential medicines: lessons for rich countries BMJ 2004 Nov 213;329 (7475) 1169072

will rise as populations age, and as the global burden of chronic disease, cancer, and HIV/AIDS increases.

Negative Effects of Untreated Pain. The physical, psychological, social, and financial health of individuals, families, communities, and states suffers when internationally controlled essential medicines such as morphine for the treatment of pain are unavailable, unaffordable, and inaccessible.

In restricted and acute situations, patients and their families may resort to illegal markets for heroin and other painkillers, risking arrest, imprisonment, and related social harms. Effective pain relief and dependence treatment restores quality of life and in many cases allows patients to return to work, participate in community life, and care for their families.

The knowledge gap. Although pain relief and dependence therapy are now state of the art in many industrialised countries, outdated laws and regulations in many countries paralyse professional development and the provision of palliative care.

Modernising public health systems to include the rational use of essential medicines for palliative care enables governments to meet their obligation to provide their citizens with the right to the highest attainable standard of health. Doing so also contributes to the UN goals of security, peace, and development.

Political leaders and the faith community worldwide can encourage south south and north south technical collaboration and knowledge translation programs to ensure that all people, including children, older persons, and other vulnerable groups, can realise their human and natural right to live and die with dignity.