Committees  |   May 2013
Pain Management in Developing Countries: An Update
Article Information
Pain Medicine / Committees
Committees   |   May 2013
Pain Management in Developing Countries: An Update
ASA Monitor 05 2013, Vol.77, 52-54.
ASA Monitor 05 2013, Vol.77, 52-54.
According to the 1948 Universal Declaration of Human Rights, the right to health includes relief from pain.1  Under this premise, 5.5 billion people are at risk of human rights violations on a daily basis.2  This staggering statistic is the result of inequitable distribution and access to treatment for moderate and severe pain across international borders. In 2008, low- and middle-income countries, comprising 83 percent of the global population, accounted for only 9 percent of the global consumption of morphine,3  a drug classified as an essential medicine by the World Health Organization (WHO). In contrast, high-income countries, representing 17 percent of the world’s population, accounted for 91 percent of morphine consumption (Figure 1). The factors that have led to this “pharmacologic disparity” are highlighted in a 2006 survey of hospice and palliative care providers from Asia, Africa and Latin America. In all three continents, similar trends were identified as barriers to morphine access: excessively strict national laws and regulation; fear of addiction, tolerance and side effects by patients and practitioners; poorly developed health care systems and supply; and lack of education by health care professionals, the public and policymakers.3  Subsequent surveys by the WHO, International Narcotics Control Board and other non-governmental agencies have confirmed this pattern throughout the world, including within Eastern Europe.4  According to Meg O’Brien, director of the Global Access to Pain Relief Initiative, morphine procurement in the developing world, on a national level, has more to do with overcoming bureaucratic factors and physician misconception than cost.5 
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