Pain Management in Developing Countries: An Update

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...