Left behind in pain - access to morphine (Report)

This report emphasizes the critical role of morphine as an essential medicine for alleviating moderate to severe pain. Morphine is vital in various medical settings, including surgical care, cancer care, palliative care, emergency care, pediatric care, and long-term care. Despite its significance, access to morphine remains alarmingly inadequate in many countries, especially in low- and middle-income regions.

The report underscores that over 80% of the available morphine in 2021 was consumed by countries in the WHO Region of the Americas (primarily North America) and the European Region, as well as high-income countries. This distribution does not align with the actual medical needs, as indicated by the estimated number of days patients experience pain and dyspnoea per capita. A WHO survey revealed that 50% of respondents from low-income countries and 18% from lower-middle-income countries stated that at least 80% of people did not receive necessary morphine or other strong opioids.

Several barriers obstruct access to morphine. One significant barrier is the lack of availability, especially in lower-income countries. In the WHO survey, one in four respondents from low and middle-income countries reported that morphine was available less than half the time when needed. Additionally, the supply of morphine is regulated internationally, making the supply process lengthy and requiring coordination among multiple parties.

The report identifies various underlying factors that can either enable or hinder access to morphine. These factors include governance structure, resource availability, capacity-building, legislation, policies, and service provision. The report suggests a list of potential areas for action, emphasizing the need for each action to be tailored to different national and regional contexts.