Philippine Daily Inquirer - - WORLD - —AP

WASH­ING­TON— Nearly 26 million peo­ple around the world die each year with se­ri­ous suf­fer­ing in part be­cause of a huge gap in pain re­lief—The US may be awash in opi­oid painkillers, but they’re rare or unavail­able in dozens of poor coun­tries, said a new re­port.

The chal­lenge is to im­prove pal­lia­tive care in low-in­come coun­tries while avoid­ing mis­takes that led to the US ad­dic­tion cri­sis.

The re­port to be pub­lished Fri­day in The Lancet says one key is us­ing off­patent mor­phine that costs pen­nies a dose—not prof­itable for drug com­pa­nies that push pricier, more pow­er­ful opi­oids in rich coun­tries, but crit­i­cal to eas­ing a health emer­gency.

In some places, even chil­dren dy­ing of can­cer or chil­dren in treat­ment for can­cer can’t get pain re­lief, said Univer­sity of Mi­ami pro­fes­sor Feli­cia Knaul. She cochaired a Lancet-ap­pointed in­ter­na­tional com­mis­sion that spent three years study­ing the dis­par­ity and what she calls “the moral obli­ga­tion” to help.

“This re­port fi­nally gives voice to the suf­fer­ing and a roadmap to gov­ern­ments,” Knaul said.

Of the few hun­dred tons of mor­phine and equiv­a­lent opi­oids dis­trib­uted world­wide, less than 4 per­cent goes to low- and mid­dle-in­come coun­tries, the re­searchers re­ported.

Some 2.5 million chil­dren are among the an­nual count of nearly 26 million who die with­out ad­e­quate re­lief, the team cal­cu­lated.

Another 35.5 million peo­ple a year have se­ri­ous pain and suf­fer­ing from those con­di­tions but aren’t dy­ing, and most live in low- or mid­dle- in­come coun­tries.

The world’s poor­est coun­tries have ac­cess to enough mor­phine to meet less than 2 per­cent of their pal­lia­tive care needs, the re­port found. In­dia fares lit­tle bet­ter, at 4 per­cent; China meets 16 per­cent of its need, and Mex­ico 36 per­cent.

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