The report, titled “Left behind in pain”, highlights the problems in access to this essential medicine and offers actions to improve safe access through balanced policy.

Despite morphine being an effective and relatively low-cost medicine for relieving strong pain, listed since 1977 in the first edition of the WHO Model list of Essential Medicines, the disparity in access across countries is stark.

There is a 5- to 63-fold difference in the estimated median consumption of morphine between high-income countries and lower income countries.

Consumption pattern varies significantly across countries of similar wealth; it does not correspond to medical need, as indicated by the estimated number of days people are in pain or suffer with severe shortness of breath for people with a terminal illness.

“Leaving people in pain when effective medicines are available for pain management, especially in the context of end-of-life care, should be a cause of serious concern for policy-makers,” says Dr Yukiko Nakatani, WHO Assistant Director-General for Medicines and Health Products.

“We must urgently advocate for safe and timely access to morphine for those in medical need through balanced policy, everywhere.”

Access to morphine for medical use is influenced by many interacting factors including enablers related to good governance, reliable/efficient procurement and supply processes, resource availability and capacity-building activities, along with barriers related to overly restrictive legislation and policies, inadequate service provision, and misinformed attitudes and perception.

The report presents a complementary set of areas for action that aim to improve safe access to morphine.

These include implementing small-scale regional or state-wide programs on improving access to morphine for medical use with a package of essential services and products for palliative care that is formulated according to the WHO Model List of Essential Medicines and the WHO Essential Package of Palliative Care.

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