Inclusion of end-of-life care in the global health agenda

Global development, strengthening of health systems, and an increase in access to treatments will improve health outcomes. However, the global need for palliative and end-of-life care will persist. As populations age and societies industrialise, the number of people who will need palliative care to manage the problems associated with chronic progressive illness, e specially cancer, are predicted to increase in low-income and middleincome countries. This increase is compounded by late presentation to medical services and restricted access to potentially curative options. The provision of palliative and end-of-life care, including access to pain relief, is a worldwide human right within existing covenants. 1 However, three documents have shown the woefully inadequate coverage in most regions. First, a worldwide classifi cation of every country’s level of palliative care provisions showed that only 58% of countries have a palliative care service, and provision ratios are as poor as one service per 90 million population. 2 Second, WHO’s 2014 global atlas of palliative care reported that less than 10% of the 20 million people every year who need palliative care at the end of life actually receive it, and although most care is delivered in high-income countries, 80% of people who need palliative care are in low-income and middleincome countries. 3