Palliative Care and Pain Control

Authors: Eric Krakauer, Xiaoxiao Kwete, Stéphane Verguet, Hector Arreola-Ornelas, Afsan Bhadelia, Oscar Mendez Carniado, Natalia M. Rodriguez, Zipporah Ali, Silvia Allende, James Cleary, Stephen Connor, Kristen Danforth, Liliana De Lima, Liz Gwyther, Ednin Hamzah, Dean Jamison, Quach Thanh Khanh, Suresh Kumar, Emmanuel Luyirika, Anne Merriman, Egide Mpanumusingo, Diana Nevzorova, Christian Ntizimira, Hibah Osman, Pedro Perez-Cruz, MR Rajagopal, Lukas Radbruch, Dingle Spence, Mark Stoltenberg, Neo Tapela, David Watkins, Felicia Knaul


A universally accessible essential package (EP) of palliative care and pain control can prevent and relieve suffering for chronically or terminally ill patients. It proves indispensable for achieving universal health coverage and for realizing Sustainable Development Goal 3 to “ensure healthy lives and promote well-being for all at all ages,” making it a medical and moral imperative to include such a package in publicly financed universal health coverage. In addition, it can reduce costs for health care systems and national economies and provide financial risk protection for patients and their families. Governments should enact appropriate policies and ensure that health care providers have the necessary competencies by including training in palliative care and pain control in standard undergraduate and postgraduate curricula in medicine, nursing, and other clinical fields. Costing the EP in one low-income country (Rwanda), one lower-middle-income country (Vietnam), and one upper-middle-income country (Mexico), and projecting these costs for LMICs in general, provides guidance on how to integrate the EP into health systems as an essential element of universal health coverage (UHC) in LMICs.