Promoting Palliative Care to Patients in Developing Countries—Global Perspectives and Future Recommendations
Brant J.M. Tang L. Nestoros S. Hablas M. Rukhadze T. Bustamante M. Al-Hadad S.A. Rao S.R. Spence D. Al-Qadire M. Kunirova G. Salikhanov I. Weru J. Daher M.N. Bacerril M.S. El-Azhari A. Luyirica E. Khleif M. Kotlinska-Lemieszek A. Mosoiu D. Kebudi R. Alvarez G.P. Rassouli M. Silbermann M.
2025Mary Ann Liebert Inc.
Journal of Palliative Medicine
2025
Background: Despite a plethora of evidence available on the benefits of palliative care (PC), it is estimated that only about 14% of those living in low- to middle-income countries (LMIC) or developing countries have access to PC. Objective: To globally examine PC expert perspectives regarding PC infrastructure and resources within each country, drug and opioid availability to provide PC, and workforce and educational issues. Design: Descriptive, open-ended survey seeking first-hand qualitative perspectives. Setting/Subjects: PC experts from 21 developing countries representing 5 continents around the world. Measurements: Qualitative narratives and discussions with PC experts. Results: The summaries inform four key recommendations for future progress of PC in developing countries: (1) PC infrastructure should increase accessibility to both urban and rural areas; (2) increasing medication and nonpharmacologic approaches for symptoms is essential; (3) interdisciplinary education should continue to expand and include scholarships, PC certifications, and advanced education; and 4) future research with developing countries is desperately needed to advance care and progress. Conclusions: Considerable PC progress has been accomplished; however, significant gaps remain. This report can be used to discuss PC capacity building within a country. It could serve as an important document while negotiating with authorities and Ministries of Health about expanding PC infrastructure, especially in rural areas. Finally, PC champions can use this report to advocate for increased opioid availability to promote comfort; in particular, increased availability of oral opioids is essential, so that patients can die comfortably at home. Copyright 2025, Mary Ann Liebert, Inc., publishers.
cancer , developing country , global health , LMIC , opioids , palliative care
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City of Hope National Medical Center, Duarte, CA, United States
Peking University Cancer Hospital, Beijing, China
Cyprus Anti-Cancer Society, Nicosia, Cyprus
Gharbia Cancer Society, Tanta, Egypt
National Cancer Center of Tbilisi, Tbilisi, Georgia
FARMAMEDICA, Guatemala, Guatemala
Baghdad College of Medicine, Baghdad, Iraq
Bangalore Hospice Trust, Bengaluru, India
University of the West Indies, Mona, Jamaica
Al-Bayt University, Mafraq, Jordan
Kazakhstan Association of Palliative Care, Almaty, Kazakhstan
Kazakhstan Association of Palliative Care, University of Basel, Basel, Switzerland
Aga Khan University Hospital, Nairobi, Kenya
University of Balam, Beirut, Lebanon
National Cancer Institute of Mexico, Mexico City, Mexico
Mohammed VI Center for the Treatment of Cancers, Casablanca, Morocco
African Palliative Care Association, Kampala, Uganda
Al-Sadeel Society, West Bank, Palestinian Authority, Bethlehem, Israel
Poznan University of Medical Sciences, Poznan, Poland
Hospice Casa Speranti, Brasov, Romania
Istanbul University Oncology Institute, Istanbul, Turkey
Maciel Hospital, Montevideo, Uruguay
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Middle East Cancer Consortium, Haifa, Israel
City of Hope National Medical Center
Peking University Cancer Hospital
Cyprus Anti-Cancer Society
Gharbia Cancer Society
National Cancer Center of Tbilisi
FARMAMEDICA
Baghdad College of Medicine
Bangalore Hospice Trust
University of the West Indies
Al-Bayt University
Kazakhstan Association of Palliative Care
Kazakhstan Association of Palliative Care
Aga Khan University Hospital
University of Balam
National Cancer Institute of Mexico
Mohammed VI Center for the Treatment of Cancers
African Palliative Care Association
Al-Sadeel Society
Poznan University of Medical Sciences
Hospice Casa Speranti
Istanbul University Oncology Institute
Maciel Hospital
Cancer Research Center
Middle East Cancer Consortium
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