Importance of palliative care underscored

“Death is a certainty, an inevitable realization, the only thing that we know will befall us,” Yugoslav writer Meša Selimović once wrote—a truth that underscores the growing importance of palliative care, which seeks to ease the suffering of those with serious, often incurable illnesses.

Far beyond hospice or end-of-life services, palliative care can begin early in a patient’s diagnosis, encompassing a wide range of interventions—from pain relief to breathing support—delivered at home, in hospitals, nursing homes, or hospices. Yet, despite its benefits, millions still do not have access to it.

Recent global research has revealed that the number of people requiring palliative care has increased by 74% over the past 30 years, reaching 73.5 million in 2021. The vast majority—four out of five—are in lower-income countries like the Philippines, where demand has surged by 83% since 1990. Even in wealthier nations, the need has grown by 46% over the same period.

“Life expectancy is increasing, but healthy life expectancy is not keeping pace,” said Dr. Libby Sallnow, a leading palliative care physician and head of the Marie Curie Palliative Care Research Department at University College London.

While cancer remains the primary condition among those choosing medically assisted death, palliative care is essential for people suffering from a wide range of chronic diseases such as heart ailments, dementia, and lung disorders.

A global team of researchers assessed the need for palliative care by identifying individuals experiencing severe health-related suffering—whether through physical pain or a deteriorating quality of life that cannot be addressed without specialized support.

The report highlighted a shift in disease burden: although infectious diseases have declined—particularly in low-income nations—the prevalence of non-communicable diseases has significantly increased. In wealthier countries, the majority of those needing palliative care are women aged 70 and above, often due to dementia. In poorer regions, most are women between 20 and 49.

“People are living for longer with more illness and more serious health-related suffering. We see a need to manage this much earlier in the life course [and not just] the last few days or weeks” of someone’s life,” said Dr. Sallnow.

The World Health Organization projects a grim future: by 2050, breast cancer deaths could rise by 68% globally. Although children made up 25% of those suffering from serious illness in 1990, their share has dropped to 14% by 2021, indicating a shift in the burden toward adults and elderly patients.

In Europe alone, WHO reported that 4.4 million people die each year needing palliative care—a number expected to grow. Of these, 39% have cancer, 33% have heart disease, 16% have dementia, and 6% suffer from chronic lung illness.

The European Association for Palliative Care recommends two specialized services for every 100,000 individuals. Yet many countries fall short of this benchmark due to barriers such as a shortage of trained professionals, limited access to essential painkillers, and poor public awareness of palliative care’s role.

The report labeled the global lack of palliative care as “one of the most neglected and inequitable facets of health systems.”

Dr. Sallnow emphasized the urgency to shift how the world views palliative care—moving away from the assumption that it is only for terminal cancer patients or the dying.

“The first step is for healthcare to recognize that death is inevitable and the aim of medicine is not only to avoid death, it is also to relieve suffering,” she concluded. TRACY CABRERA