ideasIdea
Put the essential palliative care package into every universal health coverage benefit list
The Lancet Commission defined a cheap basic package of drugs, equipment and staff for palliative care. Countries expanding health coverage should include it as a guaranteed benefit.
The Lancet Commission on Global Access to Palliative Care and Pain Relief specified an Essential Package (a short list of medicines including oral morphine, basic equipment, and human resources) costed at a few dollars per capita in low-income countries. Countries designing universal health coverage benefit packages routinely omit palliative care. Advocacy and technical assistance to include the package as a defined entitlement would make funding and delivery accountable.
Hypothesis
Countries adding the Essential Package to their benefit lists will show increased morphine availability at district level and higher palliative care coverage within three years compared with countries that do not.
Rationale
Benefit-package inclusion is how services move from charity to entitlement; the package is defined, costed, and endorsed.
What would test it
Track adoption across countries revising benefit packages, with availability audits and coverage estimates before and after inclusion.
Maturity
speculative
Who has to act
policy
Cost to try
Medium ($1M to $50M)
Years to first evidence
4
Bottlenecks it attacks
- Pain relief and palliative care are unavailable to most · Most people who die of cancer worldwide do so without adequate pain relief.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
- Funding follows fashion, not burden · Money goes to the cancers and questions that are easy or popular, not the ones that kill most or where a dollar would do most.