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FACT SHEET: GLOBAL LACK OF ACCESS TO
MORPHINE, AN ESSENTIAL MEDICINE

The problem. According to the World Health Organisation, more than 5.5
billion people, living in more than 150 countries, (83% of the worlds
population) have low to no access
to controlled essential
medicines such as morphine for
pain relief, palliative care, other
health acute health conditions.1
The Single Convention on Narcotic
Drugs classifies certain medicines,
including essential opioid
analgesics such as morphine, into
schedules. All member states must
impose the specific levels of
control mandated by the treaties.
Many impose more stringent
controls than necessary, resulting
in unavailability for patients and
providers.

Source: International Narcotics Control Board 2010

Although aggregate global morphine consumption has increased exponentially

over the last two decades, regional inequalities in access to pain relief are stark.
Ninety per cent of the global consumption of morphine and other opioids occurs
in Australia, Canada, New Zealand, the United States and several European
countries.
The World Health Organisation classifies morphine for pain control, as an
essential medicine. Essential medicines satisfy the priority healthcare needs of
a population and must be available, accessible, and affordable.2 The need for
inexpensive oral morphine is particularly acute in resource poor countries where
most patients only seek medical attention when disease has advanced beyond the
possibility of cure and is causing severe pain. The prevalence of untreated pain

he World Health Organization Briefing Note-February 2009. Access to Controlled Medications

Programme: Improving access to medications controlled under international drug conventions.
Available from: http://www.who.int/medicines/areas/quality_ safety/ACMP_BrNoteGenrl_EN_Feb09.pdf
2

Hogerzeil GV The concept of essential medicines: lessons for rich countries BMJ 2004 Nov
13;329 (7475) 1169072

will rise as populations age, and as the global burden of chronic disease, cancer,
and HIV/AIDS increases.
Negative Effects of Untreated Pain. The physical, psychological, social, and
financial health of individuals, families, communities, and states suffers when
internationally controlled essential medicines such as morphine for the treatment
of pain are unavailable, unaffordable, and inaccessible.
In restricted and acute situations, patients and their families may resort to illegal
markets for heroin and other painkillers, risking arrest, imprisonment, and
related social harms. Effective pain relief and dependence treatment restores
quality of life and in many cases allows patients to return to work, participate in
community life, and care for their families.
The knowledge gap. Although pain relief and dependence therapy are now state
of the art in many industrialised countries, outdated laws and regulations in many
countries paralyse professional development and the provision of palliative care.
Modernising public health systems to include the rational use of essential
medicines for palliative care enables governments to meet their obligation to
provide their citizens with the right to the highest attainable standard of health.
Doing so also contributes to the UN goals of security, peace, and development.
Political leaders and the faith community worldwide can encourage south south
and north south technical collaboration and knowledge translation programs to
ensure that all people, including children, older persons, and other vulnerable
groups, can realise their human and natural right to live and die with dignity.