HRW: Ukraine’s failure to ensure accessibility to pain treatment for patients with life-limiting illnesses
At least 80 000 patients with advanced cancer in Ukraine unnecessarily suffer from severe pain every year because they cannot get effective, safe, and inexpensive pain medications. The report “Uncontrolled Pain: Ukraine’s Obligation to Ensure Evidence-Based Palliative Care” was prepared by Human Rights Watch under support of the Open Society Foundation and the Public Health Program of the International Renaissance Foundation (Ukraine).
The report identified three key obstacles to proper pain treatment in Ukraine:
· The lack of oral morphine. For decades, oral morphine has been the cornerstone of cancer pain treatment. The World Health Organization considers it an essential medicine. Yet, Ukraine’s government has failed to make the medication available through the public health care system. It is not available in private clinics either
· Drug regulations. In its efforts to crack down on illicit drug use, Ukraine has adopted some of the most restrictive drug regulations in the world, without appropriate regard to the need for access to drugs on medical grounds. These regulations severely interfere with the medical availability of medications like morphine
· Training of health care workers. Medical students and young doctors do not receive adequate training in modern pain treatment approaches.
These three obstacles combine to deny patients adequate medical treatment, Human Rights Watch said. For example, Ukraine’s drug regulations require injectable morphine – the only formulation of the medication available in the country – to be administered by a health care worker directly to the patient. Since morphine acts for just four to six hours, this means that a health care worker must visit a patient who is dying at home, as most cancer patients in Ukraine do, six times a day.
Human Rights Watch research shows that most patients get either no morphine or one or two doses a day. If oral morphine were available, patients could receive a take-home supply and take the medications themselves.
“There is no reason people have to live out their last months in torment,” said Diederik Lohman, senior health researcher at Human Rights Watch. “Severe pain is not inevitable. Ukraine needs to fix its health policies and drug regulations to put safe and effective pain medicines in the reach of people who need them,” he added.
“Patients told us their suffering was so great that they would prefer to die than live with their pain,” Lohman said. “The Ukrainian government needs to urgently introduce oral morphine and reform its unbalanced drug regulations,” expert stressed.
The report is based on in-depth interviews with 20 patients, 35 healthcare workers, and a dozen drug control and health officials and a review of relevant regulations and policy documents.
Contact information: “Human Rights Watch”, Mary Prykhodko, +38 050 914 95 94, +38 (044) 461 97 09, stekliashka@gmail.com
***
The mission of the Public Health program is to reform public health, to improve public health through support of new approaches to solution of urgent public health problems, in particular, by introduction of a complex model of protection of the rights of patients, palliative care, and support to people living with HIV/AIDS and non-medical drug use.
