The WHO report on ‘responsible use of medicines’ has not come a day too soon. It has asked countries like India to reassess their regulatory requirements on dispensing of essential medicines like morphine. This is to ensure their wider availability and accessibility, besides sensitising prescribers, dispensers and patients about their use. The report was released at an international conference, attended by Union health minister Ghulam Nabi Azad in the Netherlands. It estimated that 5.5 billion people, who constitute 83 per cent of the world population, live in countries with low to non-existent access to controlled medicines and have inadequate access to treatment for moderate to severe pain.
The report said that one million patients with end-stage HIV-AIDS, 5.5 million with cancer, 0.8 million with injuries caused by accidents and violence and 110 million women in labour pain suffer each year from inadequate pain treatment. It is a well-known secret that there are certain diseases for which there are no cures. For instance, a patient of cancer who reaches the terminal stage of the disease would have exhausted all treatment options. In the terminal stages of most diseases, the only option available is to prescribe painkillers. In other words, what is required is management, rather than treatment, of the disease.
Painkillers remain inaccessible to many people because their availability is restricted or they are beyond their reach. The alternative is to suffer pain, which not only reduces the quality of life but also hastens death. Pain is one of the main causes of suicides. Few people outside the medical fraternity know that severe pain caused by accidents and violence can lead to cardiac arrest and death. Since some of the painkillers like morphine are addictive, there are restrictions on their manufacture and sale. However, they should be made available to patients who need them at a cost they can afford. Significantly, the WHO report has hailed the simplification of the regulations regarding use of opioids in Kerala resulting in their greater use as painkillers. It is a model the rest of India can follow.