The New York Times - October 6, 2007
Donald G. Mcneil Jr.

The 51-page document was aimed not at individual doctors, but at national health ministers, said one of its authors, Dr. Cecilia Sepúlveda, palliative care expert with the health organization.

It contains formulas for calculating how many people in a country are in need of such care.

It also outlines typical obstacles to providing it: national laws that make it hard for pharmacists to stock powerful painkillers, lack of training for doctors and nurses, and fears of addiction on the part of patients.

It also cites countries that offer good end-of-life care despite national poverty - mostly by having it done at home, by relatives given modest amounts of training.

The "most impressive" programs that Dr. Sepúlveda said she had found were in Uganda and in the state of Kerala in India. In both places, political leaders and medical doctors had combined their efforts.

In 2005, more than seven million people died of cancer, and 70 percent of them were in poor or middle-income countries where there was little money for diagnosis or treatment, the health organization report said. Unless a cure is found for cancer, more than 11 million people will die of it each year by 2030.

Although the report was initially written for countries preparing national cancer plans, it is also useful in countries with many people dying of AIDS or experiencing any other slow, painful death, Dr. Sepúlveda said.

071006
NYT071003

Copyright © 2007 - The New York Times Company. All Rights Reserved. All New York Times articles contained on the AEGiS web site are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of The New York Times Company. You may not alter or remove any trademark, copyright or other notice from copies of the content. However, you may download articles (one machine readable copy and one print copy per page) for your personal, noncommercial use only.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National Library of Medicine, Roche and Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 2007. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2007. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .