Thursday, October 07, 2010

Morphine Scarcity Produces Serious Problems for the Terminally Ill in African Countries

The Economist: Drugs in Africa

All Africa: Kenya: Drug Shortage Stirs Pain of Cancer Patients
The East African: How Cancer Patients Went Without Morphine

Powerful drugs, like morphine, are needed to provide comfort for those suffering from terminal illnesses. Globally, governments strictly control the usage of drugs that are derived from opium, such as morphine. The world’s supply of morphine is abundant, but the distribution of the painkiller is highly unequal between countries. The U.N. International Narcotics Control Board reported that 90% of the world’s morphine is distributed only in rich countries.

This means that Africans stricken with AIDS, cancer, and other ailments often suffer intense pain without the appropriate pain relief. Even Kenya, which has a far more developed healthcare system than many other African countries, struggles with procuring enough morphine for its patients. Only seven of its 250 hospitals have a limited supply of morphine available to administer to patients. Despite the 180,000 people that die of AIDS and cancer alone, Kenya only has enough morphine to treat 1,500 patients a year.

Care for cancer and AIDS patients is an enormous problem in many African countries. The majority of African patients with cancer are often diagnosed too late for affective treatment of the disease. Late diagnoses, combined with the limited availability of chemotherapy, often mean that those suffering with cancer have little chance of recovery. Therefore, African cancer patients really go to the hospital for a comfortable and dignified death. Similar to the end stages of cancer, doctors can do little for patients in the advanced stages of AIDS except try to lessen the pain with morphine.

The unavailability of funds is not the reason why morphine is so scarce in African. The cost of morphine is actually very low, costing only a few cents per dose. With all the aid pouring into Africa for people suffering with AIDS, some of that money could be used to procure the morphine needed for palliative care. Yet there are extreme morphine shortages occurring in Africa. The unavailability of palliative care may be due to attitudes in African culture. Many Africans are unaware that the pain associated with severe diseases can be lessened. East African governments have also been reluctant to allow widespread use of morphine, because of the addictive nature of the drug. Because of its nature, even healthcare professionals are weary of administering morphine. Many African doctors feel that administering the drug is synonymous with giving up hope of recovery.

Last spring Tanzania went through a two month morphine shortage that left thousands of patients, many suffering from cancer and AIDS, without their much needed painkillers. Healthcare facilities in Kenya are currently out of the drug and have been waiting for new supplies for about two months. The dark reality of the scarcity of morphine is that many patients with excruciatingly painful diseases are forced to die without any type of pain relief.

1. Are there any effective ways to change Africans’ attitudes about morphine?
2. What should be done in order to prevent morphine shortages in African countries? What are some ways to assure a more even distribution of morphine around the world?