Pain relieving drugs in 12 African PEPfAR countries: mapping current providers, identifying current challenges and enabling expansion of pain control provision in the management of HIV/AIDS

This report from the African Palliative Care Association (APCA) identifies a number of problems with the delivery of pain-relief drugs to people with HIV and AIDS receiving palliative care in Africa. The survey was conducted among palliative care organisations and the medicine regulatory bodies in 12 African countries. It found that the key problems were inadequate and unreliable supplies of drugs, restrictive legislation, poor levels of education and training about prescribing such drugs among clinical staff, and practical problems such as high costs and inadequate storage facilities. The key challenges to overcoming these problems were identified as a lack of political will, the need for education and cultural change among medical practitioners and a lack of resources.

The report recommends that where access to pain-relief drugs is currently poor networks should be established between hospices and government providers. Palliative care providers should also work with sites delivering antiretroviral therapy (ART) to ensure that palliative care patients always have access to ART. It also recommends improved training on the use of pain-relief drugs for all new and existing clinical staff, along with educational efforts to address public fears about such drugs. The report recommends that funders and policymakers address the various practical and legal obstacles that are currently restricting the delivery of pain-relief drugs.