Global effort to relieve chronic pain

Oct 11 2004

The World Health Organization (WHO) co-sponsors the first Global Day Against Pain, which seeks to draw global attention to the urgent need for better pain relief for sufferers from diseases such as cancer and AIDS.

The campaign, organised by the International Association on the Study of Pain (IASP) and the European Federation of the IASP Chapters (EFIC), asks for recognition that pain relief is integral to the right to the highest attainable level of physical and mental health.

WHO representatives will join global specialists in chronic pain management and relief at a conference in Geneva convened to highlight the Global Day Against Pain and to press for urgent action from governments across the world. The conference coincides with the release this month of the Council of Europe's newly formulated recommendations on palliative care including management of pain. The recommendations provide detailed guidance for setting up a national policy framework, and are available in 17 European languages.

"The majority of those suffering unrelieved pain are in low- and middle-income countries where there is a an increasing burden of chronic diseases such as cancer and AIDS," said Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. "Limited health resources should not be allowed to deny sick people and their families the dignity of access to pain relief and palliative care, which are integral to the right to enjoy good health. We strongly support the Global Day Against Pain and the efforts of IASP and EFIC."

New statistics released by IASP and EFIC indicate that one in five people suffer from moderate to severe chronic pain, and that one in three are unable or less able to maintain an independent lifestyle due to their pain. Between one-half and two-thirds of people with chronic pain are less able or unable to exercise, enjoy normal sleep, perform household chores, attend social activities, drive a car, walk or have sexual relations. The effect of pain means that one in four reports that relationships with family and friends are strained or broken, according to the IASP/EFIC data.

The statistics also reveal that pain is second only to fever as the most common symptom in ambulatory persons with HIV/AIDS. Pain in HIV/AIDS usually involves several sources at once. The causes include tissue injury from inflammation (including autoimmune responses), infection (e.g., bacterial, syphilitic or tubercular) or neoplasia (lymphoma or sarcoma): so-called nociceptive pain. Nearly half of pain in HIV/AIDS is neuropathic, reflecting injury to the nervous systems.

Oral morphine has proven to be a cost-effective pain medication for the treatment of moderate to severe pain when the underlying cause is cancer or HIV/AIDS. However, opioid analgesics are not adequately available, particularly in developing countries with limited resource settings, due to ignorance of their medical use, restrictive regulations and pricing issues.

“Pain relief should be a human right, whether people are suffering from cancer, HIV/AIDS or any other painful condition," said Professor Sir Michael Bond M.D., President of IASP. "Today’s Global Day Against Pain marks an immense growth in the interest in this area and today’s WHO co-sponsorship of our campaign shows that now is the time to take pain seriously.”

“Chronic pain is one of the most underestimated health care problems in the world today, causing major consequences for the quality of life of the sufferer and a major burden on the health care system in the Western world," said Professor Harald Breivik, President of EFIC. " We believe chronic pain is a disease in its own right. For people in developing countries, where pain relief is at its most minimal availability, the consequences of unrelieved pain are great.” Professor Breivik said the decision to hold a Global Day resulted from the success of the European Week Against Pain, launched by EFIC four years ago under the leadership of its Past President Professor David Niv.

http://www.who.int