Hyderabad: The World Health Organisation (WHO) considers medical morphine as the gold standard to combat pain, which is essential to provide end-of-life care for patients struggling with life threatening ailments such as HIV/AIDS and cancer.
Despite its recognition as a proven drug, access to medical morphine continues to remain a challenge for patients from the two Telugu speaking States. Roughly, there are two lakh cancer patients in Telangana and Andhra Pradesh of which an estimated 1.5 lakh cancer patients need medical morphine. However, at present, every year 13,000 patients from TS, AP, a few patients from border towns of Maharashtra and even Odisha have access to it at MNJ Institute of Cancer Research in Hyderabad.
It’s widely accepted among cancer experts that pain relief and palliative care have been poorly integrated into health care systems in the State and elsewhere. “Over the years, the acceptance levels towards medical morphine and pain relief have improved in Telangana. It’s just a matter of taking the next step and making medical morphine also available in the districts,” said Dr Gayatri Palat, founder, Palliative Care and Pain Relief Society, MNJ Cancer Hospital.
MNJ Cancer Hospital is the only anointed regional cancer centre in TS that has permissions to stock medical morphine. There are regulatory issues such as obtaining permissions from multiple agencies to stock medical morphine, which makes availability tougher.
So, patients from districts have to visit MNJ Hospital frequently to access medical morphine, which is prescribed and given free of cost. Even for patients from AP, the hospital is the only regional centre, which means patients from places such as Srikakulam visit MNJ Cancer Hospital for medical morphine.
“There is also the issue of awareness about pain relief and palliative care in India. Over the years, thanks to advocacy by WHO and many others, there is a gradual improvement in awareness about medical morphine among doctors and patients,” said Dr Gayatri.
Lack of trained professionals to prescribe and administer medical morphine also has hindered morphine availability. Almost all the palliative care experts operate in and around Hyderabad and medical morphine should be prescribed only by an expert, which makes it difficult for terminally ill patients to access.
Can palliative care end shortage of morphine?
Recognising the challenges in accessing medical morphine and implementation of palliative care programmes, the Centre had recently launched National Programme for Palliative Care (NPPC) to enable State governments to start palliative care centres in the districts.
The objective of NPPC is to work with State governments to make accessibility of rational, quality pain relief and palliative care to the needy, especially those in the districts. It also envisages smooth integration of palliative care in the existing health care systems.
Under the NPPC programme, the Centre will offer close to Rs 50 lakh per year to maintain infrastructure, provide training to staff, physician and nurses to implement palliative care programmes at each district.
NPPC also has a provision to spend close to Rs 10 lakh for year to maintain a State palliative Care unit with a co-ordinator, data entry operator and other office expenses. According to the guidelines of NPPC, 60 per cent of the share will be provided by Centre while the rest has to be met by the State governments.
The State government is coming with a framework under NPPC to set up such palliative care centres in all districts of Telangana.