The Supreme Court has, in the past, clearly stated that palliative care is a part of the right to health and, thus, life. Unfortunately, as a country with an *ageing population and a growing burden of non-communicable diseases, India is struggling to provide such care. The first nationwide palliative care need assessment* has found that 12.2% of people above the age of 60 require such assistance. Geography and even religion, it was discovered, impacted a patient’s need for palliative care. For instance, about 17% of the elderly in West Bengal require palliative care owing to ailments like chronic pulmonary diseases, stroke and cancer. This is not surprising as Bengal has a high incidence of COPD* and stroke. There is thus a case for co-relating the data revealed by the palliative care study with existing research on the incidence of disease so that a policy roadmap can be prepared and resources allocated according to a region’s specific needs. What is concerning, though, is the finding of yet another study* earlier this year which had shown that only 4% of Indians have access to palliative care. It had also highlighted that palliative care is almost non-existent at the grassroots owing to a lack of trained personnel, restricted access to opioids for pain control, and a refusal to accept the finality of an incurable illness. Moreover, palliative care requires an interdisciplinary team of healthcare professionals who are sensitive. This is hard to come by even in cities, let alone in remote villages where even* primary healthcare centres do not have adequate staff.
In sharp contrast to the rest of India, Kerala’s palliative care model is a global exemplar. As per a 2018 Lancet report, Kerala has a network of over 841 of India’s 908 palliative care institutions — one of the largest networks in the world — that cuts across economic, religious, caste and gender divisions. The affordability of palliative care in Kerala is something to be taken note of. This is because palliative care can be prohibitively expensive because unlike life-saving medications that have price caps placed by the government, the equipment needed to make a patient comfortable — oxygen machines and pipes for COPD, adult diapers, catheters and so on — are* costly and needs* to be replaced often. It must be borne in mind that providing palliative care includes supporting the families of patients. This aspect of palliative care provision must not be overlooked by future policy frameworks.
