Context

• In India, millions of individuals endure unnecessary physical and emotional suffering, often in the final stages of life, due to limited access to palliative care.
• Despite its essential role in alleviating pain and enhancing the quality of life for patients with terminal or chronic conditions, palliative care remains critically underfunded and underutilised.
• As India’s burden of non-communicable diseases rises and health-care systems are increasingly strained, integrating palliative care into mainstream health policy and practice has become not only necessary but urgent.

The Significance of Palliative Care

• Palliative care is a specialised medical approach that addresses the physical, emotional, social, and spiritual needs of individuals facing serious illnesses.
• Unlike curative treatments that aim to eradicate disease, palliative care focuses on improving patient comfort, reducing suffering, and ensuring dignity at every stage of illness, including at the end of life.
• According to the World Health Organization (WHO), around 40 million people worldwide require palliative care annually, with 78% residing in low- and middle-income countries.
• However, only 14% of those in need receive such support.
• In India, where between seven to ten million people require palliative care each year, only 1%–2% actually have access to it, a stark indicator of the system’s limitations.

Systemic Challenges in India

• Implementation Challenges
  • The growing incidence of non-communicable diseases such as cancer, diabetes, and chronic respiratory conditions further accentuates the demand for palliative care.
  • However, India’s health-care infrastructure faces multiple challenges in meeting this need.
  • While the National Health Policy of 2017 acknowledged the importance of palliative care, actual implementation has remained patchy and uneven, especially in rural and economically disadvantaged regions.
• Lack of Trained Professionals.
  • Though India boasts a doctor-population ratio of 1:834, better than the WHO norm of 1:1000, the number of medical professionals trained specifically in palliative care is disproportionately low.
  • Most medical practitioners receive minimal training in pain management or end-of-life care, resulting in inconsistent service delivery.
• Funding Constraints
  • Furthermore, inadequate funding and infrastructural gaps impede the expansion of palliative care services.
  • While palliative care has found limited inclusion in primary health care, it remains largely absent from tertiary care systems.
• Public Awareness: Misconceptions persist, and many patients seek palliative care only in the terminal stages of illness, by which time meaningful intervention is often no longer possible.

The Way Forward to Overcome These Challenges

• Enhancing the Role of Medical Education and Allied Health Workers
  • To bridge these systemic gaps, a foundational shift in medical education is needed.
  • Integrating palliative care into the MBBS curriculum would equip future doctors with both the clinical skills and the compassionate mindset necessary for delivering high-quality end-of-life care.
  • Institutions such as the Indian Council of Medical Research and the All-India Institute of Medical Sciences have initiated projects aimed at promoting pain and palliative care, indicating slow but steady progress in this direction.
  • Additionally, task-shifting, the delegation of certain responsibilities to trained non-physician health workers, offers a viable solution to India’s shortage of palliative care specialists.
  • With a sizable workforce comprising over 34 lakh registered nurses and 13 lakh allied health professionals, India has the human resource potential to significantly expand access to palliative services.
  • Targeted training and empowerment of this workforce can play a crucial role in delivering holistic, community-based care.
• Policy Reforms and Financial Accessibility
  • For sustainable impact, policymakers must prioritise long-term investments in palliative care infrastructure and training.
  • Insurance schemes like Ayushman Bharat should expand their coverage to include palliative services, making them more financially accessible.
  • Dedicated funding for public and private facilities to build palliative care units is equally important.
  • Partnerships with non-governmental organisations and private institutions can accelerate the reach and quality of care.
  • Learning from global best practices, such as the United States' well-funded and insurance-backed hospice care system, India can design cost-effective models that ensure both dignity and efficiency, tailored to its socio-economic context.
• The Need for Public Awareness
  • Many people remain unaware that palliative care is not limited to end-of-life scenarios but includes pain relief, psychological support, and enhanced quality of life at all stages of a serious illness.
  • Public education campaigns can help dispel myths, encourage early intervention, and foster community support for patients and caregivers.

Conclusion

• The integration of palliative care into India’s health-care framework is no longer optional, it is a moral, medical, and social imperative.
• A multi-pronged approach involving policy reforms, curriculum redesign, task-shifting, infrastructure investment, and public education is essential to ensuring equitable access to palliative care for all.
• Such efforts will not only improve patient outcomes but also reduce the broader economic and emotional burdens on families and the health-care system.