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EAPC
European Association of Palliative Care
EP PHC
Essential Package of Palliative Care for Primary Health Care
HIC
high-income country
HIV
human immunodeficiency virus
IAHPC
International Association for Hospice and Palliative Care
INCB
International Narcotics Control Board
LMICs
low- and middle-income countries
NCD
noncommunicable disease
NGO
nongovernmental organization
PHC
primary health care
SSRI
selective serotonin reuptake inhibitor
UHC
universal health coverage
UN
United Nations
UNICEF
United Nations Children’s Fund
WHA
World Health Assembly
WHO
World Health Organization

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1
A WHO guide for planners, implementers and managers
Introduction
 
Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health 
care (
1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care 
and symptom relief in low- and middle-income countries (LMICs) 
(1). Yet basic palliative care that can 
prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily 
to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines 
and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is “an 
ethical responsibility of health systems”
(2). Further, most patients who need palliative care are at home 
and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of 
primary care (Annex 1). This document was written to assist ministries of health and health care planners, 
implementers and managers to integrate palliative care and symptom control into primary health care 
(PHC).
This second in a series of World Health Organization (WHO) guides on palliative care follows a general one 
entitled Planning and implementing palliative care services: a guide for programme managers, published 
in 2016 
(3). The current document may be used by itself for integrating palliative care into primary care or 
in combination with the earlier guide by those working to integrate palliative care into multiple levels of a 
health care system.
This document is not a clinical manual, and does not provide clinical guidelines. Rather, it contains 
detailed information about what palliative care is and should be, the rationale for it being a medical and 
moral imperative, an Essential Package of Palliative Care for Primary Health Care (EP PHC) and a method 
for implementing palliative care within primary care in a way that strengthens health care systems 
(Annex 2). It represents the collective knowledge, experience and recommendations of a group of experienced 
palliative care clinicians, all of whom either are also primary care clinicians or work in LMICs, or both. 

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ix
A WHO guide for planners, implementers and managers

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