World Health Organization 20, Avenue Appia

67
A WHO guide for planners, implementers and managers
Annex 4
Sixty-seventh World Health Assembly resolution WHA67.19 on Strengthening 
of palliative care as a component of comprehensive care throughout the life 
course 
24 May 2014
The Sixty-seventh World Health Assembly, 
Having considered the report on strengthening of palliative care as a component of integrated treatment 
throughout the life course;
1
Recalling resolution WHA58.22 on cancer prevention and control, especially as it relates to palliative care; 
Taking into account the United Nations Economic and Social Council’s Commission on Narcotic Drugs’ 
resolutions 53/4 and 54/6 respectively on promoting adequate availability of internationally controlled 
licit drugs for medical and scientific purposes while preventing their diversion and abuse, and promoting 
adequate availability of internationally controlled narcotic drugs and psychotropic substances for medical 
and scientific purposes while preventing their diversion and abuse; 
Acknowledging the special report of the International Narcotics Control Board on the availability of 
internationally controlled drugs: ensuring adequate access for medical and scientific purposes,
2
and the 
WHO guidance on ensuring balance in national policies on controlled substances: guidance for availability 
and accessibility of controlled medicines;
3
Also taking into account resolution 2005/25 of the United Nations Economic and Social Council on 
treatment of pain using opioid analgesics; 
Bearing in mind that palliative care is an approach that improves the quality of life of patients (adults and 
children) and their families who are facing the problems associated with life-threatening illness, through 
the prevention and relief of suffering by means of early identification and correct assessment and treatment 
of pain and other problems, whether physical, psychosocial or spiritual; 
Recognizing that palliative care, when indicated, is fundamental to improving the quality of life, well-being, 
comfort and human dignity for individuals, being an effective person-centred health service that values 
patients’ need to receive adequate, personally and culturally sensitive information on their health status, 
and their central role in making decisions about the treatment received; 
Affirming that access to palliative care and to essential medicines for medical and scientific purposes 
manufactured from controlled substances, including opioid analgesics such as morphine, in line with the 
three United Nations international drug control conventions,
4
contributes to the realization of the right to 
the enjoyment of the highest attainable standard of health and well-being; 
Acknowledging that palliative care is an ethical responsibility of health systems, and that it is the ethical 
duty of health care professionals to alleviate pain and suffering, whether physical, psychosocial or spiritual, 
irrespective of whether the disease or condition can be cured, and that end-of-life care for individuals is 
among the critical components of palliative care; 
1
Document 67/31.
2
Document E/INCB/2010/1/Supp.1.
3
Ensuring balance in national policies on controlled substances: guidance for availability and accessibility of controlled medicines. Geneva: World 
Health Organization; 2011.
4
United Nations Single Convention on Narcotic Drugs, 1961, as amended by the 1972 Protocol; United Nations Convention on Psychotropic Substances, 
1971; United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988.

---

Integrating palliative care and symptom relief into primary health care
68
Recognizing that more than 40 million people currently require palliative care every year, foreseeing the 
increased need for palliative care with ageing populations and the rise of noncommunicable and other 
chronic diseases worldwide, considering the importance of palliative care for children, and, in respect of 
this, acknowledging that Member States should have estimates of the quantities of the internationally 
controlled medicines needed, including medicines in paediatric formulations; 
Realizing the urgent need to include palliation across the continuum of care, especially at the primary care 
level, recognizing that inadequate integration of palliative care into health and social care systems is a 
major contributing factor to the lack of equitable access to such care; 
Noting that the availability and appropriate use of internationally controlled medicines for medical and 
scientific purposes, particularly for the relief of pain and suffering, remains insufficient in many countries, 
and highlighting the need for Member States, with the support of the WHO Secretariat, the United Nations 
Office on Drugs and Crime and the International Narcotics Control Board, to ensure that efforts to prevent 
the diversion of narcotic drugs and psychotropic substances under international control pursuant to the 
United Nations international drug control conventions do not result in inappropriate regulatory barriers to 
medical access to such medicines; 
Taking into account that the avoidable suffering of treatable symptoms is perpetuated by the lack of 
knowledge of palliative care, and highlighting the need for continuing education and adequate training for 
all hospital- and community-based health care providers and other caregivers, including nongovernmental 
organization workers and family members; 
Recognizing the existence of diverse cost-effective and efficient palliative care models, acknowledging 
that palliative care uses an interdisciplinary approach to address the needs of patients and their families, 
and noting that the delivery of quality palliative care is most likely to be realized where strong networks 
exist between professional palliative care providers, support care providers (including spiritual support and 
counselling, as needed), volunteers and affected families, as well as between the community and providers 
of care for acute illness and the elderly; 
Recognizing the need for palliative care across disease groups (noncommunicable diseases, and infectious 
diseases, including HIV and multidrug-resistant tuberculosis), and across all age groups; 
Welcoming the inclusion of palliative care in the definition of universal health coverage and emphasizing 
the need for health services to provide integrated palliative care in an equitable manner in order to address 
the needs of patients in the context of universal health coverage; 
Recognizing the need for adequate funding mechanisms for palliative care programmes, including for 
medicines and medical products, especially in developing countries; 
Welcoming the inclusion of palliative care actions and indicators in the WHO comprehensive global 
monitoring framework for the prevention and control of noncommunicable diseases and in the global 
action plan for the prevention and control of noncommunicable diseases 2013–2020; 
Noting with appreciation the inclusion of medicines needed for pain and symptom control in palliative 
care settings in the 18th WHO Model List of Essential Medicines and the 4th WHO Model List of Essential 
Medicines for Children, and commending the efforts of WHO collaborating centres on pain and palliative 
care to improve access to palliative care; 
Noting with appreciation the efforts of nongovernmental organizations and civil society in continuing 
to highlight the importance of palliative care, including adequate availability and appropriate use of 
internationally controlled substances for medical and scientific purposes, as set out in the United Nations 
international drug control conventions; 

---

69
A WHO guide for planners, implementers and managers
Recognizing the limited availability of palliative care services in much of the world and the great avoidable 
suffering for millions of patients and their families, and emphasizing the need to create or strengthen, 
as appropriate, health systems that include palliative care as an integral component of the treatment of 
people within the continuum of care,