Challenges and Future Directions of Palliative Care Globally

The unprecedented global development of palliative care over the past 50 years, originating as a counterculture movement and evolving into an integrated healthcare system, has enabled many more of the world’s population to access high-quality palliative care. However, as observed during the COVID-19 pandemic, access to palliative care globally is not evenly distributed. Too many of the world’s population died alone, separated from their families. People in hospitals often die receiving acute clinical care, while others are receiving too little care. The need for palliative care in low- and middle-income countries such as sub-Saharan Africa, where communicable diseases such as HIV/AIDS, tuberculosis, and malaria contribute to expected deaths for many people, continues to be challenging to provide. Increasingly, people living in high-income countries, such as Europe, North America, Australia, and parts of Asia, are now dying at an older age of or with one or more noncommunicable diseases. These new dying patterns have implications for the configuration of international, national, and local palliative care policies, healthcare systems, models of care, primary and specialist engagement, workforce education, and future research directions. This chapter will describe the current and future challenges to palliative care development in low-, middle-, and high-income countries and the opportunities offered by adopting a public health approach and novel technologies, such as remote monitoring, and better engaging communities to increase global palliative care access.