An uneven map: more than 70% of specialized palliative care services in Asia-Pacific are concentrated in less than 15% of the countries and areas in the region.

More than 70% of specialized palliative care services in Asia-Pacific are concentrated in less than 15% of the countries and areas that make up the region: Australia, Malaysia, Japan, South Korea, Thailand and New Zealand. This is revealed in the Asia-Pacific Palliative Care Atlas 2025the first study on the status of palliative care in 41 countries and areas in the region, sponsored by the Global Observatory of Palliative Care ATLANTES Global Observatory of Palliative Careof the Institute for Culture and Society (ICS) of the University of Navarra, in partnership with the Asia Pacific Hospice Palliative Care association International (the Asia Pacific Hospice Palliative Care NetworkAPHN). The Atlas, which can be consulted online or purchased in print through Amazon, has followed the indicators established by the World Health Organization (WHO), of which it is a partner center.

This Thursday, at the Regional Palliative Carecongress (16th Asia Pacific Hospice Palliative Conference 2025), held in Kuching (Malaysia), this pioneering research was presented, which offers a complete x-ray of palliative care in the regions of Asia and Oceania, where 4.3 billion people live. The results paint a profoundly unequal picture. While some countries and territories are world leaders in the development palliative care, such as Australia and Hong Kong SAR (China), access remains very limited in most countries.

Although the region has the highest proportion of people in need of palliative care in the world (25 million people), the vast majority do not receive it. Children in need of palliative care in the region represent 27.2% of the global need (7.7% in the Western Pacific and 19.5% in Southeast Asia).

agreement to the Atlas, only 24.4% of countries and territories in the Asia-Pacific area have widespread or integrated palliative care service provision in the healthcare system, including Australia, Hong Kong SAR (China), Japan, Malaysia, Mongolia, New Zealand, Singapore, South Korea and Thailand. The latter country is positioned as a leader in the successful integration of palliative care into its healthcare system, backed by strong regulation and coordination networks that ensure accessible, quality services that help improve the quality of life of patients suffering from serious illnesses.

In addition, access to opioids to combat pain for people suffering from serious illnesses in the region remains limited and unequal. This gap is not only observed between countries, but also large disparities between rural and urban areas. The data show that 75% of the territories in the region do not have oral morphine for the treatment of pain in their primary care centers. Furthermore, only four (Australia, Hong Kong SAR, Japan and New Zealand) have access to opioids in 70-100% of rural areas.

Strict opioid control laws, poor prescriber safety and the exclusion of opioids from essential drug lists also restrict access in countries such as Malaysia, Indonesia, India and the Philippines.

Progress and challenges

This status contrasts with important advances developed in these countries (Malaysia, Indonesia and the Philippines), which stand out for the development of advanced palliative care policies and improvements in access to these services. However, they still face difficulties in the implementation of such policies and challenges in the provision of services.

Likewise, while countries such as New Zealand and South Korea are leaders in research and promotion of scientific meetings on palliative care, which contribute greatly to development and awareness, Pacific Island nations such as Kiribati, Micronesia and Nauru suffer from a lack of research structure and academic participation. Along these lines, while Education in this field is well developed in countries such as Australia and Japan, with programs integrated into medical training , others such as Bhutan, Brunei and island countries lack formal Education in this field.

However, there is an important effort to promote and consolidate training processes and programs. One example is the case of Thailand and the Asia Pacific Hospice Palliative Care Network association which collaborate in training programs and promote initiatives to improve access and Education in the region.

Japan and South Korea, which have achieved high levels of specialization in palliative care, are working for its expansion and integration into primary care. Another outstanding example is the case of China, which has achieved its expansion with the promotion of 2287 regional and provincial services and initiatives, although the distribution of services is still uneven, with a greater concentration of resources in urban areas.

The Asia-Pacific Atlas of Palliative Care begins aseries of five publicationsto be released throughout 2025 that will provide, for the first time, a global map of palliative care. The European and African editions will be released this spring, followed by the North American, Caribbean and South American and Eastern Mediterranean editions in the fall.