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Latin America has 1,562 palliative care services, 2.6 per million inhabitants: the number does not meet the needs of the population.

17 countries are reviewed in the Atlas of Palliative Care in Latin America, led by the association Latin American Palliative Care, the association International Hospices and Palliative Care and the University of Navarra.


FotoManuelCastells/
Members of the ICS Global Palliative Care Observatory who have led the Atlas on behalf of the University. From left to right: Eduardo Garralda, Carlos Centeno, Danny Van Steijn and Miguel Sánchez Cárdenas.

29 | 03 | 2021

Latin America has 1,562 palliative care services, 2.6 per million inhabitants: a figure that does not cover the needs of the population. These data are from the Atlas of Palliative Care in Latin America 2020, prepared by the Latin Amer ican Palliative Care association , theassociation International Hospices and Palliative Care and the Global Palliative Care Observatory of the University of Navarra, which belongs to the group of research ATLANTES of the Institute for Culture and Society (ICS).

This work is part of one of the focuses of research of the 2025 strategy of the University of Navarra, "Palliative Medicine", within "Personalized Medicine". It provides information from 17 Spanish and Portuguese-speaking Latin American countries, inhabited by more than 630 million people. It provides a systematic review of development of this care with the aim of promoting it throughout the region. 

The countries with the highest rate of palliative care teams per million inhabitants are Uruguay (24.5), Costa Rica (14.74) and Chile (13.41). At the bottom are Guatemala, Honduras (both with 0.64) and Peru (0.58). Of these services, 1,173 are integrated into hospitals. Bolivia (0.89) and Ecuador (0.83) have the highest rate of these resources. In El Salvador and the Dominican Republic, none have been recorded. 

As for pediatric palliative care, 123 teams have been detected, representing 7.9% of the reported services. The countries with the highest rate per million population under 15 years of age are Uruguay (19.3) and Argentina (5.25). In Paraguay and Venezuela, no teams have been identified. 

Another indicator analyzed is the distribution of potent opium-derived drugs for pain relief. Brazil (1,385 kg), Argentina (762.7 kg) and Colombia (556.1) top the list. The nations with the best partnership between those who prescribe these analgesics and those who regulate their use are El Salvador and Uruguay. Brazil, Guatemala, Honduras, Paraguay and Venezuela have the worst partnership.

training of physicians and promotion of specific laws
The training of physicians constitutes another factor core topic to promote discipline, from agreement with the Atlas. Eight countries recognize Palliative Medicine as specialization program and/or subspecialty: Argentina, Brazil, Colombia, Costa Rica, Ecuador, Mexico, Paraguay and Venezuela. Chile is in the process.

Likewise, the promotion of specific laws is a fundamental indicator for observing the development of the specialization program. According to this study, Colombia, Costa Rica, Chile, Mexico and Peru currently have a palliative care law. Mexico, El Salvador, Costa Rica, Panama, Venezuela, Ecuador, Brazil, Uruguay, Argentina and Chile have reported a national palliative care plan or strategy, some explicitly for cancer patients. However, their scope and whether they have the appropriate budget for implementation is unknown. 

The Lancet Commission on Global Access to Palliative Care and Pain Relief estimates that 3.5 million Latin Americans live each year with suffering from a serious illness. The World Health Organization (WHO) predicts that the global need for palliative care will continue to increase as a consequence of the growing burden of non-communicable diseases (cancer, cardiovascular pathologies...) and the aging process of the population.

Some data of the Atlas

 

Palliative care teams

Palliative care teams (in-hospital only)

Pediatric palliative care teams

 

Total

Rate per million inhabitants

Total

Rate per million inhabitants

Total

Rate per million inhabitants under 15 years of age

Argentina

482

10,79

422

9,44

58

5,25

Bolivia

20

1,78

8

0,71

1

0,28

Brazil

198

0,94

68

0,32

14

0,31

Chile

244

13,41

12

0,66

8

2,19

Colombia

79

1,6

40

0,81

9

0,79

Costa Rica

73

14,74

1

0,2

3

2,83

Ecuador

78

4,63

42

2,49

1

0,21

El Salvador

25

3,9

21

3,28

1

0,58

Guatemala

11

0,64

5

0,29

1

0,17

Honduras

6

0,64

0

0

1

0,34

Mexico

120

0,92

41

0,31

6

0,17

Panama

55

13,21

10

2,4

3

2,66

Paraguay

24

3,48

3

0,43

0

0

Peru

19

0,58

11

0,34

2

0,23

Dominican Republic

16

1,47

6

0,55

1

0,32

Uruguay

85

24,5

9

2,59

14

19,31

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