This project is the follow up of a first survery carried out in the European Region as a collaboration of the European Society for Medical Oncology (ESMO) and the EAPC, which was published in Annals of Oncology.

The under-treatment of cancer pain has been identified as a major international public health crisis. This is particularly so in many of the developing economies of the world and in many parts of the under developed world. Despite efforts by many international organizations to address this problem, and some limited successes in isolated countries, in the big picture relatively little headway has been made.

Public health initiatives to address this problem are required but on a global and local scale. To be effective, public health initiatives must have a valid and reliable data as to what are the factors contributing to this health care dilemma. To date, collection of this data has been sporadic and not systematic. This lack of specific information may be one of the factors that have hampered progress to date.

All of the partners understand the value of this study as the only international one with data of this kind. The data will have major health implications for cancer patients around the world.

The partners see themselves as having and international mission and commitment to improving the fate of cancer patients with pain. Many partner organizations have a proven track record of data collection from the diverse geographic locations, data verification and collation, and report presentation. The partner organizations have experience in teaming with other potential collaborative partners in projects of this kind. This is the largest international collaboration program led by ESMO in any field and underscores the society’s commitment to supportive and palliative care on a global level as one of its major interests in an international setting.We see this as a project of major international significance that will both garner necessary data and mobilize a wide range of important collaborative partners to help address the issue of identifying and rectifying barriers to the availability of medication for the management of cancer pain in the developing world.

The goal of this high profile project is to obtain reliable data regarding the availability and barriers to accessibility of opioids to cancer patients in Africa, Asia, the Middle East, Latin America. A survey questionnaire will benchmark current standards against international standards set by WHO / International Narcotics Board, which implement and control UN drug conventions. The survey results will provide a critical resource for local, regional and international bodies addressing this vital human rights and public health issue of a person’s right to effective pain management.

It is hoped that the clear elucidation of barriers to accessibility will facilitate effective lobbying and policy development to address the necessary regulatory reform required to improve the availability and accessibility of opioids for the management of severe cancer pain.

1. To evaluate the formal availability and cost to the consumer of the range of opioid drugs used in the management of cancer

2. To evaluate the regulatory barriers to the accessibility of opioid drugs for patients with cancer pain in each participating country

The survey results will be submitted first to Annals of Oncology for publication. Presentations about the survey and its results will be given at the EAPC Research Congress in Trondheim 2012, at the ESMO Congress 2012 and the EAPC Congress 2013. 

All partners will be invited to peer review individual country reports, which they will be encouraged to present at international, regional and national meetings and to publish in local scientific journals.

The publication in Annals of Oncology, the regional and individual country reports, and the session at the  Congresses are the main deliverables in this project.