Chronic pain in developing countries

By Steve Dechan

The epidemic of chronic pain in western countries is a well-documented issue. According to NICE, between a third and a half of the UK population were suffering with chronic pain in 2018.(1) However, while the issue of chronic pain is not being dealt with appropriately in the western countries, in the developing world, it does not get anywhere near as much coverage or preventative action.

Research conducted by Mark Johnson, Raga Elzahaf and Osama Tashani in 2013, revealed that in the countries classed as ‘developing’ by the Human Development Index (HDI), 33.9% of adults are impacted by chronic pain.(2)

The Human Development Index was developed during the 1980s in order to challenge the traditional economic conceptions of development. The Index rates countries from 0 to 1 and is calculated by averaging three scores reflecting health, education and living standards. A country with a HDI score below 0.9 is typically classed as developing.

Developing countries lag not only in terms of access to quality health care, but also in terms of access to quality pain relief-focused education. Even though developing countries have the highest proportion of people suffering from chronic pain globally, healthcare practitioners in these countries still face barriers to proper education and therefore, proper treatments.

Attempts have been made to mitigate this lack of access, particularly with initiatives such as scholarships, free online educational resources and low/no subscription fees for professionals from developing nations to attend international meetings. However, effective interventions are yet to be realised.

The International Association for the Study of Pain (IASP) brings together scientists, clinicians, health-care providers and policymakers to stimulate and support the study of pain and translate that knowledge into improved pain relief worldwide.(3) However, only 12% of the organisation’s membership are residents in Africa, Latin American, and the Middle East.

Discussions around care and treatment for chronic pain in developing countries are hard to separate from the social, cultural, and economic barriers faced by patients in these countries. Efforts have been made by different pain societies, groups, governmental and non-governmental associations to improve pain-related education and management in these areas for both clinicians and patients. The current situation is certainly better than it was in years past, however, the potential for further improvement should not be understated.(4)