pain relief for all ~ WE can do this!

We intend this page to be in continuous evolution:  Please remember that reliable access to opioid analgesics to control moderate to severe pain is a fundamental human right.    In western countries, comprising about 20% of the planet's population, we consume greater than 90% of the licit supply of opioid analgesics regulated by the International Narcotics Control Board.   Yet developing countries, comprising about 80% of the planet's population, consumes <10%.  There is a great gap that exists with respect to availability and accessibility to opioid analgesics in developing countries.  Learn more about this gap at Treat the Pain. 


Oral Morphine solution is considered by the W.H.O. and the Republic of Rwanda, to be an essential medicine, meaning it is safe when used as directed, effective in reliving moderate to severe pain in about 96% of people, and affordable. 


With the authorization and support of the prior minister of health in Rwanda, HWB has been supporting the production of this essential medicine in collaboration with the Rwanda Biomedical Center (RBC) since 2014.  


Presently there are about 15kg of morphine HCl powder in the country that the Ministry of Health purchased. This amount of morphine powder represents capacity for up to 43,000, 250ml bottles.   In the effort to promote long-term sustainability, this year HWB sent the Quality and Pharmacy team from RMS, Ltd. to Uganda to meet with our colleagues at APCA, Hospice Africa Uganda, and 3 bottle manufacturers.   


The team identified a supplier meeting their quality standards, and in a gesture of solidarity, HWB just purchased of  40,000 of these bottles, each with a measuring cup that fits to the bottle to improve dosing accuracy and patient safety.  


We are also working with the government to provide support to defining the quantitative method for production and insuring purity of the finished Morphine HCl product.   We previously did this with Morphine Sulfate.   This work is all aimed at improving safety and consistency and ongoing accessibility to opioid analgesices for the Rwandan people: including clinicians and patients. 


Each 250ml bottle produced will last the average cancer patient about 8-30 days depending upon their usage pattern.  It is stable at room temperature for up to 1 year. 


Remember that the goals of pain control are to help people sleep better at night, eat better because pain is controlled, and be more active during the day while both resting and during activity.   


Please do all you can to dispel 'opiophobia,' and learn about the pain treatment gap that exists between developed and developing countries.  Recognize that responsible and clinically indicated prescribing of opioids is dignity preserving, and remember most of all, that access to pain control is a Fundamental Human Right


"Please, do not make us suffer anymore." Human Rights Watch
Definitive paper that explores the gap in access to adequate pain treatment in developing countries, and invites us to think of appropriate access to pain control as a fundamental human right.
Adobe Acrobat Document 431.4 KB