Drug Availability
PACAM advocates for improved access to essential palliatve care drugs (especially opiates) through strong working partnerships with stakeholders including the government, Christian Health Association of Malawi (CHAM) and individuals.
Throughout the health sector, drug availability is a difficult issue and this is no different in palliative care. Liquid oral morphine (oral morphine solution) is a quick acting and relatively cheap preparation, it is available at selected sites across Malawi. There is limited understanding of the cost and suitability of opiate preparations, though morphine (either as oral morphine liquid or slow release tablets) has been available at limited sites since 2004. Laxative stock-outs have sometimes hampered best practice. Malawi in particular faces the problem of not having enough qualified prescribers of morphine, creating another barrier in delivering this medication to those who need it.
Both types of morphine have been used for the effective relief of severe pain for both adults and children both in hospital and the community. Skills and training are required in order to appropriately and safely prescribe morphine, monitor its effects, side effects, and be aware of other symptom control medications which are available and effective. Referral systems between hospital and community based programmes are essential to ensure that drugs necessary for relief of long term symptoms can be made available as necessary.
