About one million people in Pakistan need palliative care each year, yet only 15,000 to 30,000 receive these essential pain relief services. Health experts point to shortages of trained staff and barriers to accessing pain medicines as the main reasons for the gap in palliative care.
To address these issues, the Drug Regulatory Authority of Pakistan (DRAP) has unveiled plans for a new online digital procurement system to simplify procedures and improve hospital access to controlled opioid medicines. The initiative was announced during a meeting at the Health Services Academy on controlled drugs regulations and palliative care, where DRAP deputy director Muhammad Ansar said practical steps are being taken to relieve suffering for patients with life‑threatening conditions.
The new system will reduce paperwork and shorten approval times from more than four months to roughly two to four weeks. DRAP will pilot the digital platform in Islamabad before rolling it out nationwide based on lessons learned from the trial.
Officials also said registration is being granted for oral morphine syrup to treat severe pain in children, and preparations are underway to import modern pain medicines such as fentanyl and buprenorphine patches that are widely used in palliative care globally. Tramadol will soon be added to the list of controlled drugs and supplied only on prescription, with stricter oversight of its raw materials to prevent misuse while ensuring availability for genuine patients.
Professor Shahzad Ali Khan of the Health Services Academy warned that palliative care is a vital but neglected part of Pakistan’s health system. He said an excessive focus on curative treatment forces many patients to endure unnecessary pain and that improving access to pain medicines, training health workers, and correcting misconceptions about opioids are urgent priorities.
Dr Samia Latif, representing a UK public health faculty interest group, stressed that palliative care aims to improve the quality of life for patients and their families by addressing physical, mental, social and spiritual distress. She cautioned that many doctors and families still associate palliative care or opioid use with imminent death, leading to delays in referral and needless suffering.
Dr Wasim Gul highlighted Pakistan’s lag in opioid availability compared with regional neighbours and developed countries. He noted Pakistan’s annual morphine quota is about 20 kilograms, and actual consumption has not exceeded about 7 kilograms in recent years, showing the problem lies in systemic restrictions rather than patient need.
Kamran Niaz of the UN Office on Drugs and Crime said international drug control treaties are intended to safeguard medical availability of controlled medicines, but overly strict national regulations have created a significant treatment gap. DRAP presented new digital software during the meeting that will allow hospitals to apply for increased controlled‑drug quotas. After training hospitals in Islamabad, a formal launch is planned for January 2026, with the goal of expanding the system across Pakistan to strengthen palliative care access.
