The WHO essential medicines list has been revised.
Transdermal fentanyl (about 150 times the cost of ordinary morphine tablets in India) and sustained release morphine (several times the cost of immediate release poor man’s morphine) now find a place in the list. Already the situation was bad enough. Not only in India, but through much of the low-income world, hospitals and pharmacies were being persuaded to stock only the expensive medicines and doctors were informed systematically only about them.
Now things are sure to get worse – for the 80%; for the voiceless. Decision makers will be persuaded steadily, steadily, to spend the scarce resources on the expensive medicines. Instead of getting low-cost morphine for as long as needed, people of our countries will now get a patch of fentanyl – once? twice? And then they will be plunged back into their sea of pain.
Our Morphine Manifesto which has been buried alive, must be turning in its grave.