Achieving the Promise 2025
World Hospice and Palliative Care 2025 Theme – Achieving the Promise: Universal Access to Palliative Care
I remember listening to Dr Luis Jose De Souza (fondly called Lucito D’Souza) describe how he came to establish the first palliative care centre in India in 1986 — Shanti Avedna Sadan in Mumbai.
One day Dr De Souza, a surgical oncologist at the famous Tata Memorial Cancer Hospital in Mumbai, discharged a man with an ugly, fungating wound – an illness no longer amenable to curative treatment. The man had no family to take him home. When Dr De Souza arrived at the hospital the next morning, he found the man lying on the pavement outside, rejected by the world, his wound uncovered and untreated. That painful sight gave birth to Shanti Avedna Sadan in 1986.
A quarter of a century later, another hospital, another city: A 16-year-old girl—a tsunami survivor—was turned away from the hospital and was found lying on the street. Her only family was a 14-year-old brother, away at sea on a fishing boat. With no home and no support, she faced a painful malignancy of the leg, alone and in agony. A kind Aayush doctor, seeing her suffering, took her to his consulting room and kept her there while he reached out to the palliative care community across the country. Volunteers and doctors came together: pain medicines were delivered, care was arranged, and she was eventually admitted to a home for the terminally ill where she lived for the last one week of her life. Although the home was a vegetarian place, they bent their rule and got her what she craved to eat – chicken! When she wanted to watch television, they moved the one in the hall to her room. She died before her brother could return, but her last days were filled with dignity, care, and love.
Was this a good story or a bad one? For the most part, it was heart-breaking. And yet, in the end, compassion made all the difference. This is the reality of palliative care in our country: from nothing in 1998, we now reach only about 4% of those in need, though often after days or months of suffering. Should we take satisfaction in this progress? Yes. But should we not also be deeply concerned about the 96% still left in pain and despair?
This year’s World Hospice and Palliative Care Day theme is “Achieving the Promise: Universal Access to Palliative Care”. Universal Health Coverage (UHC) with its vision of preventive, promotive, curative, rehabilitative, and palliative care, set 2030 as the goal. And yet here we are, in 2025, still far from that promise — especially in low and middle-income countries, where 85% of the world’s population lives.
Even if we cannot fully achieve the goal by 2030, we must get closer. We need to take stock: identify our strengths, acknowledge our weaknesses, seize opportunities, and systematically address barriers. Together, as a community of like-minded activists, we can make progress visible—and when that happens, our tribe will grow.
Dr. M R Rajagopal
Chairman Emeritus, Pallium India
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