E.P.E.C. India

The Education in Palliative and End-of-Life Care – India Project

EPEC-India now has it’s webpage on the EPEC website.
The link is: http://epec.net/EPEC/Webpages/epecindia.cfm


India is a developing country with a population of 1.136 billion (2007). While still being affected by communicable diseases, India is experiencing an epidemiological transition. The rapidly changing health and socio-economic status and lifestyle have led to non communicable diseases like cancer emerging more strongly in the morbidity and mortality pattern.

There are an estimated 2.5 million cases of cancer in India at any given time. Worse, yet, more than 70% of all cancers are found when the disease is so advanced that treatment for cure is much less effective and they would all need palliative care.

About 2.5 million people in India are estimated to be living with HIV/AIDS, the second largest in the world2. It is estimated that 50–80% of patients with HIV/AIDS would benefit from palliative care services.

However, pain relief and palliative care is a new notion in this country. It is estimated that less than 1% of the needy have any access to palliative care in India.

One of the biggest challenges in the development of palliative care in India is lack of training and awareness among professionals in pain management and palliative care. Thanks to the work of many pioneers in India, there already exists an impressive model of palliative care education and service delivery based on a strong social network and organizational structure. The need, however, is still overwhelming and it was felt that the model needed to be expanded to train a network of health care providers in the community for an effective coverage.

The Education of Physicians in End of Life Care (EPEC) Project was created in the USA with a mission is to educate all healthcare professionals on the essential clinical competencies in palliative care. Seeing the success of the program in the US ,a need was felt to develop a similar project to augment the education in palliative care by providing a curriculum that would provide a standard for both education and care in the field, to provide a de facto national standard in palliative care education and practice.


To develop a project on Education in Palliative and End of Life Care in India(EPEC-India)to augment the education of professionals and the volunteers in palliative care.


A curriculum similar to EPEC is developed in India taking into consideration its medical, socio-cultural and legal environment. The subjects vary from a very basic module on pain management and palliative care in general to a very advanced module on specific needs like developing palliative care services and palliative care in children, HIV and AIDS, Cardiology and pulmonology. The teaching methodology consists of didactic sessions, videotape presentations, interactive discussions, and practical exercises to teach fundamental palliative care skills in communication, ethical decision-making, psychosocial considerations, and symptom management. The videotapes and case studies are created based on Indian scenario.


The curriculum development was completed in July 2007. In order to test it, a first workshop was held at Sri Ramachandra University in Chennai, India from August 2007. This was attended by palliative care experts and other physicians. Information and feedback gathered from this workshop has been used to make final adjustments to the curriculum.

The second workshop was held as a preconference CME of an International Conference of Indian Association of Palliative Care, held at Kochi February 2008.It was attended by 300 delegates of doctors, nurses and volunteers.

There are already demands to hold similar workshops in different parts of India. In 2008, held at Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.

In addition to the standard print format, the curriculum is now freely available on the web, as is currently the case for the EPEC Curriculum. It also uses the same approach of providing automatic permission to use and adapt the curriculum for educational, non-profit purposes


1. http://www.cancer.org/docroot/AA/content/AA_2_5_8x_India.asp
2. http://www.nacoonline.org/upload/Publication (2006-2011)
3. http://www.who.int/entity/cancer/media/FINAL-Palliative Care Module.pdf
4. http://epec.net/EPEC/Webpages/epecindia.cfm