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Recommendation 7b: To respond to pain relief and palliative care needs in low-income nations as well as to prevent such countries from being exploited by for-profit opioid manufacturers, international agencies should coordinate distribution of free, generic morphine to hospitals and hospices.

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     Faced with the humanitarian tragedy of untreated pain, lower income countries may be tempted to turn over the regulatory keys to the pharmaceutical manufacturers whose profit-seeking has been destructive in other nations. The international community has a moral responsibility to not force lower income nations to choose between relieving needless suffering and risking an opioid addiction epidemic brought on by multinational corporations.

     Accordingly, the World Health Organization, with support of donor organizations, should coordinate delivery of generic morphine to hospitals and hospices in low income countries. This will require the support of the International Narcotics Control Board, which oversees the United Nations conventions on narcotics drugs and licenses and regulates licit opioid production.

     Without the influence of the profit motive, this model has more likelihood of relieving suffering without overpromotion and overprescription of opioids. The cost of implementing such a model is far from prohibitive. The cost of providing morphine-equivalent pain treatment to every child experiencing serious health suffering in low- income countries is only US$1 million a year.