Ban on Morphine in Certain African Countries

Early last week, Donald McNeil wrote in the New York Times about the ban on prescribing morphine for extreme suffering in some countries of Africa, raising questions on the ethics of this ban. The World Health Organization advocates the use of the opioid morphine in pain relief of HIV and cancer, yet many countries in Africa, striken with HIV and certain cancers, deny the availability of this accessible and effective drug. McNeil's article sites examples of suffering such as a woman with breast cancer where the cancer had spread to her lymph nodes and ribs; a 2-year-old with third degree burns down the front of his body; an 7-year-old with sickle cell anemia; and an 8-month-old with meningitis. Morphine would put all 4 of these patients in some comfort that they are no longer familiar with. Usually, the unavailability of drugs in Africa is attributed to the high costs; that is not the case with morphine. The author states a hospital in Uganda makes its own and the price of a 3-week supply is less than a loath of bread. Instead, morphine is unavailable in certain countries because of ban on morphine. Some of these governments only allow doctors to administer morphine, one such country being Sierra Leone, where the doctor to patient ratio is 1 in 54,000. Patients in need rarely get one on one time with a doctor. In other African countries, morphine is allowed by their governments, yet pharmacies will not stock it in fear of potential consequences.

People suffering in intense pain, near death, should be allowed some comforts in their final days. The author writes that the benefits administering morphine to those in severe pain far outweigh the risks, and I agree. There should at least be an attempt in these countries to provide relief for the suffering citizens, and closely monitor the distribution of the drug and be aware of any sort of corruption/crime issues that may arise. I can understand the fears some of these governments and the pharmacies have due to corruption, crime, and addiction; however, these governments watch people suffer in such severe pain when there is an easy and affordable remedy to allow some comfort in one's last days. That seems like the true crime to me.