The evolution of serious health-related suffering from 1990 to 2021: an update to The Lancet Commission on global access to palliative care and pain relief

The purpose of this initiative is to provide public access to estimates of the evolution of severe health-related suffering (SHS) for the years 1990, 2000, 2010, 2019, 2020 and 2021, as well as annual opioid data distributed in morphine equivalent (DOME) between 1990 and 2022 in 183 countries. These data support the analyses presented in the following scientific papers: 1. Knaul, F. M., Arreola-Ornelas, H., Kwete, X. J., Bhadelia, A., Rosa, W. E., Michael Touchton, M., … Radbruch, L. (2025). The evolution of serious health-related suffering from 1990 to 2021: an update to the Lancet Commission on Global Access to Palliative Care and Pain Relief. The Lancet Global Health. 2. Knaul, F. M., Arreola-Ornelas, H., Kwete, X. J., Bhadelia, A., Berterame, S., Connor, S. R., … Radbruch, L. (2025). Distributed Opioids in Morphine Equivalent: A Global Measure of Availability for Palliative Care. Journal of Pain and Symptom Management, Volume 69, Issue 2, 2025. DOI. 3. Kwete, X. J., Bhadelia, A., Arreola-Ornelas, H., Mendez, O., Rosa, W. E., Connor, S., … Knaul, F. M. (2024). Global Assessment of Palliative Care Need: Serious Health-Related Suffering Measurement Methodology. Journal of Pain and Symptom Management, Volume 68, Issue 2, 2024. DOI. Documents corresponding to an update to the report of the Lancet Global Commission on Pain Relief and Palliative Care published in 2018: Knaul, F.M., Farmer, P.E., Krakauer, E.L., De Lima, L., Bhadelia, A., Kwete, X.J., Arreola-Ornelas, H., et al. Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report Lancet, 391 (2018), pp. 1391-1454. DOI: 10.1016/S0140-6736(17)32513-8 This database seeks to promote transparency in research and provide fundamental tools for the global analysis of health-related suffering and access to opioids for palliative care. It also facilitates the formulation of evidence-based public policies, with the aim of improving equity and access to palliative care and pain management worldwide.