Leading causes of death in Asia
In Asia, the leading causes of death vary from country to country, but some of the most common causes of death across the region include:
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Cardiovascular diseases: These includes heart disease and stroke, which are the leading causes of death in many Asian countries, including China, India, and Japan.
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Cancer: Cancer is a leading cause of death in many Asian countries, with common types of cancer including lung, liver, stomach, and breast cancer.
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Respiratory diseases: Chronic obstructive pulmonary disease (COPD) and pneumonia are two of the leading causes of death from respiratory diseases in Asia.
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Lower respiratory infections: In some Asian countries, such as India and Bangladesh, lower respiratory infections are a significant cause of death, particularly among young children.
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Kidney disease: Chronic kidney disease is becoming increasingly prevalent in Asia, and is a leading cause of death in countries such as India and Sri Lanka.
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Diabetes: Diabetes is a growing problem in Asia, and is a leading cause of death in countries such as India, China, and Malaysia.
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Liver disease: Liver disease, including cirrhosis and hepatitis, is a leading cause of death in some Asian countries, particularly those where alcohol consumption and viral hepatitis are prevalent.
Hope for patients with serious illnesses in Asia
The World Health Organization (WHO) states in its fact sheet on palliative care that in 2018, 79% of the world's population, mainly people in low- and middle-income countries, consumed only 13% of the total amount of morphine used for the management of pain and suffering, or 1% of the 388 tons of morphine manufactured worldwide [1]. This highlights the unequal distribution of palliative care resources and the need to improve access to such care across communities in low and middle-income countries.
The population in Asia is huge and by 2060, there will be more than 1.2 billion Asian people aged 65 and older. While knowledge of how to relieve suffering at the end of life has been strengthened over the years, there has been little done to transform this knowledge into action. As a result, around 11 million Asians a year will die in pain and distress per year because they lack access to pain medications.
Palliative care provides advanced care planning and support to individuals who are suffering from a serious illnesses. The aim of palliative care is to improve the quality of life for these individuals by providing relief from moderate to severe pain, through the use of medications and other methods.
The Lien Collaborative's specialist volunteers bring palliative care and training to Myanmar, Bangladesh, Sri Lanka and are continuing to expand efforts in India, China, Bhutan, Timor-Leste and Laos. When international experts and local stakeholders work together to develop palliative care capacity in government-run health systems, the barriers to pain relief and humane care can be removed.
Palliative care needs in Asia
In Asia, the need for palliative care is increasing due to the growing aging population, the increasing burden of chronic diseases, and the limited availability of hospice and palliative care services. Despite the high burden of suffering, access to palliative care remains limited in many countries, particularly in rural and underserved areas. Additionally, cultural and religious beliefs, lack of education and understanding of palliative care, and inadequate government support are also barriers to the provision and utilization of palliative care services in Asia.
It continues to be a pressing issue, with a need for further development and promotion of access to quality hospice and palliative care services in the region. Cultural views and beliefs of stakeholders, as well as policies and funding structures, greatly influence palliative care development in Asia Pacific, which might differ from those in Europe or the West.
Palliative care needs in Asia vary by country and region, but some common needs include:
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Improving access to palliative care services, especially in rural and remote areas.
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Integrating palliative care into the broader healthcare system, including into hospital settings.
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Raising awareness about palliative care and reducing stigma associated with end-of-life care.
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Developing trained workforces, including healthcare professionals and volunteers, to provide palliative care services.
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Increasing funding and resources for palliative care, including medication and equipment.
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Addressing cultural and religious beliefs that may impact the use and perception of palliative care.
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Improving pain management, symptom control and overall quality of life for patients and their families.
A graph showing the ranking of countries by quality of death index
Source: Economist Intelligence Unit in 2015
More than half of Asia’s nations are part of the middle-income group and according to the latest report on the quality of death and dying assessment by experts, the majority of these nations fall into grade groups C to F
More than half (60%) of the world’s population live in Asia. Many of these people live in developing economies. In addition, almost half of the world does not have access to palliative care services.
In Asia, it is estimated that:
• 24 million people need palliative care yearly, including more than 1 million children under 15
• 11 million people will die in pain and distress due to lack of access to pain medications
• Up to 80% of cancers in developing countries are diagnosed in advanced stages when cure is unlikely.
24 Million
in Asia need palliative care yearly
This includes more than 1 million children under 15 years of age.
11 Million
persons die in pain and distress. There is 46% of those in need suffer from the lack of access
80%
of cancers in developing countries diagnosed late. Cancers diagnosed in advanced stages is unlikely to be curable.
The healthcare systems of developing nations in Asia are often pushed to their limits. High patient demand and limited resources mean even basic medical needs can be difficult to meet, which often come at high cost to those who seek it. Under these conditions, trying to introduce palliative care for those with non-communicable diseases, is a challenge, but one that must be met.
Given the difficult socio-economic background of these developing countries in Asia Pacific, it is of little surprise that many low-income countries in Asia ended up being ranked at the bottom in the Quality of Death Index.
Whether it is the pain caused by cancer, or breathlessness caused by end-stage respiratory diseases or heart failure, treating the pain and symptoms and the associated problems caused by non-communicable diseases is just as important as treating the diseases themselves.
The lack of access to pain medications results in around 11 million Asians dying in pain and distress every year. These unnecessary sufferings can be reduced by breaking down barriers to effective and affordable pain relief opioids such as oral morphine – the gold standard essential medication for pain relief according to the WHO.
Other than the physical pain that patients of life-threatening illness experience, they may also experience psychological, social and spiritual suffering. Physical pain is often made worse by other worries, by fear and by anxiety.
These forms of suffering can be alleviated through palliative care:
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Treatment for good pain and symptom management
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Practical and financial support to meet the basic needs and daily necessities of the patients and their families or help to cover medical expenses.
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Emotional support to help patients and their families to deal with the changes in life circumstances as well as concerns or fears
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Effective communication and providing of information
The time is now for Asian countries to build palliative care into their national health systems This can be done, and must be done, to alleviate the unnecessary suffering of so many millions.
There is now good evidence to show that palliative care produces better health outcomes in terms of quality of life and patient and caregiver satisfaction, along with reduction of use of unwanted or ineffective medical interventions and intensive care.