Achieving Global Pediatric Palliative Care Equity—What We Have Yet to Learn

Abstract

Injustice arises when equity is not a central consideration in health care interventions—a reality made more apparent during the COVID-19 pandemic. Pediatric palliative care is a proven intervention that enhances care and is associated with decreased suffering for children with serious illness and their families. However, nearly two-thirds of countries lack access to pediatric palliative care despite a clear need. Children in low- and middle-income countries experience disproportionately high illness-related morbidity and mortality, an inequity highlighted in pediatric cancer. More than 80% of US children with cancer will survive 5 years, compared with less than 30% of children with cancer living in low- and middle-income countries; this injustice is more striking when considering that more than 80% of global pediatric cancer cases occur in these countries. For children with cancer living in low- and middle-income countries, improving integration of pediatric palliative care is just as crucial as improving access to life-extending therapies to decrease family suffering and improve quality of life.