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Global palliative care

Access to palliative care, particularly in low and middle income countries, is one of the world's health largest inequalities.

Here at the Wolfson Palliative Care Research Centre, we are developing collaborations and workstreams to address some of these issues.

We welcome enquiries from international palliative care researchers regarding future collaborations. Please contact Dr Joseph Clark (joseph.clark@hyms.ac.uk).

Dr Joseph Clark

Dr Joseph Clark is a Lecturer in Global Palliative Care within the Wolfson Palliative Care Research Centre. Joseph works on a number of global palliative care projects focussing on international drug policy and palliative care in low and middle-income countries.

Joseph's profile

Dr Sunitha Daniel

Dr Sunitha Daniel is a PhD student at the Wolfson Palliative Care Research Centre. Her PhD is on the psychological concerns of Indian women, the largest diaspora in the world, with breast cancer in relation to the impact of disease and its treatment. 

She is a Consultant in Palliative Medicine and Community Oncology working under National Health Mission, General Hospital, Ernakulum, Kerala, India, and Honorary consultant (Academic and Research) at the Pallium India, which is a leading Palliative care Non-governmental Organisation in India.

She is instrumental in the initiation and leading the PalliCOVID Kerala taskforce, which has developed a "Palliative Care in COVID-19 Resource tool kit" for LMIC countries. Resources include an eBook, webinars, and online teaching modules freely accessible to all.

She also works with the Indian National Cancer Grid in developing a preliminary screening tool to detect Serious Health-related Suffering as well as Guidelines for Palliative Care Management of various symptom clusters. 

View Sunitha's publications on ORCID. 

Projects in global palliative care

BREATHE-INDIA: BREATHlEssness in INDIA - Development of a breathlessness beliefs and behaviour education intervention for use in the community-setting. Read more

Exploring the association between chronic breathlessness and workforce participation, using Australia as an exemplar. Read more

Estimating worldwide needs for morphine for pain in advanced cancer and proportions theoretically met by country estimates of requirements and consumption. Read more

Does the International Narcotics Control Board (INCB) sufficiently prioritise enablement of access to therapeutic opioids? A systematic critical analysis of six INCB annual reports, 1968-2018. Read more

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: a systematic review, critical interpretative synthesis and development of a conceptual framework. Read more

How physicians in South India recognise, assess and manage people with chronic breathlessness syndrome: a thematic analysis. Read more

A systematic review and critical interpretative synthesis of the psychological concerns of Indian women with breast cancer living in different national contexts: the importance of culturally congruent care. Read more

Improving Appropriate Access and Availability of Opioids for Cancer-related Pain Control in India: bridging the gap between policy and practice  - a qualitative study. Read more

Roles and experiences of informal carers providing care to people with advanced cancer in Sub Saharan Africa. Read more

Global Palliative Care publications

Clark J, Salins N, Daniel S, Currow DC, Jones L, Pearson M, Bunton R, Mankel J, Braithwaite C, Gilchrist MM and Johnson MJ. Views and experiences of opioid access amongst palliative care providers and public representatives in a low-resource setting: a qualitative interview study. Plos Global Public Health (in press)

Currow D and Clark J. Pharmacological Imperialism. J of Palliat Med. 2023;26(2):158-159.

Clark J, Kinchin I, Kochovska S, Johnson MJ and Currow DC. What If… Caregivers' Subsequent Workforce Participation Was a Measure of Palliative Care Services' Impact? An Hypothesis-Generating Study. J of Palliat Med, 2023. https://doi.org/10.1089/jpm.2022.0498.

Clark J, Kochovska S, Currow DC. Burden of respiratory problems in low-income and middle-income countries. Curr Opin Support Palliat Care. 2022 Dec 1;16(4):210-215. doi: 10.1097/SPC.000000000000061. Epub 2022 Sep 13. PMID: 36102933.

Clark J, Crowther L, Johnson MJ, Ramsenthaler C, Currow DC. Calculating worldwide needs for morphine for pain in advanced cancer and proportions feasibly met by country estimates of requirements and consumption. Retrospective, time-series analysis (1997-2017). PLOS Global Public Health. 2022. https://doi.org/10.1371/journal.pgph.0000533.

Clark, J., Chang, S., Kinchin, I. et al. Lower workforce participation is associated with more severe persisting breathlessness. BMC Pulm Med, 2022. https://doi.org/10.1186/s12890-022-01861-y

Daniel, S, Venkateswaran C, Hutchinson A, and Johnson MJ. "‘I don’t talk about my distress to others; I feel that I have to suffer my problems...’Voices of Indian women with breast cancer: a qualitative interview study." Supportive Care in Cancer (2020): 1-10. doi:10.1007/s00520-020-05756-8

Clark J, Gnanapragasam S, Greenley S, Pearce J and Johnson M. Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework. Palliat Med, 2020. doi: 10.1177/0269216320966505  

Clark JD, Johnson M, Fabowale B, Farrelly M, Currow D. Does the International Narcotics Control Board (INCB) sufficiently prioritise enablement of access to therapeutic opioids? A systematic critical analysis of six INCB annual reports, 1968-2018. Journal of Global Health Reports. 2020;4:e2020042. doi:10.29392/001c.12925

Daniel SClark J, Gnanapragasam S, et al Psychological concerns of Indian women with breast cancer in different national contexts: a systematic review and mixed-methods synthesis BMJ Supportive & Palliative Care Published Online First: 11 May 2020. doi: 10.1136/bmjspcare-2019-002076

Clark J, Barnes A, Campbell M and Gardiner C. A Life or “Good Death” Situation? A Worldwide Ecological Study of the National Contexts of Countries That Have and Have Not Implemented Palliative Care. J Pain Symptom Manage, 2019:57:793-801. doi: 10.1016/j.jpainsymman.2018.12.007

Clark J, Barnes A and Gardiner C. Re-framing Global Palliative Care for the Sustainable Development Goals Era: a qualitative study of the views of international palliative care experts. J Pain Symptom Manage, 2018;56(3):363-370. doi: 10.1016/j.jpainsymman.2018.06.009

Currow D and Clark J. Why Smart Emerging Economies Will Invest in Excellent Palliative Care, if Palliative Care Services Do Their Part. J of Palliat Med. 2018;21(3):276-77.

Clark J, Barnes A and Gardiner C. Systematic Mapping Review of International Palliative Care Research. 2016. BMJ Supportive and Palliative Care. doi:10.1136/bmjspcare-2015-001008