According to the International Narcotics Control Board,¹⁴ the average defined daily dose consumption of morphine for statistical purposes (S-DDD)¹⁵ in Lesotho (2000-02) was 8. This compares with other African countries as follows: Swaziland 1; Egypt 2; Uganda 4; Zimbabwe 13; Namibia 73; South Africa 103. Twenty nine countries reported no morphine consumption during 2000-2002 (Table 2).

Table 2 Average daily consumption of defined daily doses (for statistical purposes) of morphine per million inhabitants, 2000-2002: countries of Africa

Source: International Narcotics Control Board Narcotic Drugs: Estimated World Requirements for 2004. Statistics for 2002. New York: United Nations, 2004.

According to the Rapid Appraisal, drug access in Lesotho for symptom control and pain management is limited. Pain management in health facilities and households primarily consists of aspirin, Paracetamol, Ibuprofen and Indocid. There is limited availability of morphine, especially oral morphine. The Rapid Appraisal prioritises the need for greater accessibility to morphine, as part of a holistic approach to palliative care:

While pain management, specifically access to opioids including morphine, is a priority for quality palliative care, comprehensive programs should address a wide range of needs including non-pharmaceutical pain management skills, management of chronic diarrhoea, cough and skin disorders, oral health, increasing ability to carry out activities of daily living, spiritual and emotional support and palliative care for infants and children.¹⁶