WASHINGTON — Nearly 26 million people around the world die each year with serious suffering in part because of a huge gap in pain relief: The U.S. may be awash in opioid painkillers, but they’re rare or unavailable in dozens of poor countries, a new report says.

The challenge is to improve palliative care in low-income countries while avoiding mistakes that led to the U.S. addiction crisis.

The report to be published Friday in The Lancet says one key is using off-patent morphine that costs pennies a dose – not profitable for drug companies that push pricier, more powerful opioids in rich countries, but critical to easing a health emergency.

In some places, even children dying of cancer or children in treatment for cancer can’t get pain relief, said University of Miami professor Felicia Knaul. She co-chaired a Lancet-appointed international commission that spent three years studying the disparity and what she calls “the moral obligation” to help.

“This report finally gives voice to the suffering and a roadmap to governments,” Knaul said.

Of the few hundred tons of morphine and equivalent opioids distributed worldwide, less than 4 percent goes to low- and middle-income countries, the researchers reported.

How much is needed? The Lancet Commission provided the first global estimates of the need for palliative care, defined as “serious health-related suffering” from certain life-threatening conditions, including cancer, HIV and trauma. Some 2.5 million children are among the annual count of nearly 26 million.

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