Almost half of the world's countries have no provision for palliative care, according to new research.
The Worldwide Palliative Care Alliance (WPCA) study found that 98 of the world's 234 countries (42%) do not have a hospice or palliative care services available to seriously-ill people and their families and carers.
Currently, 80% of the world's population live in countries with no or low access to medications to treat moderate to severe pain. The WPCA said the report raises fresh concerns that too many people across the world are living and dying without adequate care, support and pain relief.
It called for palliative care to be accessible to everyone facing a serious life-threatening illness, including the growing number of people living with non-communicable diseases (NCDs), which are non-infectious diseases such as cancer, diabetes and heart disease.
However, the report found that there has been some progress in the past five years, particularly in the development of services in Africa.
Professor David Clark, from the School of Interdisciplinary Studies at the University of Glasgow, one of the report's co-authors, said: "We are encouraged that there has been a marked increase in the number of services in operation, from 10,000 in 2006 to 16,000 in 2011.
"But we are very concerned that only 20 countries globally - that's just 8.5% - provide palliative care services that are fully integrated with wider health services. Progress is modest and slow. We need a step change in activity if the global need for better care at the end of life is to be addressed."
Globally, an estimated 100 million patients and family caregivers would benefit from hospice and palliative care. Prof Clark said that current palliative care provision reaches only a "tiny proportion" of those in need.
The report is being launched to mark World Hospice and Palliative Care Day 2011.
Countries with no known hospice-palliative care activity include Afghanistan, Burkina Faso, Laos and Senegal. Australia, France, the UK and US are among countries where palliative care services are integrated with the wider health service.