{"entity":{"id":"idea-acc-earmarked-palliative-budget-share","kind":"idea","name":"Earmark a fixed share of every national cancer budget for palliative care","aka":[],"tldr":"Most of the money in cancer goes to treatments that help a few people for a short time, while pain relief for the dying, which is cheap and works, gets almost nothing. Ring-fencing a small fixed share would change that.","summary":"Palliative care receives a tiny fraction of cancer spending in most countries despite reaching more patients per dollar than most therapies. A policy earmarking a minimum share (for example, 5%) of national cancer control budgets for palliative care, including morphine supply, workforce training, and community services, would guarantee a floor. Earmarking has drawbacks but is a proven way to protect neglected functions.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Pain relief and palliative care are unavailable to most): WHO fact sheet, Palliative care","url":"https://www.who.int/news-room/fact-sheets/detail/palliative-care"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-palliative","b-funding-allocation"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Countries adopting an earmark will at least double palliative care coverage within four years, with the earmark spent rather than reallocated.","rationale":"Public health functions that lack a constituency are systematically underfunded; earmarks have protected immunisation and mental health budgets in similar situations.","test":"Track palliative expenditure, coverage, and morphine consumption in adopting versus non-adopting countries over five years.","maturity":"speculative","actor":"policy","cost":"medium","horizonYears":4},"route":"/ideas/idea-acc-earmarked-palliative-budget-share/","neighbours":{"bottleneck":[{"id":"b-funding-allocation","kind":"bottleneck","name":"Funding follows fashion, not burden","route":"/bottlenecks/b-funding-allocation/"},{"id":"b-palliative","kind":"bottleneck","name":"Pain relief and palliative care are unavailable to most","route":"/bottlenecks/b-palliative/"}]}}