{"entity":{"id":"idea-acc-local-oral-morphine-production","kind":"idea","name":"Locally prepared oral morphine solution, licensed for nurse prescribing","aka":[],"tldr":"Uganda makes liquid morphine from powder in a simple facility and lets trained nurses prescribe it, giving pain relief to patients that no doctor will ever reach. Other countries could copy this within a year.","summary":"Hospice Africa Uganda pioneered reconstitution of oral morphine solution from imported powder at low cost, distributed through a public programme and prescribed by specially trained nurses and clinical officers under a 2004 regulation. The model has been documented and adapted in a handful of countries but not widely. A package combining pharmacy standards for reconstitution, a nurse-prescriber training curriculum, and model regulation would let ministries adopt it quickly.","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":["idea-acc-balanced-opioid-policy-reform"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-palliative","b-global-access","b-workforce"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Countries adopting local oral morphine production with nurse prescribing will increase the number of patients receiving opioid analgesia at home by at least fivefold within three years at a drug cost under $0.05 per day.","rationale":"The Ugandan programme has run for more than two decades with no evidence of significant diversion; the constraints elsewhere are regulatory and logistical, both addressed by the package.","test":"Implementation in three countries with morphine dispensed, patients served, home pain scores, and diversion reports as endpoints.","maturity":"being-tested-at-scale","actor":"policy","cost":"small","horizonYears":2},"route":"/ideas/idea-acc-local-oral-morphine-production/","neighbours":{"idea":[{"id":"idea-acc-home-based-end-of-life-kits","kind":"idea","name":"Home end-of-life care kits and trained family carers where no hospice exists","route":"/ideas/idea-acc-home-based-end-of-life-kits/"},{"id":"idea-acc-balanced-opioid-policy-reform","kind":"idea","name":"National opioid quota reform so morphine reaches cancer patients","route":"/ideas/idea-acc-balanced-opioid-policy-reform/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-workforce","kind":"bottleneck","name":"Not enough oncologists, nurses, pathologists, physicists","route":"/bottlenecks/b-workforce/"},{"id":"b-palliative","kind":"bottleneck","name":"Pain relief and palliative care are unavailable to most","route":"/bottlenecks/b-palliative/"}]}}