# Earmark a fixed share of every national cancer budget for palliative care

Source: https://onco.cc/ideas/idea-acc-earmarked-palliative-budget-share/  
OnCo record `idea-acc-earmarked-palliative-budget-share` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- 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.
- Proposed test: Track palliative expenditure, coverage, and morphine consumption in adopting versus non-adopting countries over five years.
- Maturity: speculative
- Actor: policy

## Sources

- Bottleneck evidence (Pain relief and palliative care are unavailable to most): WHO fact sheet, Palliative care: https://www.who.int/news-room/fact-sheets/detail/palliative-care

## Connected records

- bottlenecks: [Funding follows fashion, not burden](https://onco.cc/bottlenecks/b-funding-allocation/), [Pain relief and palliative care are unavailable to most](https://onco.cc/bottlenecks/b-palliative/)

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