‘Hub and spokes’ pain relief model has the potential to transform the lives of hundreds in Malawi
EMMS and the Palliative Care Association of Malawi (PACAM) have launched a project to deliver a new model of oral morphine to rural communities in Malawi. If successful, the model has the potential to transform access to vital pain relief across the country.
The project launches on World Hospice and Palliative Care 2026 (10 October) which has a theme of Pain Management: An Essential Part of Palliative Care. The theme was chosen to re-emphasise the holistic treatment of pain in palliative care (physical, psychological, social, spiritual).
Currently in Malawi, oral morphine is only available in Government district and central hospitals. Here, it is prescribed by medical doctors, surgeons, clinical officers and trained nurses. Primary health facilities located in rural communities across the country cannot prescribe the medication. As a result, people living in these communities who are experiencing severe pain from life-limiting illnesses must travel long distances, often at significant cost, to attend district hospitals to access the vital pain relief they need.
EMMS and PACAM have designed a ‘hub and spokes’ model whereby medication is prescribed at district hospitals then stored and distributed at local health centres. This ensures safety measures remain in place regarding prescription, while also making it easier for people in these rural communities to access the medicine they need from their local primary care facility.
The project, which launches this week, will run until September 2027.
Executive Director of PACAM, Lameck Thambo, said: “Through this project, we hope to demonstrate an effective ‘hub and spokes’ model of district hospital prescription and rural health centre distribution for oral morphine for the management of severe pain and palliative care needs in Malawi.”
EMMS Director of Programmes, Sarah Gibson, commented: “With over 80% of Malawians living in rural areas, identifying safe and accessible routes to accessing needed pain medications at the health centre level is essential in delivering meaningful palliative care.”
About 80 patients will benefit over the course of this 12-month project. The hope is that the results will provide evidence for wider policy change on access to oral morphine in rural Malawi.
EMMS is pleased to be able to support the project at a time when countries like Malawi are experiencing the consequences of government aid withdrawal. The UK Government has announced massive cuts in financial aid to Malawi, reducing by 60% in 2026-27 with ongoing annual reductions. By 2028-29 the UK contribution to Malawi will be 90% less than it was in 2025-26.
EMMS and PACAM have a long history of working together, starting in 2015 with a project focused on education and training for HIV and other diseases. From 2015-2021 they partnered on a project titled Chifundo – Compassion – which resulted in 63,000+ adults and children with life-limiting illnesses and their families having access to good palliative care. More recently, in 2025, they delivered a project to introduce palliative care to 18 rural health facilities which reached 5,600 patients and trained 32 health care workers.
Find out more at our free webinar on Wednesday 14 October
EMMS Director of Programmes Sarah Gibson and PACAM Executive Director Lameck Thambo will share further information about the project at a live webinar at 14.00-14.30 Wednesday 14 October.
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