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Abstract
Palliative care in India is more than two decades old. Despite that, less than 3% of patients with incurable cancer get pain relief) and less than 2% of patients in need of palliative care have access to it. There is huge regional variation in the availability of services. In India, with its federal structure, health care comes mainly under the jurisdiction of state governments. Palliative care has not found a place in the health policy documents of central or state governments, but in regions where palliative care services operate with massive community participation, the local governments seem to have recognized the need of such services. For example, in Nilambur, Kerala where the community-owned Neighbourhood Network in Palliative Care programme is very active, all eleven local governments have made it mandatory to have a representative from the palliative care team in the Panchayath Health Committee.

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