In 2020 the prevalence of cancer in Morocco was 344.4 per 100 000 or 127 120 cases. [1] In 1995, Morocco introduced oral morphine to relieve the pain of cancer patients. Since then, palliative care has progressively developed in the country. Fifteen years later, the National Cancer Prevention and Control Plan 2010–2019 became a key document in further developing and expanding palliative care. WHO has also contributed to this development by providing financial and technical support, including its technical input to the national guide for palliative care in 2018.

Still, establishing effective, accessible, and efficient palliative care has not been without its challenges in Morocco. For instance, there is stigma around the use of opioids. Socioeconomic and geographic barriers hamper  access to the continuum of care and policy decisions are not well integrated into the country’s health  systems structure. In 2020, the COVID-19 pandemic posed an extraordinary challenge as it jeopardized the continuity of access to much-needed palliative care for patients with cancer. This was largely due to new safety protocols in all services and for reorganization of resources to implement new public health measures to combat the spread of the virus.

Morocco’s COVID-19 Multi-Partner Trust Fund (MPTF) Project contextualizes the country’s response to this issue through its objectives: maintaining essential health services (particularly for populations in vulnerable situations) and strengthening protection and prevention for healthcare and other frontline workers. With the scope of this project, WHO, United Nations Population Fund, and United Nations Industrial Development Organization were three agencies that provided tailored support to the government to ensure continuity of palliative care for patients with cancer.

WHO led the research and evaluation of the impact of COVID-19 response measures and drafted recommendations for national health authorities to mitigate negative consequences of COVID-19 for patients with cancer. Additionally, as a Co-Chair of the Monitoring Committee for this Project, WHO evaluated, monitored, and reported on several programmes under the project.

Within this project, the WHO Country Office (WCO) carried out three different activities to ensure access to palliative care for patients with cancer throughout COVID-19 pandemic:

1) Mobile palliative care units (MPCUs). WCO procured four vehicles to operate MPCUs for bedridden patients in four different provinces, Agadir, Tiznit, Beni Mellal and Errachidia. In total, more than 400 patients from rural and isolated areas have benefited from and will continue to receive palliative care through home visits under this programme. The presence of MPCUs made possible several visits for the most vulnerable cancer patients in December 2020.

2) Two new hospital-based palliative care units (HPCUs). WHO facilitated the procurement of vital medical equipment for two HPCUs at the Regional Oncology Centres in Agadir and Beni Mellal. These units started their operation in January 2021 and will have a lasting impact on access to palliative care for cancer patients for years to come, throughout and beyond the pandemic.

3) Online training programme for healthcare professionals to deliver palliative care. Additionally, based on the national guide, WHO prepared an online, five-day training module for palliative care and pain management  (4). As a result, 50 health professionals including nurses, general practitioners, specialists, social workers, programme facilitators, and mobile palliative care teams enhanced their technical knowledge on how to organize and coordinate palliative care, communicate with patient and their families, and manage end-of-life care.