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Introduction to the IASP 2025 Global Year

Published

14 January 2025

GLOBAL YEAR

The 2025 Global Year will examine pain management and education beyond low- and middle-income countries to include low-income settings and priority populations.

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Introduction to the IASP 2025 Global Year: Pain Management, Research, and Education in Low- and Middle-Income Settings

Authors: 

  • Margarita Calvo, PhD, Pontificia Universidad Católica de Chile, Chile 1,2
  • Saurab Sharma, PhD, Royal North Shore Hospital, Australia 1,3,4,5,6,7

Introduction:

The IASP 2025 Global Year theme is: “Pain Management, Education and Research in Low- and Middle-Income Settings.” This theme goes beyond low- and middle-income countries (LMICs) to include low-income settings and priority populations such as aboriginal people, culturally diverse groups, and refugees in high-income countries. By focusing on “low- and middle-income settings,” we acknowledge that socioeconomic challenges and disparities exist across all regions and healthcare systems. This approach shifts the focus from geography to context, fostering a more inclusive effort to understand barriers and develop effective pain management strategies. Thirty-five task force members from 24 countries, with over 60% from LMICs, have volunteered to contribute to this initiative.

Goals: 

The 2025 Global Year will identify challenges and opportunities in addressing pain in low- and middle-income settings. It will advocate for greater funding for high-quality research that addresses important research gaps, improved health professional education to enhance pain care, and enhanced access to high-quality pain management in all contexts. Additionally, it aims to improve clinician training on pain education, promote self-management, and encourage interdisciplinary and multidisciplinary care for chronic pain.1 Our hope is that it will help foster equity at the community level and on a global scale.

Why Focus on Low- and Middle-Income Settings:

Globally, pain is a significant public health issue, incurring a burden that is disproportionately distributed in LMICs and in vulnerable populations in high-income countries.2,3 The burden of disability due to pain conditions is predicted to increase in LMICs in the next decades.4,5 LMICs constitute more than 4/5th of the world’s population, but research to inform care for such a significant proportion of the world’s population is small.6 For example, the 2017 global burden of disease studies used original data for a few LMICs, but for most LMICs, they borrowed low back pain prevalence data from other regions.7

Several significant challenges hinder high-quality pain research in LMICs, which the 2025 Global Year task force hopes to help overcome. These challenges include a lack of research priority at national and institutional levels, limited awareness among academics, clinicians, and the general public, and limited research funding.6,8 Additionally, there are few or no dedicated research positions or trained researchers, and language barriers hinder research and publication. Consequently, scientists often fall prey to predatory publishing, which may cause them to question the trustworthiness of published pain research.6,9,10

In many LMICs, pain is not prioritized due to competing health issues such as trauma injuries, maternal and child health problems, and infectious diseases.11,12 An unfortunate consequence is that people with pain have limited access to effective treatments.3 The current care is often suboptimal, with low value (i.e., ineffective, unsafe, and expensive) care and potentially harmful practices like bloodletting being common.13 However, there are opportunities to test local and traditional therapies, which could improve outcomes for people living with pain. Addressing these gaps is crucial for reducing health inequities and improving the quality of life for billions living in LMICs.

The 2025 Global Year also focuses on vulnerable populations in high-income countries which include Indigenous peoples, migrants and people from diverse cultural backgrounds, and refugees.14 Many people from LMICs migrate to high-income countries due to a lack of employment opportunities, poverty, poor access to quality health care, and conflicts. In their new countries, they often face social isolation, suboptimal care, and poor health outcomes. Language barriers further exclude them from clinical research, questioning the generalizability of findings. Despite these issues, efforts to address them have been insufficient. The 2025 Global Year’s focus on these populations is crucial for improving global equity in pain care.

Output:

Outputs include factsheets, podcasts, webinars, and expert interviews. Relevant research papers in PAIN and PAIN Reports will be highlighted. We welcome assistance with translating factsheets into multiple languages to engage the global pain community to ensure they are accessible to the public, clinicians, researchers, and policymakers globally.

Join IASP in Addressing this Major Global Challenge

The 2025 Global Year unites clinicians, researchers, policymakers, and patient advocates worldwide to improve access to high-quality pain care in low- and middle-income settings. Collaborating across borders and disciplines, can transform pain care and address global disparities. Let’s seize this opportunity to spotlight these regions, amplify crucial voices, and drive sustainable change in pain management, research, and education.

References

  1. Cardosa MS. Promoting multidisciplinary pain management in low-and middle-income countries—challenges and achievements. Pain. 2024;165(11S):S39-S49.
  2. Alva Staufert MF, Ferreira GE, Sharma S, Gutierrez Camacho C, Maher CG. A look into the challenges and complexities of managing low back pain in Mexico. Glob Public Health. Jun 2021;16(6):936-946. doi:10.1080/17441692.2020.1808038
  3. Sharma S, McAuley JH. Low Back Pain in Low- and Middle-Income Countries, Part 1: The Problem. J Orthop Sports Phys Ther. May 2022;52(5):233-235. doi:10.2519/jospt.2022.11145
  4. Ferreira ML, de Luca K, Haile LM, et al. Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology. 2023;5(6):e316-e329. 
  5. Gill TK, Mittinty MM, March LM, et al. Global, regional, and national burden of other musculoskeletal disorders, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology. 2023;5(11):e670-e682. doi:10.1016/s2665-9913(23)00232-1
  6. Sharma S, Verhagen AP, Elkins M, et al. Research from low-income and middle-income countries will benefit global health and the physiotherapy profession, but it requires support. J Physiother. Jan 2024;70(1):1-4. doi:10.1016/j.jphys.2023.08.013
  7. Tamrakar M, Kharel P, Traeger A, Maher C, O’Keeffe M, Ferreira G. Completeness and quality of low back pain prevalence data in the Global Burden of Disease Study 2017. BMJ Glob Health. May 2021;6(5):e005847. doi:10.1136/bmjgh-2021-005847
  8. Sharma S, Birnie KA, Wang S, Fernandes Gomes FI, Gibbs JL, Mittinty MM. The value of the International Association for the Study of Pain to career development: perspectives of trainee and early career members. Pain. Nov 1 2023;164(11S):S31-S38. doi:10.1097/j.pain.0000000000003061
  9. Amano T, Rios Rojas C, Boum Ii Y, Calvo M, Misra BB. Ten tips for overcoming language barriers in science. Nat Hum Behav. Sep 2021;5(9):1119-1122. doi:10.1038/s41562-021-01137-1
  10. Network TE-P, O’Connell NE, Belton J, et al. Enhancing the trustworthiness of pain research: A Call to Action. The Journal of Pain. 2024:104736. 
  11. Briggs AM, Huckel Schneider C, Slater H, et al. Health systems strengthening to arrest the global disability burden: empirical development of prioritised components for a global strategy for improving musculoskeletal health. BMJ Global Health. 2021-06-01 2021;6(6):e006045. doi:10.1136/bmjgh-2021-006045
  12. Briggs AM, Jordan JE, Sharma S, et al. Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies. Health Policy Plan. Feb 13 2023;38(2):129-149. doi:10.1093/heapol/czac061
  13. Sharma S, Pathak A, Parker R, et al. How low back pain is managed—a mixed methods study in 32 countries. Part 2 of Low Back Pain in Low- and Middle-Income Countries Series. Journal of Orthopaedic & Sports Physical Therapy. 2024;
  14. Lin I, Goucke R, Bullen J, Sharma S, Barnabe C. Inequities in pain: pain in low-and middle-income countries and among Indigenous peoples. In: van Griensven H, ed. Pain: A textbook for health professionals. 2023:353.

Author Affiliations

  1. Co-chair, Global Year for Pain Management, Research and Education in Low- and Middle-Income Settings, International Association for the Study of Pain, Washington DC, USA
  2. Physiology Department, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Nucleus for the Study of Pain (MiNuSPain), Santiago, Chile.
  3. Chief Scientist for Clinical Research, Pain Management and Research Centre, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW 2065, Australia
  4. Conjoint Senior Lecturer, Pain Management Research Institute, Kolling Institute, Faculty of Medicine and Health, The University of Sydney and Northern Sydney Local Health District, Sydney, NSW, Australia
  5. Adjunct Senior Lecturer, School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
  6. Postdoctoral Research Fellow, Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
  7. Visiting Faculty, Department of Physiotherapy, Manipal Academy of Higher Education, Manipal University, Manipal, India

Fact Sheet Reviewers

  • Emma Karran, BSc PT, PhD, University of South Australia, Australia
  • Supranee Niruthisard, MD, Chulalongkorn University, Thailand
  • Andrew Rice, PhD, Imperial College London, UK

 

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