An international team of experts is calling for urgent global action to address the widespread failure to ensure children—especially those in low and middle‑income countries—receive essential medicines for pain, seizures and other serious conditions.
Published today in The Lancet Child & Adolescent Health, the two‑part series exposes the stark inequity in children’s access to controlled medicines, including morphine, benzodiazepines, phenobarbital and methadone. The articles show how children are routinely overlooked in research, policy and health systems designed to improve access—leaving millions to suffer needlessly.
Senior author Professor Ju Lee Oei, Mater Research, said children’s pain and suffering remain “largely invisible” in global policymaking.
“For every study on children’s access, there are hundreds on adults. We cannot fix what we do not measure,” Prof Oei said.
“The success stories highlighted in these papers prove this crisis is solvable with coordinated action and political will.”
Corresponding author Dr Brandon Maser, a PhD candidate at the University of Toronto and a resident physician in Paediatric Medicine at The Hospital for Sick Children in Toronto, said that these articles aim to draw attention to the immense suffering experienced by children around the world as a result of these persistent access gaps, and to recommend potential paths forward.
“Being a parent and a physician, one of the hardest things to witness is a child in pain. Yet across the world right now there are millions of children who are suffering needlessly because controlled essential medicines are inaccessible to them due to policy and system failures,” Dr Maser said.
“Children in low-income and middle-income countries face a convergence of multiple barriers and vulnerabilities for accessing medicines. These challenges are compounded by unique regulatory, service-related, and sociocultural factors related specifically to controlled medicines. Even in settings where controlled medicines are available and affordable, child-appropriate formulations—such as oral solutions for children who cannot swallow tablets—are frequently neglected.
“But these barriers do not excuse denying a child relief from pain. These are simple, affordable medicines that should be accessible to every child in need, regardless of setting. The fact they are not, is a profound injustice and a failure of our compassion for those most vulnerable in the world.”
Barriers include restrictive regulations, supply chain weaknesses, stigma surrounding controlled medicines, limited training for health professionals, and the near-total neglect of child‑friendly formulations. In many settings, medicines exist on paper but are functionally inaccessible—forcing caregivers to crush adult tablets or forgo treatment entirely.
The authors call for targeted global action and present a new framework to help governments, health systems and NGOs strengthen access pathways for children’s access to controlled medicines. They argue that ensuring children receive appropriate controlled medicines is not only feasible, but a “political and moral imperative” that is “urgent and long overdue.”
The full journal articles, titled “Controlled medicines for children’s medical needs: a review of the scope, determinants, and consequences of inequitable access” and “Children’s access to controlled medicines: policy lessons, intervention priorities, and a framework for action” were published in The Lancet Child & Adolescent Health on 18 February 2026.
