On January 23, 2014, the Executive Board of the World Health Organization adopted a resolution urging countries to ensure access to pain medicines and palliative care for people with life-threatening illnesses. According to Human Rights Watch, more than 6.5 million people are estimated to die each year without any access to pain medicines, almost all in low- and middle-income countries. Some 40 million people each year require palliative care for relief of pain and other symptoms. However, a 2011 study by the Worldwide Palliative Care Alliance found that an astonishing 74% of countries have no palliative care services or services that reach only a small percentage of the population. "The WHO resolution on palliative care is a real breakthrough," said Diederik Lohman, senior health researcher at Human Rights Watch. "It clearly and unambiguously recognizes the obligation of all countries to make sure no one needlessly suffers from pain and other debilitating symptoms."