More than 2.7 million people die each year in moderate or severe pain without access to adequate pain treatment – even though the World Health Organization (WHO) considers morphine an essential medicine for the treatment of pain. Morphine is safe, effective, inexpensive, and easy to administer in resource-constrained settings. However, a web of barriers prevents millions of individuals from accessing pain relief and forces them to live and die with treatable pain. These barriers include legal and regulatory restrictions, weak health systems, inadequate training of healthcare workers, and misconceptions about pain and its treatment. Access to pain treatment is particularly limited in low and middle-income countries where approximately 70% of cancer deaths and 99% of HIV deaths in the world occur, but just 7% of the opioid analgesics are consumed. Cancer deaths are expected to double by 2030 and many of those deaths will be in developing countries with little to no access to adequate pain treatment.