In the editorial by Richard Powell et al, we are reminded of a 2005 WHO report on sub-Saharan Africa, which shows that 9.67 million people are in need of palliative care. This number is big and tends to dwarf the real progress that has been made throughout the continent. They identify four key areas of development that are necessary for palliative care to make its contribution. Liz Grant and colleagues report that of the Africans in need of palliative care, only 5% will receive it. In their feature, they recount progress to date and describe examples of programmes in Kenya, Malawi and Uganda. These articles are a timely reminder to those of us who practice outside Africa of the burden of AIDS and the coming threefold increase of need in the next …