This monograph describes the current status and achievements of a joint project among five countries -- Botswana, Ethiopia, United Republic of Tanzania, Uganda, Zimbabwe -- and the WHO. This report intends to guide the national health planners and public health programme managers within and outside Africa to conduct their own situation analysis and assessment of palliative care needs for HIV/AIDS and cancer patients. In countries with severely limited resources, a community health approach relying extensively on home-based care and community involvement in the provision of symptom control, psychosocial support and end-of-life care is recommended in order to improve the quality of life of patients suffering from chronic life-threatening conditions. At least one in every 200 individuals each year in Africa needs palliative care and there are clear gaps in the ability of existing health services to provide even basic palliative care. About 1.6 million individuals (one percent) of the population in these countries need palliative care services annually. The greatest needs of terminally ill patients were for adequate pain relief, accessible and affordable drugs, and financial support.