NCDs are a growing problem worldwide with an estimated 15 million premature deaths from NCDs annually. While reducing premature mortality is an essential goal in line with SDG 3.4, morbidity, and quality of life for those with NCDs are also critical considerations. Palliative care aims to improve quality of life and reduce serious health related suffering in individuals with life limiting NCDs and disability but is a largely unmet need, especially in LMICs. About half the need for palliative care is being met in HICs compared to only about 4% in LMICs despite LMICs having 80% of the need. Access to essential medicines is particularly challenging with a huge discrepancy between LMICs and HICs in terms of general availability of oral morphine. We are now 10 years past the WHA Resolution and palliative care including access to essential medicines must be an integral part of planning for NCD and disability care as we move forward towards the UN HLM on NCDs in 2025.