The report said twenty nine out of the 40 countries studied have no formal palliative care strategy, revealed the report. Only seven – Australia, Mexico, New Zealand, Poland, Switzerland, Turkey and UK – have national policies, while four others – Austria, Canada, Ireland and Italy – are in the process of drafting one. Kerala had long ago recognised the importance of palliative care as can be seen from the growth of community-based care units. "The State's community-operated care system is funded largely through local micro-donations of as little as Rs 10 (21 US cents) per month. The volunteers in these units, after training can provide psychological, social and spiritual support. It is this that marks the NNPC out from more medical-oriented and expensive systems in use elsewhere," said the report.