A researcher says people in the last stages of terminal illness in the region need better access to morphine to relieve their suffering.
Jo Spratt says families and communities in Pacific countries could also do with more support as they care for those who are dying.
The former nurse turned independent researcher has completed a study of palliative care in the region, where she said governments have a lot on their plate dealing with rising instances of cancer, kidney failure, stroke, lung and cardiovascular disease.
She said those caring for the dying may only have access to panadol to relieve people's suffering instead of morphine.
"We did do the contextual analysis in Solomon Islands and just at a glance it was extremely difficult to understand the system, who could get it, who couldn't, and definitely in rural areas people do not have access to morphine and that's just the mainstay of good palliative care," Jo Spratt said.
"People need that really strong pain relief."
Dr Spratt, who has recently completed her doctorate thesis, which explored how overseas aid policy changes, said donors could help by providing access to morphine and other palliative care support for volunteers and palliative care clinicians.
Strong traditions in Pacific islands around community care for the dying also needed to be nurtured, she said.
"Everybody spoke about community caring and everybody talked about the fact that people go home to die.
"It is the culture in many Pacific island countries to care for community and family members at home for sure and that social fabric, social capital is very high and people do do that but it is very challenging."
There were challenges around broaching conversations with the terminally ill and dying, she said.
"There were some disturbing stories I heard about people being sent home not necessarily even knowing they were dying."
Dr Spratt also found some distress for carers trying to find the necessary resources like drugs and dressings, feeling very much alone as they cared for the dying.
The governments were doing they best they could with tight health budgets and the inability to provide high-tech intervention for disease, she said.
However, collegial networks, often self-funded, and local initiatives by NGOs and others was promising. A hospice planned in PNG was an exciting initiative, she said.
"One of the things we may have done in our country (New Zealand) too much is medicalize death and definitely the strength in Pacific island countries is that community care, family care.
"That's something to be built on, supported and nurtured not taken away from."