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A recent Editorial in The Lancet Neurology1 highlighted the importance of palliative care for patients with progressive neurological diseases and the requirement for increased funding and research. Because data on prevalence, incidence, and stage of disease in many low-income and middle-income countries is scarce, proxy data is used to estimate palliative care needs. One method of estimation proposed by WHO and the World Palliative Care Alliance relies on mortality data. 2 The number of patients with a progressive neurological disease who require palliative care is estimated by the number of deaths attributable to a particular cause and multiplied by the prevalence of pain in that patient group. We highlight this method’s flaws with an example from Malaysia. An assessment3 in 2012 using this method indicated that no patients with multiple sclerosis required palliative care because no deaths were reported …