Global challenges in pediatric oncology

Abstract

Childhood cancer burden is shifted toward LMICs; global initiatives directed at pediatric cancer care and control are urgently needed. International partnerships facilitating stepwise processes that build capacity while incorporating epidemiology and health services research and implementing intensity-graduated treatments have been shown to be effective.

Access to Cytotoxic Medicines by Children With Cancer: A Focus on Low and Middle Income Countries

“…[1] A key issue is the identification of the priority medicines for supply in the public sector, and here the role played by the World Health Organization (WHO) has been critical. The first WHO model list of essential medicines (EML) was produced in 1977 and is reviewed every two years.…”

Improving Care for Children With Cancer in Low- and Middle-Income Countries-A SIOP PODC Initiative

“…A detailed description of each of these is beyond the scope of this article and the interested reader can look at the recent reviews for specifics. [2,6,7] It is worth emphasizing that the socioeconomic circumstances of the individual patient/parent are critical to the outcomes, but so is the national context. Indeed, annual government healthcare expenditures correlate strongly with childhood cancer survival.…”

“…[5] In some LIC, children comprise 40-50% of the population, and the proportion of childhood cancers represents 3-10% of cancer cases, [8] whereas in HIC, this proportion is only about 1%. [8] Mortality patterns also differ since cancer accounts for 4-5% of childhood deaths in HIC (where cancer is the leading cause of death from disease among children aged [1][2][3][4][5][6][7][8][9][10][11][12][13][14], and less than 1% in LMIC (where deaths from infectious diseases are more prominent). [5] In this article, we summarize the recent progress of the Paediatric Oncology in Developing Countries (PODC) committee of the International Society of Paediatric Oncology (SIOP) to address the disparities in treatment and outcomes of childhood cancer in LMIC.…”

In the realms of future: new frontiers of ‘techno-oncology’ as a platform for global improvement in the outcomes of childhood cancer

“…Despite ongoing efforts and improvements, survival outcome of childhood cancers in developing nations remains significantly inferior to the cure rates in developed nations [1,2]. Several factors including higher rates of mortality, relapse, abandonment of therapy and socioeconomic factors have been deemed contributory [3][4][5].…”

“…Such efforts need to be all-inclusive to incorporate infrastructure, personnel, support systems, funding and technology [1][2][3]. Several successful training and education/fellowship programs for physicians, nurses and ancillary personnel are available through partner sites in HICs.…”