Journal of Global Oncology (Aug 2018)

Establishing Cancer Treatment Programs in Resource-Limited Settings: Lessons Learned From Guatemala, Rwanda, and Vietnam

  • Claire M. Wagner,
  • Federico Antillón,
  • François Uwinkindi,
  • Tran Van Thuan,
  • Sandra Luna-Fineman,
  • Pham Tuan Anh,
  • Tran Thanh Huong,
  • Patricia Valverde,
  • Arielle Eagan,
  • Pham Van Binh,
  • Tien Nguyen Quang,
  • Sonali Johnson,
  • Agnes Binagwaho,
  • Julie Torode

DOI
https://doi.org/10.1200/JGO.17.00082
Journal volume & issue
Vol. 4
pp. 1 – 14

Abstract

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Purpose: The global burden of cancer is slated to reach 21.4 million new cases in 2030 alone, and the majority of those cases occur in under-resourced settings. Formidable changes to health care delivery systems must occur to meet this demand. Although significant policy advances have been made and documented at the international level, less is known about the efforts to create national systems to combat cancer in such settings. Methods: With case reports and data from authors who are clinicians and policymakers in three financially constrained countries in different regions of the world—Guatemala, Rwanda, and Vietnam, we examined cancer care programs to identify principles that lead to robust care delivery platforms as well as challenges faced in each setting. Results: The findings demonstrate that successful programs derive from equitably constructed and durable interventions focused on advancement of local clinical capacity and the prioritization of geographic and financial accessibility. In addition, a committed local response to the increasing cancer burden facilitates engagement of partners who become vital catalysts for launching treatment cascades. Also, clinical education in each setting was buttressed by international expertise, which aided both professional development and retention of staff. Conclusion: All three countries demonstrate that excellent cancer care can and should be provided to all, including those who are impoverished or marginalized, without acceptance of a double standard. In this article, we call on governments and program leaders to report on successes and challenges in their own settings to allow for informed progression toward the 2025 global policy goals.