Access to Medications: Cases Studies in Solutions 

By Dr. Richa Parikh


In this talk, Dr. Dan Milner discusses various strategies to improve access to oncology drugs to patients both in the US and globally, in an equitable manner to mitigate disparities. The drug access approach at the African Access Initiative (AAI) was highlighted as an example of an effective way of procuring prioritized cancer drugs and providing life-saving cancer treatments to patients. Owing to ASCO’s growing global membership, especially in low- and middle-income countries (LMICs), ASCO is committed to improving access to cancer care and research globally. There have been unified efforts by ASCO and UICC/WHO to improve access to cancer drugs globally through the ‘Access to Essential Cancer Medicines’ summits, wherein strategies to ensure affordability, access, quality, delivery, and optimal utilization of cancer medicines are discussed.


The St. Jude Global program was established with four core pillars – capacity building, education, research, and resource mobilization, with a goal to advance access to and ensure quality of care for children with cancer globally. This program, in collaboration with >300 institutions from 83 countries organized in 7 regional networks, forms the St. Jude Global Alliance which is operating to expand reach globally in pediatric hematology oncology. St. Jude was established as the first WHO Collaborating Center for Childhood Cancer in March 2018, and launched the Global Initiative for Childhood Cancer with a goal of reaching at least 60% survival rate for children with cancer, saving one million more children by 2030 and alleviating suffering.


The CureAll Pillars & Enablers (Centers of excellence and care networks, Universal health coverage, Regimens for management, Evaluation and monitoring, Advocacy, Leveraged financing, and Linked policies and governance) were established to achieve this goal. In December 2021, St. Jude Children’s Research Hospital and WHO announced the Global Platform for Access to Childhood Cancer Medicines to ensure an uninterrupted supply of quality cancer medicines with an estimated 120,000 children in LMICs benefitting in 6 years.


Texas Children’s Hospital and Baylor College of Medicine launched an initiative ‘Global HOPE’, to improve diagnosis and treatment of children with cancer in sub-Saharan Africa. City Cancer Challenge (C/Can) was launched by UICC in 2017 and has been a standalone Swiss Foundation since 2019. This initiative supports cities around the world to improve access to equitable and quality cancer care through a holistic and bottom-up approach to strengthen the foundations of the healthcare system.


An example is a pilot project in Asuncion where essential breast cancer medicines were donated from Amgen via Direct Relief to Paraguay in 2022, and preparatory steps were taken to enable the local health system to accelerate its readiness for access to oncology drugs. Finally, the ATOM Coalition was established with key objectives of making available more WHO Essential Medicines List (EML) generic and biosimilar cancer drugs, securing increasing number of patented medicines in the pipeline and improving capacity to receive and use cancer drugs in targeted LMICs. 


Author Bio: 

Dr. Richa Parikh received her medical degree from Grant Government Medical College, India. She completed IM residency from University of Arkansas for Medical Sciences. She is currently a third-year Hematology/Oncology fellow at Karmanos Cancer Institute. She will be joining Emory University as Assistant Professor/myeloma faculty in Fall 2024. 


COI: Served on advisory board for Sanofi. 


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