A PLOS journal review paper explains why pediatric cancer care is a growing priority in developing countries
In high income countries, the leading cause of death in children is cancer. In Lower and Middle Income Countries (LIC’s and MIC’s), infectious diseases have traditionally been the leading cause of death in children. However, significant progress in immunisation efforts through the 90’s, continuing through to the present have dramatically decreased childhood mortality rates in LIC’s and MIC’s. The PLOS journal report, authored by Dr.Sumit Gupta and his colleagues, states that from 1990 to 2011, in 106 countries, 80% of the decline in childhood mortality rates was as a result of fewer deaths from infectious causes.
A growing proportion of childhood deaths are caused by non-infectious diseases such as cancer. In Middle Income Countries, 18.6% of childhood deaths are attributable to cancer. In Lower Income Countries, this figure is 6%.
To combat pediatric cancer in Lower and Middle Income countries, the report suggests that a national body should be responsible for creating and implementing a national childhood cancer strategy. Based on well established childhood cancer strategies in high income countries, the report provides suggestions of what a national strategy should endeavor to achieve. These include:
- Financial coverage of childhood cancer treatments in order to limit financial burdens on caregivers
- The official accreditation of childhood cancer centres – Cancer treatment centres should be evaluated and accreditation should be granted based on patient pressure, infrastructure present and data reporting ability. Thus, financial incentives could be associated with accreditation and a national plan could assist centers that hope to obtain accreditation.
- Mandatory data reporting for childhood cancer. Registries should be created for this, in order to better inform adequate resource allocation.
- National treatment protocols and standards of care should be established
The authors of the report say that both top-down and grass-roots approaches are important for the creation of childhood cancer policies.
As childhood cancer accounts for a growing proportion of childhood mortality, efforts to improve diagnosis and treatment are important in Lower and Middle Income Countries with a lack of resources.