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In 2018, WHO launched, with the support of St. Jude Children’s Research Hospital, the Global Initiative for Childhood Cancer, to provide leadership and technical assistance to governments to support them in building and sustaining high-quality childhood cancer programmes. GICC aims to increase the survival rate of children with cancer globally to at least 60% by 2030.
Strategic discussions chart CureAll path forward
As part of its role as the lead implementation partner for the Global Initiative for Childhood Cancer and as the WHO Collaborating Centre for Childhood Cancer, St. Jude Children’s Research Hospital recently hosted strategic discussions focused on supporting and strengthening the CureAll implementation and broader progress toward 2030 goals. These strategy sessions included Ministry, hospital and partner representatives from six countries actively engaged in the GICC, along with WHO Country and Regional Offices and Headquarters.
Knowledge Action Portal
Through the Global Initiative for Childhood Cancer (GICC) Knowledge Action Portal, we bring together leading organisations and global experts on childhood cancer with Member States and non-State actors to exchange knowledge and evidence-based policies. This interactive, multilingual online portal for information-sharing offers focal points for cancer in ministries of health a forum for establishing and managing partnerships, organising training programmes and sharing resources.
Cancer centres of excellence help increase survival rates among children
A complex interplay of factors contributes to lower survival rates in low- and middle-income countries (LMICs). These include incorrect diagnosis, insufficient diagnostic capacity and delays in treatment and treatment abandonment. When cancer services are accessible, most children with cancer can be cured. What is required is a series of small, strategic investments to improve health systems. Establishing national cancer centres of excellence is one such measure that is implemented through the Global Initiative.
In the past two years over 12 countries participating in the Global Initiative have established cancer centres of excellence and made investments to increase the capacity of their health workforce to deliver quality services for children with cancer. These cancer centres connect the dots across levels of healthcare through a robust referral pathway and harness competencies of a well-trained and multi-disciplinary health workforce—enhancing health outcomes.
CureALL poster contest to showcase impact
The CureAll Poster Contest showcased impact through the Initiative across all regions and reflected how implementing countries leveraged the CureAll framework to improve cancer outcomes. Three countries that won the contest include, Peru, Myanmar and Palestine.
In Myanmar, GICC Country Champion Dr Aye Aye Khaing describes how advocacy efforts through the Initiative resulted in a commitment from the government to fund childhood cancer medicines 100% and build a national cancer registry. Dr. Dalwa Massad, a GICC Country Champion from Palestine describes challenges in providing cancer care and treatment in a fragile and conflict area — and how some of these challenges were overcome through GICC in close partnership with the Ministry of Health. In Peru, GICC Country Champion Dr Essy Maradiegue, describes several achievements through GICC, including improving the abandonment rate in childhood cancer treatment, regulating childhood cancer laws, rolling out a national education program on comprehensive care for children with cancer and implementing a National Childhood Cancer Observatory.
Hear from our GICC Country Cancer Champions on how the Initiative is improving cancer outcomes for children:
Myanmar: Reviewing cancer benefit packages and strengthening cancer registries
"At the start of the Initiative, we used evidence from data collection activities under GICC to advocate with the Ministry of Health and the Procurement division for essential medicines for childhood cancer. As a result of these advocacy efforts, the Government committed to 100% funding towards Childhood Cancer Medicine in early 2020. Furthermore, prior to the Initiative, all our data collection was manually undertaken. We had no electronic records of patients, so it was difficult to track gaps and progress. Now, through GICC, we’re running data management training courses for doctors and nurses so that they are able to collect and manage data from cancer patients and enable us to build a national cancer registry. These are some examples of how we've improved cancer outcomes for children in the country." - Dr Aye Aye Khaing, GICC Cancer Champion, Myanmar
Palestine: Strengthening essential medicines and technologies
"I remember talking to one mother who told me that after months, she was finally able to sleep through the night because her child was now receiving morphine at the hospital and had stopped screaming in pain. So many children with cancer and their families across Gaza have suffered because of the shortage of basic cancer medicines. We used data from a qualitative study — that included responses from parents of children with cancer, oncologists in referral hospitals, social workers, nurses, Ministry of Health focal points and pharmacists — to advocate for better procurement of cancer medicines, training healthcare workers and making provisions for children in hospitals such as creating a youth ward for adolescents and raising the age limit for transferring patients to adult oncology from 12 years to 16 years. All these changes were possible because the Ministry of Health was with us right from day one. We didn’t conduct the study and then go back to them saying 'this is what you need to implement.' Instead, we did the study together with them so they had complete ownership over the results." - Dr. Salwa Massad, GICC Country Champion, Palestine
Peru: Reforming national childhood cancer policies
“The launch of GICC in Peru marked a turning point in the country’s public policies around childhood cancers. Major developments that ensued thereafter include approval of the national childhood cancer law that ensures health coverage right from the diagnostic stage, paid leave for caregivers and the creation of a national paediatric cancer registry. Furthermore, Peru’s Ministry of Health implemented a multisectoral national strategy that reduced treatment dropout rates from 18.6% to 8.5%. This success can be attributed to forming local specialists’ committees to prevent abandonment, using a remote application to monitor cases, hiring an 'accompaniment monitor' to liaison with families, and collaborating with social assistance services. Additionally, under GICC, a National Childhood Cancer Observatory was created to carry out epidemiological monitoring and surveillance. The Observatory reports information on new childhood cancer cases, mortality and abandonment of treatment, which enables data-driven strategies to address challenges. And lastly, through GICC, over 6,000 primary care health professionals were trained in early diagnosis of childhood cancer to enable timely diagnosis and treatment. The country has thus seen significant developments in childhood cancer policies and services under GICC.”
Regional Updates
Campaign to promote early diagnosis of childhood cancer
On International Childhood Cancer Day 2023, the Pan American Health Organization (PAHO), St. Jude Children’s Research Hospital and Childhood Cancer International launched a new campaign 'Support Kids with Cancer’to alert parents, caregivers, and health professionals in Latin America and the Caribbean about the first signs of the most common cancers in children and adolescents to improve timely diagnosis and treatment outcome.
Download campaign material
Watch the campaign video below:
Transforming childhood cancer care in Nepal through shared care
Himal Chand's father Bir Bahadur talks about the impact of a unique ‘Shared Care model’ of childhood cancer treatment that is changing the lives of cancer patients and their families in Western Nepal. The new treatment model makes a significant portion of cancer care for children available closer to home, providing treatment and care while minimizing hardships on children and their families.
Making all or part of the cancer treatment available nearer the child’s home has been shown to help overcome factors that limit access to treatment, improve adherence, reduce financial and other burdens, and incrementally improve cancer care capacity.
Recognizing the need for action to improve the survival of children with cancer globally, WHO, along with St. Jude Children’s Research Hospital and global partners launched the Global Initiative for Childhood Cancer (GICC) in 2018. As part of the global initiative, Myanmar, Nepal, and Sri Lanka were identified as focused-support countries in the WHO South-East Asia Region. The shared care centers model implemented in Myanmar and Nepal is one of the key activities in these countries.
Beating childhood cancer in Ghana
In Ghana, about 1200 children under the age of 15 are estimated to develop cancer annually. Unlike adult cancers, 8 out of 10 children diagnosed with cancer will survive the disease if it is detected early and access to treatment and care are available. However, in resource-constrained countries like Ghana, the reverse has been true: only 20% of children diagnosed with cancer survive. For many, the cost of treatment was prohibitive – as high as US$ 7000 for up to three years treatment for leukaemia. In low-income countries only 30% of patients access treatment.
Through GICC, childhood cancers were added to the National Health Insurance Scheme (NHIS) benefit, making some components of care such as diagnostics and supportive care free. The benefit package includes Burkitt’s lymphoma (bone marrow cancer often found in the jaw), Wilms’ tumour (cancer of the kidney), retinoblastoma (cancer of the back of the eye) and acute lymphoblastic leukaemia (cancer of the blood).
Data shapes people’s views on cancer in Kyrgyzstan
Childhood cancer is largely not preventable and not amenable to screening. It is therefore essential to track cases so that services for early diagnosis and treatment can be delivered where they are needed. Since 2015, Kyrgyzstan’s cancer registry has been providing crucial information on cancer cases. One of the key strengths of Kyrgyzstan’s cancer registry is that it collects and analyses data on childhood as well as adult cancer cases.
There is suspected under-reporting of childhood cancer mortality in Kyrgyzstan, likely due to delays in registering the death of a child by the family. This was discovered through cross-checking cancer registry data with data from the first children’s hospice established in the country. Cancer registry data also reveals that girls with cancer are underdiagnosed compared to boys. Diagnoses are shown to be much more frequent for working aged people than for children and older people, and diagnostics and treatment for cancer patients are still largely confined to big cities.
As well as providing data, cancer registry publications also serve as a tool for advocacy. In 2021, the government budget for cancer was increased as a result of strong civil society advocacy, mostly driven by cancer patient organizations. Kyrgyzstan’s cancer registry is part of a strong network of such registries in the European Region that collaborate and support each other.
