Partnering to Strengthen Health Systems and Improve Access to Quality Cancer Care

Abstract

Access within health care is a universal concern, independent of country income levels or the percentage of gross domestic product investment in health. Addressing the ongoing COVID-19 pandemic has shed light on the hidden access challenges across systems that present barriers to care for many people. These include cultural and language barriers, diminished trust in the health system, and lack of familiarity with negotiating care. 1 Although innovation has addressed certain barriers such as eliminating up-front costs during the pandemic, we still see immense hurdles to care. 1 In addition to participation barriers, staffing constraints, fragmentation of care, and uneven distribution of resources can pose significant obstacles. 2,3 A recent commentary in Communications Medicine emphasized that access to cancer care is dependent on ensuring the presence of staff, stuff, space, systems, and social support, 3 a concept coined by one of the leading architects of improving access, Paul Farmer.For example, screening and diagnosis initiatives for breast cancer are critical to identify cancers in early stages when there is more opportunity to improve outcomes and at lower cost to the health system. 4,5 However, screening programs can only succeed if subsequent diagnosis is confirmed and treatment is initiated within appropriate timelines. 4,6 This cannot occur if the system lacks the capacity in terms of resources, staffing, knowledge, or diagnostic capabilities to confirm diagnosis and refer the patient for care. Another challenge occurs when efforts to address access are implemented with a focus on speed and quantity rather than on quality of care. The Lancet Commission on High Quality Health in the SDG Era has warned that poor quality care is now a bigger barrier to reducing mortality in low-and middle-income countries than insufficient access. 7 Licensed under the Creative Commons Attribution 4.0 License 1

Innovation to Advance Cancer Control Equitably

“…The imbalance in the impact of genomic advances between high-income countries and LMICs needs to be addressed, and the authors offer suggestions in a resource appropriate stepwise fashion to benefit children with CNS tumors living in LMICs, including clinical trials, twinning and collaboration, and compassionate use programs. 5 Israel 6 in her commentary presents Novartis' breaking barrier challenge which commits to lower the system barriers that hinder access to treatment with a focus on three key areas—precision oncology, care integration, and data in action. These three studies focus on inequity in access to cancer care and suggest new ways to make progress in closing the care gap.…”