Browsing by Author "Freccero, P."
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Item Are essential medicines available, reliable and affordable in low-middle income countries?(Journal of Cancer Policy, 2019-03) Eden, T.; Burns, E.; Freccero, P.; Renner, L.; Paintsil, V.; Dolendo, M.; Scanlan, T.; Khaing, A.A.; Pina, M.; Islam, A.; Chunda-Liyoka, C.; Kouya, F.; Molyneux, E.A critical challenge for reducing the cancer survival disparity between children living in low-middle income countries (LMICs) and those in high income countries (HICs) is the apparent lack of consistent supplies of reliable, good quality, effective and affordable essential medicines for curative, supportive and palliative care in LMICs. Using a semi-structured 17 point questionnaire we asked ten paediatricians in nine countries for their perceptions of availability, accessibility, affordability and quality of the drugs they needed to treat their patients with cancer. All the countries needed to procure and import some or all of the required essential medicines. Despite their countries signing up to the latest World Health Organisation Essential Medicines Listing there were inconsistent supplies of key medicines. This occurred sometimes due to inadequate global production of some drugs but more often to failure of adequate registration, procurement, importation and distribution. Costs played a significant role regarding prompt importation in some of the countries and cheaper biosimilar drugs were procured often without certification of quality production and provenance. Where families carried the whole financial burden of drug costs the doctors cited it as a major but not the only reason for treatment refusal or subsequent abandonment. Only a concerted effort by each country, the WHO, ethical pharmaceutical companies and all worldwide medical and nursing groups, with the help of parent support organisations across the world can overcome the failure of access to, affordability of and ensured quality of these off -patent, generic drugs. This applies not just to childhood cancer but all medicines for communicable and non-communicable diseases.Item Development of paediatric oncology shared-care networks in low-middle income countries(Journal of Cancer Policy, 2018-06) Burns, E.; Collington, M.; Eden, T.; Freccero, P.; Renner, L.; Paintsil, V.; Dolendo, M.; Islam, A.; Khaing, A.A.; Rosser, J.In order to reach out and offer optimum access for children with cancer across each country the development of networks of paediatric oncology units rather than just a single centre in one city has been the practice in high income countries over the last 30–40 years and is now being considered by developing countries. At a workshop bringing delegates from 4 countries in Africa and Asia to share their concepts, ideas and experiences of developing such networks and how to move forward, it was recommended that there should be a Hub (referral centre), shared-care centre hospitals, a real emphasis on good communication, ability to train staff within the network and a focus on ensuring that each hospital and country’s government must be supportive for it to be successful.