Browsing by Author "Scanlan, T."
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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 Haematological Cancers in African Children: Progress and Challenges(British Journal of Haematology, 2017-06) Molyneux, E.; Scanlan, T.; Chagaluka, G.; Renner, L.Cancer is increasingly important in low and middle-income settings where infectious diseases are declining. Childhood cancers treated in well-resourced centres have excellent outcomes with more than 80% survival. This success is not reflected in low-income settings where challenges involve every step on the care pathway. Access to diagnosis, delayed presentation, advanced disease, co-morbidities and underlying malnutrition make treatment difficult. Treatments are costly for impoverished families. Yet, the common haematological malignancies (Burkitt lymphoma, Hodgkin lymphoma, non Hodgkin lymphoma) are relatively easy to diagnose and, when managed with simple chemotherapy protocols, give limited but good results. As funding becomes available for cancer research we must ensure that the care and cure of these children is top of the agenda. There is already evidence of improved outcomes in middle-income countries. For others there is a long journey ahead.