The International Society of Paediatric Oncology (SIOP) urges WHO member states to consider the enormous benefit of Universal Health Coverage (UHC) in addressing the growing burden of childhood cancer, and to recognise the significant number of life years gained when a child completes treatment, survives their disease, and has the opportunity to become a productive member of their community for six or more decades.
UHC, defined as access to the full spectrum of health services needed by individuals or communities without suffering financial hardship, was a target first established by the UN Sustainable Development Goals (SDG) in 2015. It was reaffirmed at the UN General Assembly High Level Meeting on UHC in 2019. The WHO’s commitment to UHC is now reflected in their efforts to achieve the Thirteenth General Programme of Work 2025 target – that being, an additional billion of the world’s people benefiting from UHC.
It is a sobering fact that 80% of children with cancer live in countries with severely limited healthcare resources. In places such as Africa, Latin America, Asia, and Eastern Europe, the costly financial burden of paying for the necessary treatments and out-of-pocket costs falls squarely on the families of the children. This situation can force parents to refuse treatment from the start, or to abandon treatment when their resources are expended. Tragically, either option is likely to lead to the child’s death. Even if the family can borrow the funds, they can often find themselves in penury following the end of treatment and therefore in a crippling, and possibly permanent, state of debt.
We at SIOP are certain that, as UHC becomes implemented more comprehensively across the globe, childhood cancer treatment will show similar benefits to those documented in Indonesia by Indraswari and colleagues (2021). After the implementation of UHC, the number of low-income patients with insurance rose from 40% to 85%, treatment abandonment fell from 36% to 19% and survival rates improved from 14% to 22%. These statistics are encouraging, but the death of even one child is an irreplaceable loss. The widespread adoption of UHC would significantly reduce the number of these tragedies.
SIOP is excited and pleased to hear that Ghana has announced the inclusion of childhood cancer treatment in its National Health Insurance Scheme (NHIS). This took several years of advocacy by local stakeholders and thoughtful planning by the National Health Insurance Authority. Four of the commonest cancers – acute lymphoblastic leukaemia, Burkitt lymphoma, Wilms tumour and retinoblastoma are covered. As these form over 60% of childhood cancers in Ghana; this decision is a huge step in the quest to make treatment more accessible and improve outcomes. In line with UHC, we hope this milestone in Ghana, a lower-middle-income country, will encourage other countries with measured resources to include childhood cancer services in their UHC strategies.
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