Nita Radhakrishnan (India)

With the World Health Organization (WHO) Global Initiative for Childhood Cancer, there is renewed interest in sustainable interventions to improve childhood cancer care in low/middle- income countries (LMICs).  “Twinning” is a well-recognized intervention that refers to a targeted international paediatric-oncology partnership (TIPP) between one or more institutions in a high-income country (HIC) and a low/middle- income country (LMIC) [“North-South twinning”], or between LMIC centres [“South-South twinning”]. Such arrangements are of limited scope, and not an end in themselves.

 So what role should Twinning, and by implication the associated Working Group, currently play? We feel the Working Group should provide knowledge-based resources to maximize the success of such ventures, and to this end we have published guidelines in Pediatric Blood and Cancer in 2020 [link here], to lay out in detail several key components in operating successful TIPPs and to highlight awareness of common pitfalls. The driving force behind most successful TIPPs is a local physician champion who, having received specialized training, often abroad, looks to set up/improve the unit where s/he works with the assistance of an HIC partner (capacity building). Such local champions do not need regulation or policing but they do need a way to actively network.


  • We plan to utilize the POINTE website to continually and transparently put out information on ongoing TIPPs, including metrics such as abandonment rates and event-free/overall survival.
  • We would like to work more closely with the POINTE website and C4K to foster regional physician training, nurse training, and specialist training. Regional tumor boards, web-based learning and similar tools can ensure ongoing transfer of knowledge for all members of the unit.
  • We created a blog at where members can post their thoughts, ideas and communicate freely about their efforts. The Group will meet quarterly to ensure we are meeting the aspirations of all members and the children we serve



Resource library in the Twinning Working Group archive of POINTE at