WHO has released a suite of tools to help countries improve diagnosis and treatment of cancer among children coinciding with International Childhood Cancer Day. The package includes a “how-to” guide for policy-makers, cancer control programme managers and hospital managers; an assessment tool to inform implementation; and a multilingual online portal for information-sharing.
The new tools will support countries with the implementation of the CureAll approach, adopted by WHO’s Global Initiative for Childhood Cancer. The initiative, launched in 2018, aims to achieve at least 60% survival for childhood cancer globally by 2030. Currently, children living in high-income countries have an 80% chance of cure, while less than 30% of children diagnosed with cancer in many low- and middle-income countries (LMICs) survive.
During the last two years, the Global Initiative, supported by St Jude Children’s Research Hospital, a WHO Collaborating Centre in the US, has become active in more than 30 countries and benefits from the participation of more than 120 global partners. These partners work together to support governments with the implementation of the CureAll approach, addressing common reasons for the low survival of children with cancer in LMICs. These reasons include late or incorrect diagnosis, insufficient diagnostic capacity, delays in or inaccessible treatment and treatment abandonment.
Solutions to all of these issues are provided in the new “how-to” guide, which is based on four pillars: centres of excellence with defined referral pathways and a trained workforce; inclusion of childhood cancer in national benefit packages for universal health coverage; treatment standards based on evidence and tailored to local capacity; and robust information systems for continuous monitoring of programme performance.
An assessment tool to inform the implementation of the Initiative and support the real-time interpretation of data has also been launched. The tool, developed under the leadership of WHO with the International Atomic Energy Agency, the International Agency for Research on Cancer and other partners, will enable national cancer programmes to develop tailored approaches for cancer control in their setting. This tool can generate data for decision-making and help address data gaps in LMICs.
The importance of sharing of data, clinical experience and expertise is key to improving standards and performance in cancer programmes around the world. A new online community of practice, the WHO Knowledge Action Portal, will support the implementation of the Global Initiative for Childhood Cancer. The portal, with content in six languages, offers focal points for cancer in ministries of health a forum for establishing and managing partnerships, organising training programmes and sharing resources.
Impact of COVID-19
The onset of the COVID-19 pandemic in early 2020 created a need for another type of data, on the effect of COVID-19 on children with cancer. In response, St. Jude Children’s Research Hospital began collecting, in collaboration with partners, data on COVID-19 infection among children with cancer. As of early February, more than 1500 childhood cancer patients from 48 countries had tested posted for COVID-19.
Data available appears to indicate that the effect of COVID-19 on children with cancer is less severe than feared, although there remains a concern about the effect of the pandemic on willingness to seek care and complete therapy. This will have consequences for children with cancer in the longer term and may lead to worsened outcomes.