Strengthening Access to Cancer Medicines for Children in East Africa: Policy Options to Enhance Medicine Procurement, Forecasting, and Regulations

Abstract

Abstract Gaps in access to quality essential medicines remain a major impediment to effective care of children with cancer in low-and middle-income countries (LMICs). The World Health Organization reports that less than 30% of LMICs have consistent availability of childhood cancer medicines, compared to over 95% in high-income countries. This outcome is due to a number of factors, principal among them market inefficiencies that limit availability of affordable products, supply chain disruptions, inadequate data for evidence-based forecasting and procurement, and limited targeted policy and financing for childhood cancer. Information provided within this policy brief is drawn from review of literature and a mixed-methods study that analyzed determinants of cancer medicine access for children in Kenya, Tanzania, Uganda, and Rwanda. The study objectives were to prospectively track and analyze availability and cost of essential chemotherapeutic and supportive care medicines, and investigate determinants of medicine access. Three key policy options are presented to guide critical health system planning for strengthening access to cancer medicines for children: pooled procurement, evidence-based forecasting, and regional harmonization of regulatory processes. This policy brief is intended for policy-makers, clinicians, and health-system planners involved in procurement, supply chain management, policy and financing of childhood cancer medicines.