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Centre for Global Child Health

SickKids, PAHO and St. Jude join forces with local leaders to improve childhood cancer survival in the Caribbean

Paediatric cancer experts and health authorities convened by the Pan American Health Organization (PAHO), together with the SickKids Centre for Global Child Health and St. Jude Children’s Research Hospital, are calling for stepped-up action to improve the survival rate for children suffering from cancer in the Caribbean.

In the Caribbean and globally, cancer is among the leading causes of death in children under age 15. Local Caribbean data shows that the two-year overall survival for children with cancer is about 55 per cent, compared to 80 to 85 per cent in most high-income countries. Higher rates of treatment toxicity and patient abandonment of treatment remain barriers to successful outcomes in the Caribbean.

A group of men and women standing on stairs posing for the camera
PAHO meeting participants in Port of Spain, Trinidad, February 2020.

The experts convened by PAHO included paediatricians, paediatric oncologists, and noncommunicable disease program managers from nine Caribbean countries and territories, along with representatives of ministries of health and other collaborating organizations. The group met in Port of Spain, Trinidad to map out ways to increase support and action—at both the country and international levels—to reduce deaths in children and adolescents with cancer in the Caribbean through strengthened health systems, focusing on improving diagnosis, treatment, training, and family support.

“This meeting, which brought Caribbean and international childhood cancer experts together with representatives from national and regional governments and organizations, represented a historic opportunity to improve the outcomes for children with cancer across the Caribbean,” said Dr. Sumit Gupta, Staff Oncologist and Clinician Investigator, Haematology/Oncology, and Co-Director of Policy and Economics Research in Childhood Cancer (PERCC) at SickKids.

The meeting identified priority areas of action as: earlier detection and diagnosis of childhood cancer in primary care, with timely referral for specialized treatment; increased access to essential medicines for childhood cancer; training and continuing multi-disciplinary medical education for specialists and primary care providers; improved continuity of care, including for children who live far from treatment centers to prevent abandonment of treatment; and the production and sharing of evidence for public health use and to mobilize political and financial support.

The actions proposed by the experts in Trinidad build on earlier efforts by the SickKids-Caribbean Initiative (SCI), established in 2013 to build sustainable local capacity to diagnose, treat and manage paediatric cancers and blood disorders in six participating countries (The Bahamas, Barbados, Jamaica, St. Lucia, St. Vincent and the Grenadines, and Trinidad and Tobago), and a regional working group for Latin America and the Caribbean set up by PAHO in 2017 to develop strategies and recommendations for health system strengthening for childhood cancer.

“Progress made by the SickKids-Caribbean Initiative has resulted in better data structures, more trained health care workers, and improved capacity. This progress represents groundwork that the WHO and PAHO initiative can, in partnership with SCI and others, build upon and expand across the region,” said Dr. Avram Denburg, Staff Oncologist and Clinician Scientist, Haematology/Oncology, and Co-Director of PERCC at SickKids.

A group of 10, males and females, standing next to each other posing for a picture
Physician Leads from the SickKids-Caribbean Initiative’s six Caribbean partner countries with Margaret Manley-Kucey (far left), Dr. Sumit Gupta (second from the left) and Dr. Avram Denburg (fifth from the left) from SickKids at the PAHO meeting in Port of Spain, Trinidad.

 

The current efforts are also part of the broader Global Initiative for Childhood Cancer launched by the World Health Organization (WHO) in 2018 to improve survival rates by addressing barriers to access and quality of care for children with cancer.