{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:16:52Z","timestamp":1788189412779,"version":"build-2803163510"},"reference-count":20,"publisher":"Pan American Health Organization","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<title>ABSTRACT<\/title>\n                  <sec>\n                    <title>Background.<\/title>\n                    <p>Childhood cancer survival exceeds 80% in high-income countries but remains below 50% across much of Latin America. In Ecuador, limited access to diagnosis and essential medicines, and fragmented governance have hindered progress. In 2025, Ecuador became the first country in the Region of the Americas to implement the Global Platform for Access to Childhood Cancer Medicines, an initiative led by the World Health Organization (WHO) and St. Jude Children\u2019s Research Hospital to ensure equitable access to quality medicines while strengthening health systems.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Methods.<\/title>\n                    <p>Between 2023 and 2025, Ecuador\u2019s Ministry of Public Health, the Pan American Health Organization (PAHO), WHO and St. Jude codesigned a participatory implementation plan. A national situational analysis guided the 2024\u20132026 roadmap and focused on governance, regulatory alignment, supply-chain optimization and workforce capacity. Key operational tools included medicine forecasting and quantification methodologies, developing standardized treatment protocols, and coordinating with the immunization program\u2019s cold-chain infrastructure.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Results.<\/title>\n                    <p>The initiative catalyzed the creation of the National Commission for Childhood and Adolescent Cancer, integration of all prioritized oncology medicines into the national formulary, and consensus in national treatment protocols. Strengthened logistics reduced delivery times for medicines to less than 96 hours, and chemotherapy management training established a foundation for continuing education. Ecuador became the first country in the Region to receive medicines for childhood cancer procured through the Global Platform.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Conclusions.<\/title>\n                    <p>Implementation of the Global Platform in Ecuador has strengthened pediatric oncology and positioned it as a national health priority. By coupling medicine access with systemic reform, Ecuador has demonstrated that collaborative governance, intersectoral coordination and political commitment can build sustainable capacity to deliver equitable childhood cancer care.<\/p>\n                  <\/sec>","DOI":"10.26633\/rpsp.2026.74","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:28:53Z","timestamp":1788186533000},"page":"1","source":"Crossref","is-referenced-by-count":0,"title":["Transforming pediatric oncology in Ecuador through the Global Platform for Access to Childhood Cancer Medicines"],"prefix":"10.26633","volume":"50","author":[{"given":"Marmol","family":"Lissette","sequence":"first","affiliation":[{"name":"National Directorate for Strategies on the Prevention and Control of Noncommunicable Diseases, Mental Health, and the Socioeconomic Phenomenon of Drugs, Ministry of Public Health, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"V\u00e1squez","sequence":"additional","affiliation":[{"name":"Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America"},{"name":"vasquezmar@paho.org"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilda","family":"Villacr\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Antiporta","sequence":"additional","affiliation":[{"name":"Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Lavayen","sequence":"additional","affiliation":[{"name":"Regional Revolving Funds, Pan American Health Organization, Washington, DC, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina","family":"Meza","sequence":"additional","affiliation":[{"name":"National Directorate of Hospitals, Ministry of Public Health, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Sol\u00eds","sequence":"additional","affiliation":[{"name":"National Directorate of Medicines and Medical Devices, Ministry of Public Health, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Santana","sequence":"additional","affiliation":[{"name":"National Directorate of Comprehensive Health Care, Ministry of Public Health, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Sol\u00eds","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology Department, Baca Ortiz Hospital, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Del Carmen Trujillo","sequence":"additional","affiliation":[{"name":"Clinical Oncohematology Department, Eugenio Espejo Hospital, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema","family":"Sol\u00f3rzano","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology Department, Portoviejo Specialty Hospital, Manab\u00ed, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Clinical Oncohematology Department, Abel Gilbert Pont\u00f3n Specialty Hospital, Guayaquil, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Calle","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology Department, Icaza Bustamante Hospital, Guayaquil, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Bonilla","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology Department, Icaza Bustamante Hospital, Guayaquil, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gissela","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology Department, Hospital Sociedad de Lucha contra el Cancer (SOLCA) Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Espin","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology Department, Hospital SOLCA Guayaquil, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enmanuel","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology Department, Hospital SOLCA Cuenca, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richar","family":"Cede\u00f1o","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology Department, Hospital SOLCA Manab\u00ed, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soledad","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology Department, Hospital SOLCA Loja, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Araceli","family":"Morales","sequence":"additional","affiliation":[{"name":"Department of Noncommunicable Diseases and Mental Health, World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toby","family":"Kasper","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine, St. Jude Children\u2019s Research Hospital, Memphis, TN, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Millan","sequence":"additional","affiliation":[{"name":"Department of Noncommunicable Diseases and Mental Health, World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Alcocer","sequence":"additional","affiliation":[{"name":"Regional Revolving Funds, Pan American Health Organization, Washington, DC, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Lim","sequence":"additional","affiliation":[{"name":"Regional Revolving Funds, Pan American Health Organization, Washington, DC, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Maza","sequence":"additional","affiliation":[{"name":"Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Luciani","sequence":"additional","affiliation":[{"name":"Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Rodr\u00edguez-Galindo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine, St. Jude Children\u2019s Research Hospital, Memphis, TN, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Quezada","sequence":"additional","affiliation":[{"name":"Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11167","reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"V\u00e1squez L, Fuentes-Alab\u00ed S, Loggetto P, Benitez-Majano S, Metzger ML, Jarquin-Pardo M, et al. Advances in the Global Initiative for Childhood Cancer: implementation in Latin America and the Caribbean. Rev Panam Salud Publica. 2023;47:e128. doi: 10.26633\/RPSP.2023.128.","DOI":"10.26633\/RPSP.2023.128"},{"key":"ref2","unstructured":"Pan American Health Organization. Infograf\u00eda: perfiles de pa\u00eds del c\u00e1ncer en la ni\u00f1ez: Ecuador [Infographic: childhood cancer profiles: Ecuador]. Washington (DC): PAHO; 2021 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/www.paho.org\/es\/documentos\/infografia-perfiles-pais-cancer-ninez-ecuador"},{"key":"ref3","unstructured":"St. Jude Children\u2019s Research Hospital. Global Platform for Access to Childhood Cancer Medicines [Internet]. Memphis (TN): St. Jude Children\u2019s Research Hospital; 2026 [cited 2026 Jun 15]. Available from: https:\/\/global.stjude.org\/en-us\/featured\/global-platform-for-access-to-childhood-cancer-medicines.html"},{"key":"ref4","unstructured":"World Health Organization. CureAll framework: WHO Global Initiative for Childhood Cancer. Increasing access, advancing quality, saving lives. Geneva: World Health Organization; 2021. https:\/\/iris.who.int\/handle\/10665\/347370"},{"key":"ref5","unstructured":"Ministry of Public Health of Ecuador. Ecuador ser\u00e1 el primer pa\u00eds en Am\u00e9rica Latina en ser parte de la Plataforma Global para el Acceso a Medicamentos contra el C\u00e1ncer Infantil [Ecuador will be the first country in Latin America to join the Global Platform for Access to Childhood Cancer Medicines] [Internet]. Quito: Ministry of Public Health; 2024 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/www.salud.gob.ec\/ecuador-sera-el-primer-pais-en-america-latina-en-ser-parte-de-la-plataforma-global-para-el-acceso-a-medicamentos-contra-el-cancer-infantil\/"},{"key":"ref6","unstructured":"Ministry of Public Health of Ecuador. Ecuador pionero en las Am\u00e9ricas para garantizar acceso a medicamentos contra el c\u00e1ncer infantil [Ecuador: a pioneer in the Americas in ensuring access to childhood cancer medicines] [Internet]. Quito: Ministry of Public Health; 2024... [cited 2025 Oct 22]. Spanish. Available from: https:\/\/www.salud.gob.ec\/ecuador-pionero-en-las-americas-para-garantizar-acceso-a-medicamentos-contra-el-cancer-infantil\/"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Walt G, Gilson L. Reforming the health sector in developing countries: the central role of policy analysis. Health Policy Plan. 1994;9(4):353-70. doi: 10.1093\/heapol\/9.4.353.","DOI":"10.1093\/heapol\/9.4.353"},{"key":"ref8","unstructured":"Pan American Health Organization. Ecuador, primer pa\u00eds en la regi\u00f3n que inicia la implementaci\u00f3n de la Plataforma Global de Acceso para Medicamentos Contra el C\u00e1ncer Infantil [Ecuador, the first country in the region to begin implementing the Global Platform for Access to Childhood Cancer Medicines] [Internet]. Washington (DC): PAHO; 2024 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/www.paho.org\/fr\/node\/94733"},{"key":"ref9","unstructured":"Pan American Health Organization. Ecuador pionero en las Am\u00e9ricas para garantizar acceso a medicamentos contra el c\u00e1ncer infantil [Ecuador: a pioneer in the Americas in guaranteeing access to medicines for childhood cancer]. [Internet]. Washington (DC): PAHO; 2024 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/www.paho.org\/es\/noticias\/2-8-2024-ecuador-pionero-americas-para-garantizar-acceso-medicamentos-contra-cancer"},{"key":"ref10","unstructured":"Pan American Health Organization. QuantMET [online training portal]. Washington (DC): PAHO; 2026 [cited 2026 Jun 15]. Available from: https:\/\/quantmetdev.paho.org\/"},{"key":"ref11","unstructured":"St. Jude Children\u2019s Research Hospital. Chemoglobe: chemotherapy cost visualization tool beta [Internet]. Memphis (TN): St. Jude Children\u2019s Research Hospital; 2025 [cited 2025 Oct 22]. Available from: https:\/\/chemoglobe.stjude.org\/"},{"key":"ref12","unstructured":"Ministry of Public Health of Ecuador. Comisi\u00f3n Nacional de C\u00e1ncer en ni\u00f1os, ni\u00f1as y adolescentes [National Commission for Childhood and Adolescent Cancer] [Internet]. Quito: Ministry of Public Health; 2025 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/www.conasa.gob.ec\/comision-nacional-de-cancer-en-ninos-ninas-y-adolescentes\/"},{"key":"ref13","unstructured":"Ministry of Public Health of Ecuador. La Comisi\u00f3n Nacional de C\u00e1ncer Infantil fortalece la articulaci\u00f3n con organizaciones sociales del pa\u00eds [The National Commission for Childhood Cancer strengthens coordination with social organizations across the country] [Internet]. Quito: Ministry of Public Health; 2025 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/www.conasa.gob.ec\/la-comision-nacional-de-cancer-infantil-fortalece-la-articulacion-con-organizaciones-sociales-del-pais\/"},{"key":"ref14","unstructured":"National Assembly of Ecuador. Aprobaci\u00f3n del Proyecto de Ley Org\u00e1nica para la Atenci\u00f3n Integral del C\u00e1ncer [Approval of the Organic Law for Comprehensive Cancer Care] [Internet]. Quito: National Assembly of Ecuador; 2026 [cited 2026 Jun 15]. Spanish. Available from: https:\/\/www.asambleanacional.gob.ec\/es\/blogs\/comisiondiez\/113154-aprobacion-del-proyecto-de-ley-organica-para"},{"key":"ref15","unstructured":"Ministry of Public Health of Ecuador. Bolet\u00edn: Voces de Vida [Internet]. Quito: Ministry of Public Health; 2025 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/www.conasa.gob.ec\/comision-nacional-de-cancer-en-ninos-ninas-y-adolescentes\/boletin-voces-de-vida\/"},{"key":"ref16","unstructured":"Pan American Health Organization. Recomendaciones b\u00e1sicas para el manejo de citot\u00f3xicos en la quimioterapia pedi\u00e1trica. M\u00f3dulo 01: Conceptos b\u00e1sicos para el manejo de medicamentos citot\u00f3xicos en pediatr\u00eda [Basic recommendations for the management of cytotoxic medicines in pediatric chemotherapy. Module 1: Basic concepts for the management of cytotoxic medicines in pediatrics]. Washington (DC): PAHO; 2025 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/iris.paho.org\/handle\/10665.2\/63355"},{"key":"ref17","unstructured":"Pan American Health Organization. Curso virtual. Recomendaciones b\u00e1sicas de manejo de quimioterapia pedi\u00e1trica \u2013 Edici\u00f3n Ecuador 2025 [Virtual course. Basic recommendations for the management of cytotoxic medicines in pediatric chemotherapy\u2013 Ecuador edition 2025]. Washington (DC): PAHO; 2025 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/campus.paho.org\/es\/curso\/quimioterapia-ecuador"},{"key":"ref18","unstructured":"Ministry of Public Health of Ecuador. Mediante la gesti\u00f3n del MSP, SOLCA ser\u00e1 parte de la Plataforma Global para acceso a medicamentos contra el c\u00e1ncer infantil [Through the Ministry of Health\u2019s leadership, SOLCA will become part of the Global Platform for Access to Childhood Cancer Medicines] [Internet]. Quito: Ministry of Public Health; 2025 [cited 2025 Oct 22]. Spanish. Available from: https:\/\/www.salud.gob.ec\/msp-logra-integracion-de-SOLCA-a-la-plataforma-global-para-acceso-a-medicamentos-contra-el-cancer-infantil\/"},{"key":"ref19","unstructured":"United Nations Children\u2019s Fund. WHO and UNICEF welcome first delivery of essential childhood cancer medicines to Nepal under Global Platform Initiative [Internet]. New York: UNICEF; 2025 [cited 2025 Oct 22]. Available from: https:\/\/www.unicef.org\/nepal\/press-releases\/who-and-unicef-welcome-first-delivery-essential-childhood-cancer-medicines-nepal"},{"key":"ref20","unstructured":"St. Jude Children\u2019s Research Hospital. WHO, St. Jude launch groundbreaking international delivery of childhood cancer medicines [Internet]. Memphis (TN): St. Jude Children\u2019s Research Hospital; 2025 [cited 2025 Oct 22]. Available from: https:\/\/www.stjude.org\/media-resources\/news-releases\/2025-medicine-science-news\/who-st-jude-launch-groundbreaking-international-delivery-of-childhood-cancer-medicines.html"}],"container-title":["Revista Panamericana de Salud P\u00fablica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/iris.paho.org\/bitstreams\/e3266c63-6a0f-4c2b-a9da-a4cdfe3ce578\/download","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:28:55Z","timestamp":1788186535000},"score":1,"resource":{"primary":{"URL":"https:\/\/iris.paho.org\/handle\/10665.2\/72153"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":20,"alternative-id":["RPSP.2026.74"],"URL":"https:\/\/doi.org\/10.26633\/rpsp.2026.74","relation":{},"ISSN":["1020-4989","1680-5348"],"issn-type":[{"value":"1020-4989","type":"print"},{"value":"1680-5348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]}}}