Revolutionising cancer treatment access in low-resource settings

A recent opinion article published in The Lancet Oncology, titled ‘Revolutionising cancer treatment access in low-income and middle-income countries – a sustainable approach,’ highlights the innovative strategies and sustainable pathways developed by the UICC-led ATOM Coalition to improve access to oncology medicines and technologies in low-income and middle-income countries (LMICs).

The article was written by Amy Israel, Senior Advisor to the ATOM Coalition; Cary Adams, CEO of UICC; Dr Gilberto Lopes, a UICC Board Member and Chair of the ATOM Coalition; Dr Dan Milner, Executive Director of the ATOM Coalition; and Sumithra Krishnamurthy Reddiar, Country Support for the ATOM Coalition.

The authors first outline the persistent and challenges that exist in accessing critical cancer medicines and technologies in LMICs. “The availability of essential medicines in LMICs has only modestly improved over the past 15 years. Average availability of commonly used generic medicines in public sectors of LMICs increased from 29–54% in 2009 to 38–68% in 2024. However, availability of patented medicines fared worse, ranging from 18-48% in the private sector,” the authors explain, citing two studies published in The Lancet [1] and The Lancet Oncology [2].

The article goes on to expose the barriers to access, which involve an array of interconnected factors, including fragmented health systems, complex regulatory mechanisms, procurement issues, supply chain fragility, the absence of pharmaceutical and diagnostic companies with a heavy reliance on third-party distributors, weak early detection capabilities, costly treatment and care, and lack of universal health coverage.

The authors then explain some of the actions taken by the ATOM Coalition since its launch in 2022. Harnessing the collective expertise of over 40 partners spanning civil society, public, and private sectors, the Coalition is able to address these different challenges, and enhance the availability, affordability, and appropriate use of oncology medicines and diagnostics in LMICs.

The article also outlines four sustainable access pathways developed by the ATOM Coalition:

1. Public health-oriented licensing:  Innovators can grant non-exclusive licenses for their patented priority cancer medicines through Medicines Patent Pool, allowing high-quality generic manufacturers to produce and distribute these medicines in ATOM Coalition target countries, enabling long-term sustainable access and maximising patient reach.
2. Humanitarian access through donations: Companies with donation programmes through the Max Foundation can optimise impact and reach in ATOM Coalition countries, thereby preparing the environment for medicine uptake and strengthening capacity for the long term.
3. NCDconnect: A digital procurement platform with partner IDA Foundation, which streamlines supply chains, allows buyers to consolidate their demand for efficiency, and enables economies of scale to enhance predictability.  
4. Indirect commercialisation: IDA Foundation can support the introduction of medicines with capabilities to manage the entire process from regulatory to last-mile delivery, offering solutions across the value chain.

The ATOM Coalition's efforts demonstrate that equitable access to cancer medicines is achievable through collaboration and innovative solutions.

Access the article in The Lancet (paid subscription) 

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References:

[1] Cameron, A ∙ Ewen, M ∙ Ross-Degnan, D ∙ et al. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet. 2009; 373:240-249

[2] Fundytus, A ∙ Sengar, M ∙ Lombe, D ∙ et al. Access to cancer medicines deemed essential by oncologists in 82 countries: an international, cross-sectional survey. Lancet Oncol. 2021; 22:1367-1377