Challenges

The “Promoting Timely Diagnosis of Cancer in Children, Adolescents in the Andean Subregion” project addresses the critical challenge of high childhood cancer mortality rates in the Andean subregion, which includes Bolivia, Chile, Colombia, Ecuador, Peru, and Venezuela. Childhood cancer is the leading cause of death from non-communicable diseases in these countries, with significant disparities in survival rates compared to high-income countries. Key issues include late diagnosis, treatment abandonment, malnutrition, infection-related toxicity, and inadequate access to effective treatments. To achieve Sustainable Development Goals (SDGs) 3 (Good Health and Well-being) and 10 (Reduced Inequalities), it is essential to improve early diagnosis, treatment accessibility, and healthcare system strengthening through regional cooperation and evidence-based strategies.

Toward a Solution

The initiative aims to significantly reduce childhood cancer mortality rates in the Andean subregion by promoting early diagnosis and improving access to effective treatments. This aligns with SDG 3 (Good Health and Well-being) and SDG 10 (Reduced Inequalities), focusing on enhancing healthcare systems and reducing disparities in cancer survival rates.

To address these challenges, the project employed a multifaceted approach centered on three pillars: training, communication, and collaboration. Training involved capacity-building for healthcare professionals and community health workers through workshops, virtual courses, and national training plans. For example, more than 3,500 professionals were trained onsite, and more than 44,000 participants were trained through the dissemination of a regional virtual course on childhood cancer on the PAHO Virtual Campus for Public Health.

Within the framework of South-South cooperation, a communication strategy was developed focused on raising awareness about the symptoms and signs of childhood cancer in the countries of the Andean subregion. This strategy included the creation of communication materials such as graphic pieces, radio advertisements, jingles, and videos, culturally and linguistically adapted to each country. For example, in Colombia, an adaptation was made to the Wayúu language. The campaign aimed to increase awareness about the importance of early recognition of the symptoms and signs of childhood cancer, especially among the general population, parents, caregivers, and educators. In addition, collaboration was strengthened between the communication teams and cancer technicians of the ministries of health of the Andean countries, along with PAHO and ORAS-CONHU, to ensure the relevance and effectiveness of the messages.

Collaboration was fostered through South-South cooperation, enabling the exchange of good practices and methodologies between countries. Activities included in-person and virtual training sessions, communication campaigns, binational experience-sharing sessions, adaptation of educational materials, and technical meetings to develop a regional roadmap to strengthen early diagnosis of childhood cancer.

The participatory nature of the initiative was evident in the involvement of various stakeholders, including ministries of health, regional health authorities, international organizations like the Pan American Health Organization (PAHO), and local communities. Concerted actions included regular meetings, workshops, and collaborative projects to ensure alignment and commitment from all partners.

The initiative’s success in transferring good practices across countries is demonstrated by the widespread adoption of training programs and communication materials. For instance, over 33,000 healthcare professionals enrolled in Ecuador’s mandatory virtual course on early cancer diagnosis seen, making the country a regional leader in training efforts in this area. Similarly, Bolivia, Ecuador and Venezuela’s development of national manuals for early cancer detection showcased the effective transfer of knowledge and practices to the other countries involved in the initiative.

Quantitative outcomes highlight the initiative’s impact; a)  Andean roadmap and ministerial resolution (2024-2030, ORAS-CONHU) declaring childhood cancer a public health problem; b) more than 3,500 professionals trained in the timely diagnosis of childhood and adolescent cancer; c) more than 44,000 participants trained through the dissemination of a regional virtual course on childhood cancer on the PAHO Virtual Campus for Public Health; d) national early detection campaigns; and e) a strengthened partnership with St. Jude Children’s Research Hospital that mobilized additional resources; f) publication of good practices in South-South cooperation.

Innovative aspects of the initiative included the use of virtual platforms for widespread training, the adaptation of communication materials to local contexts, and the establishment of regional cooperation mechanisms. These innovations improved the competitive advantage of participating countries by building robust healthcare systems capable of addressing childhood cancer effectively.

Sustainability was ensured through policy impacts, such as the adoption of national cancer plans and cooperation agreements. The initiative’s benefits are likely to continue over the medium to long term, supported by ongoing regional integration efforts and the commitment of involved stakeholders.

Replicability was facilitated by the adaptable nature of the training and communication materials, which can be tailored to different contexts and settings. Conditions for successful replication included strong stakeholder engagement, adequate funding, and the establishment of clear guidelines and protocols.

Lessons learned from the initiative emphasized the importance of effective cooperation, continuous monitoring, and the need for culturally relevant approaches. Future efforts should focus on expanding funding sources, optimizing resource use, and strengthening intersectoral collaboration to sustain and scale the initiative’s impact.