Transforming pediatric oncology in Ecuador through the Global Platform for Access to Childhood Cancer Medicines
Abstract
ABSTRACT Background. 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’s Research Hospital to ensure equitable access to quality medicines while strengthening health systems. Methods. Between 2023 and 2025, Ecuador’s 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 2024–2026 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’s cold-chain infrastructure. Results. 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. Conclusions. 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.