The Challenge of Childhood Cancer in Developing Countries

Cancer is one of the major causes of morbidity and mortality across the world but more in developing countries. Worldwide about 160,000 new cases and 90,000 deaths occur every year in children under the age of 15 years due to cancer. Childhood cancer is the second leading cause of death worldwide surpassed only by accidents (1). Data on cancer incidence are scanty in developing countries. Most of them are hospitalbased statistics and of little value due to inadequate cancer registry and records keeping in developing countries. In developing countries, though significant progress is made in combating common childhood killers like malaria, pneumonia, gastroenteritis; cancer and trauma are emerging as major childhood killers (2). However, the greatest burden of childhood cancer is in these countries where more than 90% of the world’s children are living. As stated above, over the past decades, although substantial achievements have been made in combating common communicable causes of childhood morbidity and mortality, malignancy was not considered as a public health problem in the developing world including Ethiopia. On the other hand, childhood cancers in most cases are treatable where more than 70% of these children can be cured of their cancers as demonstrated in most centers in the developed world. On the contrary, mortality rates for most pediatric cancers are close to 100% in developing countries (3). To improve the lives of children living with cancer in the developing countries, strategies have to be designed that aimed increasing access to quality and modern treatment and define the minimal requirements for delivery of optimal care. Strategies to achieve the above goals would include the following (4): 1. Establishment of a pediatric cancer unit where needy children get access to optimum treatment; and oncology registry, research and training are coordinated. 2. Training of cancer care specialists of all cadres including nurses, clinicians, pathologists, radiologists, surgeons and other support staffs as human power is the key challenge faced by developing countries. 3. Development of standardized treatment protocols for all the major pediatric cancers as adopting protocols from the developed world may not work. 4. Establishment of supportive care and putting in place guidelines for supportive care. 5. Establishment of quality palliative care and palliative care policies. 6. Drug pricing and availability initiatives/policies.