Barriers to healthcare access of Pinoy kids with cancer revealed

MANILA, Philippines - Over 200,000 children develop cancer worldwide each year. Eighty percent of these children live in poorer developing countries where less than 10 percent will survive, compared to at least 80 percent survival rate in high-income countries. 

In the Philippines, about 3,500 new cases among children will be diagnosed with cancer each year, with 70 percent of them at late stages of the disease when cure is no longer possible, or can only be possible with most aggressive and costly treatment most families could not afford. 

Only one in five children will be treated effectively, mostly as paying patients, but treatment abandonment rate is still high at 80 percent, and survival rate is barely two in 10 children. 

Because of the high cost of diagnosis and treatment that childhood cancer entails, many families can be pushed to poverty in their attempt to save their children.

“The rise of cancer worldwide is a major obstacle to human development and well-being,” said Dr. Christopher Wild, director of the International Agency for Research on Cancer (IARC), a United Nations agency. 

“These new figures and projections send a strong signal that immediate action is needed to confront this human disaster, which touches every community worldwide, without exception,” Wild added.

IARC’s The World Cancer Report 2014 confirms that inequality exists in cancer control and care globally.  The number of deaths due to the disease among the world’s poor is growing at a faster rate than previously expected. Specifically, by 2025, almost 80 percent of the increase in the number of all cancer deaths will occur in less developed regions.

Dr. Julius Lecciones, executive director of the Philippine Children’s Medical Center (PCMC), and country coordinator of My Child Matters Philippines, said, “We observed an increasing number of children with cancer in many hospitals. At PCMC, for instance, there are 506 children actively being treated for cancer, with about 30 percent increase in the number of patient admissions each year, the fastest growing population of patients in the hospital.” 

“Leukemia, a highly curable disease in children and accounts for about 40-60 percent of childhood cancers, is the number one killer of patients at PCMC, more than the deaths due to dengue shock syndrome, sepsis and prematurity combined. The poorer patients are most vulnerable,” he said. 

Lecciones added: “Seventy-seven percent of cancer patients at PCMC are service patients. Only 34 percent of them are PhilHealth members, and a significant number are from the provinces. Without financial assistance coming from different sources, many of them will not survive.”

Additionally, the reality of cancer cure rates in children is reflective of the inexcusable inequities in access to care and essential cancer medicines that occur globally. In more than 70 percent of the 200,000 newly diagnosed cases of childhood cancer worldwide each year, mostly from low-income countries, lack of access to effective treatment results in unacceptably low survival rates. 

However, death is only part of the picture, with cancer-related illness and disability limiting opportunities for schooling and education, and ultimately impeding full participation in the workforce. Parents and caregivers of children may also be severely impacted by the significant costs of treatment, pushing families into poverty.

“Inequities in access to cancer services are closely associated with socioeconomic status with the poor and vulnerable populations unable to afford expensive cancer medicine, as well as experiencing other obstacles to access such as distance to quality treatment facilities,” Lecciones said. 

“Poor diagnosis of childhood cancer can also be equated with too few specially trained doctors and nurses, and the mistaken belief that childhood cancer is too difficult to cure, combine to create very low survival rates in our country,” he said.

“Additionally, in many countries, irrelevant of their resource setting, lack of health insurance and other barriers prevent people from getting access to even basic cancer healthcare. Universal health coverage (UHC) to ensure access to healthcare is a key element of any effort to reduce social inequities in cancer outcome,” he added. 

According to the World Health Organization, universal health coverage is the hallmark of a government’s commitment to improve the well-being of all its citizens.

It has been proven that cancer is curable even in resource-poor countries.  It is possible to save lives of 50-60 percent of children with easily treatable malignancies with relatively simple and inexpensive drugs and procedures that have been known to doctors for decades. 

The PCMC, through its My Child Matters program implemented since 2006, demonstrated that by mobilizing all stakeholders for concerted action to ensure that strategies to control childhood cancer are targeted to those who are most in need, early detected cases now increased to 60-70 percent from 30 percent, treatment abandonment rate decreased from 80 to 10 percent, and survival rate improved from 16 to 78 percent. 

This was achieved through sustained national public awareness and information campaigns for the last seven years, the development of a national referral network of 35 public and private hospitals all over the country, partnership with DOH-NCPAM in the ALLMAP which provided free chemotherapy drugs for service patients, and technical support to PhilHealth in the crafting of the expanded-benefit Z-package for acute childhood leukemia.

The My Child Matters campaign was started in 2006 as a mobilization campaign to raise awareness for childhood cancer and enlist the support from both the private and public sectors for a concerted effort for childhood cancer prevention and management.

Lecciones said, “We need to increase the political priority given to cancer by demonstrating that the government’s investment in dealing with its growing cancer problem is an investment in the economic and social well-being of Filipinos.” 

According to the Universal Declaration of Human Rights, “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.”