Navigating Inequity: The Struggle for Access to Targeted Cancer Therapies in Low-Income Nations

-by Dr Melsa Omaya

Cancer remains one of the world’s most persistent and growing global health challenges, affecting millions of lives each year and accounting for the majority of deaths and disabilities worldwide. In Kenya, as in other lower-income countries, the incidence of cancer is rising fast, creating unprecedented challenges for health systems, many of which were designed in an era that did not foresee this epidemic. For lower-income countries, these challenges are multiplied by the double burden of disease, the long-running battle against infection is complicated by the rising burden of chronic diseases.

In recent years, advancements in medical science have led to the development of targeted therapy, a revolutionary approach to cancer treatment that focuses on attacking specific molecules or pathways involved in the growth of cancer cells. While targeted therapy offers immense promise for improving cancer treatment outcomes and mitigating the side effects associated with chemotherapy, its practical implementation in low-income countries presents a multitude of challenges. The intersection of limited resources, infrastructure, and access to healthcare creates significant barriers to the widespread adoption of targeted therapy for cancer treatment in these regions.

Expensive Tests

Targeted therapy often demands precise genetic/molecular profiling of patients' tumors, which involves relatively expensive testing. As a resident in oncology, it is my responsibility to explain all treatment options to my patients, their financial situation notwithstanding. Frequently, patients spend all their resources on the tests but, in the end, do not benefit from treatment as all their resources are exhausted. One wonders whether it is ethically sound to discuss revolutionary treatment in the first place, knowing that only the wealthy can access it.  In many respects, this mirrors the early days of anti-retroviral therapy for HIV/AIDS; for years, it was considered an intervention only for wealthy nations.

Limited Access to Cutting -Edge Treatments

One of the foremost challenges faced by low-income countries in utilizing targeted therapy is the limited access to cutting-edge treatments. Targeted therapies often involve specialized drugs that are expensive to develop, produce, and distribute. This high cost can make these treatments unaffordable for many patients and healthcare systems in poor countries. Furthermore, the lack of well-established pharmaceutical manufacturing facilities in these regions can result in dependence on imported drugs, leading to further financial strain.

Infrastructure and Technical Expertise

The effective administration of targeted therapy requires a robust healthcare infrastructure and a skilled workforce. However, many low-income countries struggle with inadequate medical facilities, diagnostic capabilities, and trained personnel. Targeted therapy often demands sophisticated laboratory equipment and well-trained technicians. In regions where basic medical resources are scarce, implementing such complex diagnostic procedures becomes a significant challenge.

Uneven Distribution of Resources

The distribution of medical resources and expertise within low-income countries is often uneven. Urban areas tend to have better-equipped hospitals and healthcare professionals, leaving rural populations at a disadvantage. This urban-rural divide translates to unequal access to targeted therapy, as patients in remote regions may face difficulties in accessing treatment centres and obtaining necessary follow-up care.

Lack of Health Insurance and Financial Barriers

Inadequate health insurance coverage and financial barriers present additional obstacles to using targeted therapy in poor countries. Even if the treatments themselves were available, the cost of consultations, laboratory tests, and other ancillary services could accumulate, making the overall treatment journey unaffordable for many patients. This financial burden forces individuals to delay or forego treatment, leading to poorer health outcomes.

Clinical Trial Participation

Clinical trials play a pivotal role in advancing medical research and treatment options. However, low-income countries often struggle to participate in and conduct clinical trials for targeted therapies. The reasons include limited research infrastructure, regulatory hurdles, and a lack of patient awareness about the potential benefits of clinical trials. Consequently, these countries miss out on opportunities to contribute to medical knowledge and gain early access to innovative therapies.

Conclusion

The potential of targeted therapy to revolutionize cancer treatment is undeniable, but its adoption in low-income countries remains an intricate challenge. Addressing issues related to access, infrastructure, finances, and education is crucial to ensuring that all individuals, regardless of their economic circumstances, can benefit from these groundbreaking treatments. Global efforts, encompassing governments, organizations, and the medical community are essential to overcoming these challenges and moving towards more equitable cancer care worldwide.