Access to childhood cancer medicines grows trust and security in Zambia

When a child is sick, establishing trust is incredibly valuable between a family and the treating physician. When that child is facing cancer, building that trust is even more crucial. In the United States, where survival rates for pediatric cancer treatment are eclipsing 80%, families readily place their child’s life within physicians’ hands, trusting that these medical professionals will do everything they can to save their loved ones. However, in much of the rest of the world, survival rates remain stubbornly low at 30%, causing a disconnect between physicians and families, leading to a culture of discontinuing pediatric cancer treatments, or worse, avoiding therapy altogether.

One such country impacted by a low survival rate of childhood cancer is Zambia, located in south-central Africa. Zambians have not had regular access to proper medicines for children with cancer. A lack of local chemotherapy manufacturers meant the drug supply was erratic, causing frequent disruptions to treatment plans. Faced with these disruptions, families sometimes decided to stop therapy; they had lost trust in the physicians and medicines that were available.

When Maliwa Mushikita, senior pharmacist at Cancer Diseases Hospital, Zambia, first learned of the Global Platform for Access to Childhood Medicines (Global Platform), she thought, “Here was an opportunity we couldn’t miss — a chance to improve supply chain management of our medicines and overall pediatric cancer care.” Administered by a partnership between St. Jude and World Health Organization (WHO) collaborating with a participating country, the specific approach is co-designed by all groups involved to create a sustainable solution. The Global Platform purchases cancer medicines in bulk, then initially distributes them at no cost to recipient countries. The initiative assures the quality and efficacy of those medicines, which are all on the WHO Essential Medicines List, a problem that many resource-limited health centers across the world do not have the capacity to confront.

These offerings met the exact needs of Zambian children being treated for cancer: a regular supply of high-quality medicine, which could build the trust needed for families to participate in treatment. They could be secure in the knowledge that physicians in Zambia, like those in highly resourced settings, would receive the best therapy available, without running out of their supply of oncology drugs.

“After coming onto the Global Platform, we’ve seen a significant improvement in the consistent availability of medicines,” Mushikita said. “Participating in this project has been a game-changer for our institution and for the country at large. Since our first consignment in March of 2025, we have treated close to 303 pediatric patients.”

Medicines form the foundation of local trust

While receiving medicines from the Global Platform has started changing the landscape for childhood cancer treatment in Zambia, there is still much left to do. A history of pharmaceutical unavailability has lost the faith of everyday people in the country. The Zambian team is now tasked with communicating about the newfound supply and what it means for families facing pediatric disease.

“Medicines alone are not enough,” Mushikita said. “We have to look at childhood cancers holistically, i.e., we need to reach the remotest areas, screen the children and refer those eligible for treatment, as early detection will improve treatment outcomes and overall survival rates. We must conduct community sensitization countrywide, so families know that we have these medicines available.”

With over 70 languages spoken throughout Zambia, creating a countrywide campaign is complex. In addition, the Cancer Diseases Hospital, the only cancer center in the country, is located in the capital, Lusaka, complicating efforts to bring messages to outlying populations.

“Patients travel long distances from across the country to be treated,” Mushikita said. “We must strengthen logistics and outreach systems to identify children in remote areas and bring them into care in collaboration with the Ministry of Health and other partners.”

For those patients and families that the hospital has reached, especially those that are now receiving medicine, the reaction is positive. “The patients and caregivers are very thankful,” Mushikita explained. “We had a big celebration and launch at the institution when the medicines first arrived, where many families expressed their gratitude for them.” The occasion was graced by the permanent secretary (Ministry of Health), World Health Organization (Country Director) and Civil Society organizations.

Securing the future of pediatric cancer care in Zambia

Physicians can help these families feel more secure that the supply of medicines will be regular, no longer the erratic inventory historically leading to treatment abandonment. “Previously, caregivers would sometimes leave the hospital because there were no medicines available,” Mushikita said. “Now, since receiving the medicines, more caregivers are bringing their children in and adhering to their treatment programs.”

Treatment adherence is very important for many pediatric cancer treatments, which can be long-term, multi-year therapies. Any disruption can decrease the treatment’s potency, leading to worse outcomes. By making treatment continuous, with families better adhering to the therapy schedule, clinicians expect to improve those odds.

Currently, Zambia has not made its analysis of the medicines’ effects public, so there is no formal report available to determine if the program has increased survival. However, an estimated 303 children have received medicine, an early sign of success. “It looks very promising,” Mushikita said. “We’ve seen quite a number of children come back for their reviews and adhere to their treatment appointments; it is quite fulfilling to see such a consistent supply of high-quality cancer medicines so far.”

Patient and caregiver behavior is already changing: the ultimate sign of faith being restored into the Zambian medical system. Clinicians in Zambia, like Mushikita and her colleagues, will build further on that work, increasing the trust between children, caregivers and oncologists, empowered by the Global Platform. Together, they will secure a better future for pediatric patients with cancer in Zambia.

“As a country, we are thankful that we have actually been given this opportunity to participate in this project,” Mushikita concluded. “We hope it will transform how we manage pediatric cancers in our nation and improve survival outcomes for our children.”