Helping childhood cancer go from invisible to a public health priority in Ecuador

There was a time in Ecuador when childhood cancer existed only in whispered diagnoses, fragmented hospital charts and hopeful prayers. It was a silent crisis. A burden carried in the hearts of families but largely absent from national health data and public awareness. That is beginning to change.

In April 2023, Ecuador signed on to participate in the pilot phase of the Global Platform for Access to Childhood Cancer Medicines, a program conceived through a partnership between St. Jude Children’s Research Hospital and World Health Organization. Since then, the country has taken on an ambitious goal to bring childhood cancer into full view and build a coordinated system where treatment is consistent, accessible and grounded in evidence.

The path forward required gathering institutions that had long operated independently and asking them to move with a shared purpose. Lissette Mármol, MD, childhood cancer focal point at Ecuador’s Ministry of Public Health, recalled the moment the announcement came.

“At first, people didn’t believe it was really happening,” she said. “There was a sense of surprise, but also relief, because we finally had an opportunity to organize ourselves.”

Cancer care changes gain momentum

As the conversations at the Ministry of Public Health continued, a unified vision formed. That process also meant confronting a persistent cultural reality.

Mármol described how, in many communities, cancer remains a word people hesitate to say aloud. “Families are afraid of what the diagnosis means,” she said. “When it involves a child, the fear is even stronger, and sometimes it keeps people from seeking specialized care.” The Global Platform helped create space for a different kind of conversation.

A critical shift occurred when national leaders agreed that the strategy would center on the needs of children rather than the structure of the system. “Once we said, ‘The priority is the child with cancer,’ everything changed,” Mármol said. “This shared focus encouraged closer collaboration among institutions and strengthened coordination across the health system.” That strengthened collaboration made it possible to address longstanding barriers.

Consensus was reached on essential medicines, updates to the national formulary and the articulation of cancer-care networks, including the Sociedad de Lucha Contra el Cáncer (SOLCA), within a more integrated national approach. Plans expanded to include treatment protocols for pediatric cancers, improvements in supply-chain management and increased access across public hospitals.

The work gained visible momentum in early 2025 when Ecuador became the first country in the Americas to receive a shipment of childhood cancer medicines through the Global Platform. For many families, the delivery represented stability where uncertainty had once been the norm.

A brighter future for children with cancer in Ecuador

Beyond drug access, Ecuador is now preparing to implement an official registry that will follow each child from first symptoms through treatment and follow-up. The registry is designed to capture incidence, outcomes and barriers across the continuum of care. Mármol emphasized its importance, noting that “for the first time, we will truly understand how children are moving through the system. We will see where they start, where they get stuck and where we need to improve.”

Additional initiatives include early detection awareness, expansion of specialized services, strengthening palliative care and monitoring medication use. Despite

challenges related to leadership transitions and resource constraints, progress has continued with support from national health authorities and increased public visibility led by the First Lady of Ecuador, Lavinia Valbonesi.

More than just structural reform, the effort is shifting how childhood cancer is understood nationwide. What was once a quiet, often unspoken fear is emerging as a clearly defined public health priority. International collaboration helped launch the effort, but national ownership is shaping its future. Each advancement reinforces a system committed to recognizing every child who needs care.

For families, this shift brings real hope. For clinicians and health-system leaders, it signals a more coordinated and accountable framework for care. For Ecuador, it offers a future where children with cancer are no longer invisible but seen and supported throughout their full treatment journey.

Much work remains, but the direction is unmistakable: from silence toward recognition, from fragmentation toward cohesion, from precarious access toward dependable treatment. As Mármol put it, “We are building something that will last. And for our children, that changes everything.”