Peru shows the way forward and the courage of Ander Martinez
“When Ander was diagnosed, I didn´t have the possibility to cover the cost of the treatment. It was very expensive, and I had nothing,” says Rosalina Tocto, 29 years mother of Ander Martínez Tocto. Ander had just been diagnosed with acute leukemia at the young age of 6 years. From the beginning, the odds were stacked against him. He and his family lived in a rural town, six hours from the nearest city. His parents did not have a formal job, placing the family under financial strain.
Ander and his family were not alone in this situation. “In Peru, nearly 1800 children and adolescents are diagnosed with cancer every year; however, up to 70% will have a late stage, often metastatic due to delays in diagnosis,” says Dr. Juan García, medical chief of the Pediatric Department of in the National Institute of Neoplastic Diseases (INEN) in Lima, Peru. “Most of our patients come from outside Lima and the majority of parents do not have formal employment and therefore do not have any type of insurance.”
Fortunately, Peru has made a strong commitment to Universal Health Coverage. In 2009, a law was passed to improve access to care by introducing a mandatory health insurance system and registering everyone living in extreme poverty under Seguro Integral de Salud (SIS), regardless of age or circumstance.
Dr. Reina Bustamante, Executive Director of the Division of Prevention and Control of Cancer of the MINSA says “UHC is an important step in public health particularly for those who lack public or private insurance like Ander. In this context, we are trying to follow WHO guidance to achieve UHC and ensure all individuals and communities receive the health services they need without suffering financial hardship.”
In 2019, Peru was selected as a focus country for the WHO Global Initiative for Childhood Cancer as the first focus country in the Region. The Global Initiative aims to improve survival for all children with cancer to at least 60% by 2030 while reducing suffering, altogether with the potential to save an additional one million lives.
Four main goals were formulated for the national pediatric cancer plan: (1) improve early diagnosis of childhood cancer, (2) decrease treatment abandonment, (3) implement a national pediatric cancer registry and (4) improve the quality of services in pediatric oncology units.
Dr. Liliana Vasquez, pediatric oncologist who works as an external consultant for the Division of Prevention and Control of Cancer of MINSA said, “Ten working groups have been established to achieve the goals.”
Dr. Vivian Perez, advisor of the Non-Communicable Diseases Office in PAHO-Peru added “the initial focus for the Initiative will be on six cancers selected as tracers for monitoring progress across the health system, alongside engagement of at least six focus countries with a record of strong political commitment and foundational efforts supporting children with cancer.”
For Ander, his health care team, the commitments from the government of Peru and partners and Global Initiative have made it possible to be successfully treated and will now allow him to dream of a healthy future though better access to surveillance monitoring and psycho-oncological support aimed at childhood cancer survivors.
Peru is showing what is possible for all countries. By concerted action and promoting universal health coverage, every child in the world can have access to high-quality care with the greatest likelihood of survival, and every family should be protected from financial hardship. We can do more together.