ASCO 23: Global Health Initiative is Ensuring Equitable Cancer Care Beyond South Florida’s Borders

Newswise — MIAMI, FLORIDA (May 30, 2023) – Dr. Gilberto Lopes has a passion for equitable cancer care that extends far beyond his home base at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine and the South Florida region.

Lopes, Sylvester’s and UM’s chief of medical oncology, medical director for international programs and associate director for global oncology, has taken a leadership role with the Access to Oncology Medicines (ATOM) Coalition, a global initiative established by the Union for International Cancer Control and partners like Sylvester to reduce suffering and deaths from cancer in low- and lower middle-income countries (LLMICs) by improving patient access to essential cancer medicine.

He will highlight his and others’ work with the coalition during a presentation at ASCO’s 2023 annual meeting in Chicago June 2-6. His talk, scheduled for June 3, is titled, “The Potential for Using the ATOM Model to Impact Cancer Mortality in Low- and Lower Middle-Income Countries.”

Lopes serves as the Coalition’s co-chair, and Sylvester is a founding member and one of only two academic medical centers in the coalition. Its other partners include pharmaceutical companies, foundations and professional associations such as the American Society for Clinical Oncology (ASCO) and American Society for Clinical Pathology (ASCP).

Launched in May 2022, the coalition aims not only to improve cancer medicine availability, but also to increase the capacity of these countries to properly diagnose cancer and manage their precious supply of these vital medications. The coalition plans to prioritize generic and biosimilar medicines currently on the World Health Organization’s Essential Medicines List (WHO EML) to treat cancers that cause the heaviest mortality in LLMICs.

“These are vital, lifesaving cancer medications for the most lethal cancers in ATOM Coalition target countries,” Lopes explained. “They include medicines for lung, colorectal, breast, cervical, prostate and childhood cancers.”

Background

In 2020, more than 10 million people died from cancer worldwide – and 70 percent of the deaths occurred in low- and middle-income countries, according to the World Health Organization. Additionally, the WHO forecasts that most cancer deaths over the next decade will occur in these countries.

Lopes said the coalition has identified 46 target countries that need greater access to cancer medicines and support services to bolster their capacity for long-term drug scalability and sustainability. The countries are spread over seven regions: Africa, Americas, Eastern Mediterranean, Europe, South Asia and the Western Pacific.

Among these countries, with a combined population of about 2.5 billion residents, there were 3.5 million new cancer patients in 2020 and 2.3 million premature cancer deaths, Lopes noted. “By 2040,” he added, “we project a staggering 4 million cancer deaths within these countries.”

Moving Forward

The coalition is currently working on the selection of its initial subset of countries for focused country capacity-building engagement, with additional ones phased in over time, Lopes said. Countries will be selected based on a range of readiness criteria, including the presence of ATOM Coalition partners, health systems preparedness, diagnostic capability, essential medicines already on their national EML and other access programs.

“When the first subset of targeted countries is determined, our focus will shift to the ATOM Coalition operating model’s two main tenets – increasing availability and affordability of cancer medicines and increasing target countries’ capacity to use them appropriately,” Lopes explained.

Toward this goal, he continued, the coalition will work with governmental and other stakeholders in these countries to assess needs, offer training and provide capacity-building support. Additionally, the coalition will support generic, biosimilar and originator drug manufacturers to develop, register and supply essential cancer medicines at affordable prices. It also will look at using voluntary licenses for patented essential medicines and new drugs of significant public health importance for the countries.

Indeed, in October 2022, the Medicines Patent Pool (MPP) and Novartis AG, both supporters of the ATOM Coalition, signed a voluntary licensing agreement to increase access to nilotinib, an oral medication used in the treatment of chronic myeloid leukemia (CML), which is on the WHO EML for the treatment of cancer. This allows participating generic manufacturers to supply generic versions of nilotinib. This is the first license that MPP has signed for a cancer treatment, and the first time a company is licensing a patented cancer medicine through a public health-oriented voluntary licensing mechanism. This mechanism was instrumental in increasing access to HIV medications in lower income countries.

Moving forward will require continued engagement with all relevant stakeholders, including the private sector, national government and local civil society organizations, Lopes said. Other key elements that the coalition is building to ensure success include a governance structure and an engagement strategy led by the ATOM Coalition Council and partners in each country, which will be supported by local coordination groups – and, of course, sustainable funding sources.

Lopes said the coalition needs more seed funding now and more ongoing funding for its long-term viability. Potential sources include pharmaceutical companies and related royalty agreements, development agencies, and foundations.

Although the coalition faces daunting challenges ahead, Lopes is confident of its eventual success. “We have the energy, expertise and collective will to reach our lofty goals,” he said. “We must succeed. It’s too important for the future of these countries.”  

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