Free cancer treatment for children: Will Nepal deliver?

When a child is diagnosed with #cancer, the world of their family crumbles. There is shock, despair, and, above all, in the context of #Nepal, the paralyzing fear of how to afford treatment. In a country where nearly 20% of the population lives below the poverty line, catastrophic health expenditures push families into spiralling debt. This is why the announcement of St. Jude's Global Platform for Access to Childhood Cancer Medicines offering free cancer medicines is not just a beacon of hope—it's a potential game-changer.

The initiative by St. Jude Children's Research Hospital aims to provide equitable access to medicines for childhood cancer across the globe, including Nepal. St. Jude is revered globally as a pioneer in pediatric cancer research and treatment. It has played a pivotal role in raising childhood cancer survival rates and ensuring no family pays for treatment at its main hospital in the United States. Its mission, rooted in compassion and scientific excellence, has become a beacon of hope for countless families worldwide. To appreciate the significance of this program, one must first understand the brutal financial and emotional toll childhood cancer inflicts on impoverished families. Treatment often requires chemotherapy, radiation, specialized diagnostics, and months—if not years—of follow-up care. The cumulative cost is far beyond the reach of an average Nepali household.

While Nepal has made considerable progress in reducing poverty, healthcare spending remains overwhelmingly out-of-pocket. For many families, the prospect of selling land or withdrawing children from school to pay for a sibling's treatment is a grim reality. In this context, free treatment for diseases like cancer isn't just a public health intervention; it's a shield against poverty.

St. Jude's initiative also highlights an often-overlooked truth: access to essential medicines is a moral imperative, not a luxury. When a globally respected organization known for treatment excellence like St. Jude steps forward, it sends a strong message—humanitarian assistance in health is indispensable, especially when international health aid is becoming a victim of political tides. The Trump-era rollback of global health funding is a reminder of how fragile aid-based systems are.

This is where the brilliance of St. Jude's model shines. By creating a platform that includes partners like the World Health Organization (WHO) and 联合国儿童基金会 , St. Jude does not merely distribute medicines; it fosters a sustainable global ecosystem to bridge inequities in paediatric cancer care.

But should Nepal always rely on external interventions? The Government of Nepal recently pledged to provide free cancer treatment for children under a new policy announced in late October 2024. While this promise has generated widespread hope, the details remain ambiguous. Will the scheme cover a child's cancer treatment journey, including diagnostics, medicines, and aftercare? Who qualifies, and how will hospitals ensure timely access to services?

The St. Jude initiative, should be viewed as catalytic-stopgap, and not a permanent solution. Nepal's government must seize the momentum and ensure long-term sustainability by embedding free childhood cancer treatment into the core of its health policies. Governments do not provide free healthcare as a matter of charity—they do it because it's part of the social contract. Citizens trust their leaders to safeguard their right to life, dignity, and health.

?Development partners like World Health Organization and 联合国儿童基金会 can adapt. International groups have focused on addressing gaps in underfunded public health systems for too long. This technique is fine but it fails to address the root cause—governments' underinvestment in public health systems. International assistance and development organisations must adopt a proactive nudging methodology to encourage governments to meet their health sector obligations and pay them. Rwanda, with little resources, has established a health system that offers fair access to key services. Rwanda succeeds by deliberately using international help to develop national ownership.

Nepal can draw from this example. Free cancer medicines for children should not be seen as a token gesture from foreign donors but as a fundamental entitlement of the Nepali people. St. Jude's initiative can act as a catalyst to jump-start this process. Still, its impact will only be meaningful if the Nepali government picks up the baton and institutionalizes access to free treatment.

One practical step could be establishing a dedicated national fund for childhood cancer treatment, co-financed through public revenue and international support. Ensuring adequate data tracking and accountability mechanisms will be equally critical. Further, local capacity must be strengthened—from equipping government hospitals with oncology specialists to ensuring that rural health centres are stocked with essential cancer drugs.

This is where World Health Organization and 联合国儿童基金会 can add value—by not just offering technical assistance but advocating for long-term budgetary commitments from the government. Health is political, and political will must be backed by financial investment. If Nepal can ensure sustained funding for cancer treatment, it will improve survival rates and send a powerful message that children's lives are a national priority.

As we look ahead, remember that initiatives like St. Jude's are intended to elicit action rather than encourage dependency. Free medicines for children should be viewed as emblems of a country's commitment to the future.?

Dr Sunoor Verma is an international expert in global health diplomacy, leadership communication, and complex coalition-building.

This article is published in print and online in The Himalayan Times, Nepal on 13 February 2025

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