WHO Launches 2026-2030 Market Shaping Strategy for Childhood Cancer Medicines
核心洞察
WHO and Global Platform partners launched a 2026-2030 market shaping strategy to fix fragile supply of essential childhood cancer (搜索) medicines in low- and middle-income countries.
A baseline assessment of 51 hospitals in 12 countries found only about 45% of essential childhood cancer (搜索) medicines were available.
WHO issued its first prequalification invitation covering six established medicines: pegaspargase, asparaginase, hydrocortisone, dactinomycin, vincristine and cytarabine.
The World Health Organization and partners in the Global Platform for Access to Childhood Cancer (搜索) Medicines have launched a market shaping strategy for 2026-2030 aimed at the supply failures that keep essential childhood cancer medicines out of reach in low- and middle-income countries.
The strategy, titled "Closing the childhood cancer (搜索) survival gap through sustainable access to medicines: market shaping strategy 2026-2030," was released during childhood cancer awareness month. It draws on the experience of the Global Platform, which WHO and St. Jude Children's Research Hospital jointly established in 2021 in collaboration with UNICEF and the Pan American Health Organization (搜索) Strategic Fund, which act as procurement agents.
A Baseline of Missing Medicines
The case for the strategy rests on a baseline evaluation conducted in 12 countries before the Global Platform was launched. Across 51 hospitals visited, only around 45% of essential childhood cancer (搜索) medicines were available. Nearly half of the medicines assessed had been out of stock for at least one month in the previous year, even when they appeared on procurement lists or in hospital records.
WHO estimates that approximately 400,000 children and adolescents develop cancer each year, with close to 90% living in low- and middle-income countries. Survival exceeds 80% in many high-income countries but remains below 30% in many lower-income settings. Since WHO and partners launched the Global Initiative for Childhood Cancer (搜索) in 2018, nearly 500,000 children in 90 countries have benefited from strengthened systems to provide care and address inequalities.
"Access to childhood cancer (搜索) medicines depends not only on what medicines exist, but on whether markets are able to deliver them reliably, affordably, and at quality," said Santiago Millan, Technical Lead for the Global Platform at WHO's Department of Noncommunicable Diseases and Mental Health. "This strategy provides a practical roadmap for governments, manufacturers, procurement partners and civil society to work together to build healthier markets and ensure that more children can complete treatment and survive."
Two Structural Constraints
The strategy identifies two of the most significant constraints on childhood cancer (搜索) medicines globally: a fragile and concentrated supplier base for essential products, and fragmented, underfunded demand that contributes to uncertainty and supply disruptions.
Childhood cancer (搜索) represents a relatively small market compared with many adult diseases. Demand for individual medicines can be scattered across countries and hospitals, while some older oncology products offer limited commercial incentives to manufacturers. Countries may also procure small quantities independently, reducing purchasing power and making demand less predictable. WHO identifies lengthy regulatory processes and affordability challenges as additional barriers.
The result, as WHO frames it, is a paradox: a medicine can be medically essential while the market supporting its production and distribution remains fragile.
Ten Interlinked Interventions
To address these constraints, the strategy sets out ten interlinked interventions ordered so that near-term actions come first. These include broadening the quality-assured supplier base, consolidating demand through pooled procurement and published forecasts, and deploying volume guarantees. Those steps are intended to create conditions for regulatory reliance, integration of these medicines into nationally financed benefit packages and, ultimately, voluntary licensing for newer therapies.
"No child should be denied a chance of survival because the medicines they need are unavailable, unaffordable, or out of reach," said Dr Carlos Rodriguez-Galindo, executive vice president of St. Jude and director of St. Jude Global. "By creating healthier and more sustainable markets, we can help ensure that every child, everywhere, has a fair opportunity to receive life-saving treatment and reach their full potential."
Six Established Medicines Enter Prequalification
WHO published its first expression of interest inviting manufacturers to submit childhood cancer (搜索) medicines for WHO prequalification in August 2026. The invitation covers six established products selected for persistent supply, access or formulation-related gaps rather than for novelty: pegaspargase, asparaginase, hydrocortisone, dactinomycin, vincristine and cytarabine.
The prequalification invitation specifies the formulations sought: pegaspargase 750 units/mL solution for injection or infusion in a 5-mL vial; asparaginase 10,000 units powder for solution for injection; hydrocortisone sodium succinate 100 mg powder for injection, preservative-free; dactinomycin 500 mcg powder for injection; vincristine 1 mg/mL solution for injection in single-dose vials; and cytarabine 100 mg/mL solution for injection, preservative-free, in several vial sizes.
The six were identified through horizon scanning and consultations with government agencies, healthcare professionals, partners and technical experts through the Global Platform. They sit alongside a separate group of six medicines WHO has prioritized for development of better child-friendly formulations, placing both formulation gaps and supply gaps within the same prequalification initiative.
Assessment under the WHO Prequalification Programme includes review of product quality, safety and efficacy data, evaluation of manufacturing practices, inspections where appropriate, and potentially random sampling and testing. Products meeting WHO requirements can be included on the WHO List of Prequalified Medicines and considered acceptable for procurement by United Nations organizations and other purchasers. WHO states that prequalification alone will not solve the problem and that it is pursuing the wider market measures in parallel.
The timing of cancer treatment makes shortages consequential. Many paediatric oncology protocols combine medicines delivered on defined schedules over weeks, months or years. When a key medicine is unavailable, clinicians may face treatment delays, substitutions or changes to established protocols, and repeated shortages can make it harder for hospitals to plan treatment and for families to complete care consistently.
Country Participation and Next Steps
The Global Platform has worked with 12 participating countries since 2024: Ecuador, El Salvador, Ghana, Jordan, Moldova, Mongolia, Nepal, Pakistan, Senegal, Sri Lanka, Uzbekistan and Zambia. Additional countries are expected to join, with onboarding planned for 2027.
Earlier this year, a high-level round table convened at the World Health Assembly initiated engagement on market shaping with Member States, industry, civil society and other stakeholders.
"Zambia is proud of our progress in childhood cancer (搜索), including our early leadership in the Global Platform for Access to Childhood Cancer Medicines," said Dr Kennedy Lishimpi, Permanent Secretary for Technical Services at Zambia's Ministry of Health. "Yet persistent market challenges continue to affect access for children, and it is critical that we continue to work together to enhance the reliability and affordability of childhood cancer medicines."
WHO states that the lessons from this work extend beyond cancer, and that the same market shaping approaches can inform access to medicines for other noncommunicable diseases as the strategy is implemented.