Regional Landscape of Access, Availability, and Quality of Essential Pediatric Oncology Medicines in Latin America: Results From a Multicountry Survey.
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BACKGROUND: Equitable access to essential pediatric oncology medicines is critical for improving childhood cancer outcomes in Latin America. However, disparities in availability, affordability, and quality continue to threaten treatment continuity and survival. This study assessed access to essential pediatric oncology medicines from the perspective of healthcare professionals and identified key structural barriers and opportunities for improvement. METHODS: A cross-sectional survey was conducted among 148 health professionals involved in the care of children and adolescents with cancer across 137 institutions in 19 countries. The survey was disseminated through professional networks, including national focal points supporting the PAHO/WHO CureAll framework and delegates of the Latin American Society of Pediatric Oncology. A structured online questionnaire collected data on medicine availability, access, procurement mechanisms, quality concerns, and civil society involvement. Outcomes were stratified by country income level and geographic subregion. RESULTS: Seventy percent of respondents reported that pediatric oncology medicines were financed through government mechanisms. Nevertheless, administrative delays, coverage denials, and out-of-pocket payments remained common, particularly in Central America and Mexico. Respondents from lower-middle-income countries were significantly more likely to report medicine unavailability (76.2% vs. 20%; p < 0.001) and family out-of-pocket purchases (90.5% vs. 40%; p < 0.001) compared with high-income settings. Quality concerns were reported by half of the respondents. Civil society organizations frequently helped bridge supply gaps and advocate for access. CONCLUSIONS: Access to essential pediatric oncology medicines in Latin America remains uneven and reflects structural differences in health system organization and financing. Strengthening health system capacity and governance is essential to ensure equitable and reliable access to quality-assured treatment.