In Rwanda, there is basically no chemotherapy available through government purchasing. The Partners in Health/Dana-Farber partnership supplies all the standard-of-care chemotherapy regimens for the cancer patients at the Butaro Cancer Center of Excellence, explained Lawrence N. Shulman, MD, Chief of Staff and Director of the Center for Global Cancer Medicine, Boston, and Senior Advisor for Partners in Health.
“We have prioritized cancers where we can make an impact in overall survival—early-stage breast cancer, early-stage cervical cancer, Hodgkin lymphoma, large B-cell lymphoma, acute lymphoblastic leukemia, Wilms tumor,” said Dr. Shulman. “For cancers where we cannot significantly improve survival, we offer palliation—pancreatic cancer, for instance.”
He continued, “There are written pathways similar to those used in the United States for all of the diseases we treat, which run from diagnostics, to treatment, to follow-up care—all aspects of the continuum of care. So it is more than guidelines for the chemotherapy regimens, but rather, for overall care.” ■
In eealthy industrialized nations like the United States, escalating costs of cancer care have put the term “cost-effective care” on the forefront of health-care policy discussions. However, the cost issues we wrestle with in our $3 trillion health-care system are vague abstractions for much of the ...