Bridging the Gap: Regional Disparities in Access to Pediatric Hematopoietic Stem Cell Transplantation (HSCT) in the Andean Subregion
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Pediatric hematopoietic stem cell transplantation (HSCT) is a life-saving therapy for malignant and non-malignant hematologic diseases. However, access to this high-complexity treatment remains limited and uneven across the Andean subregion. This study aimed to evaluate the current status, capacity, and equity of pediatric HSCT programs in six Andean countries (Bolivia, Chile, Colombia, Ecuador, Peru, and Venezuela) within the framework of WHO Global Initiative of Childhood Cancer. METHODS: A mixed-methods, cross-sectional situational assessment was conducted between November 2024 and January 2025 under the coordination of the Andean Health Organization (ORAS-CONHU) and the Pan American Health Organization (PAHO). Standardized national and center-level surveys (34 and 150 items, respectively) were applied to Ministries of Health and HSCT centers to collect data on infrastructure, workforce, financing, quality management, and barriers to access. Quantitative data were analyzed descriptively and validated by national committees, complemented by qualitative interviews with key stakeholders. RESULTS: Twenty-seven HSCT centers were identified across the subregion, revealing major disparities in access and capacity. Chile reached 100% coverage of estimated transplant needs, whereas Colombia, Peru, and Venezuela achieved 80%, 29%, and 42.5%, respectively. Bolivia and Ecuador had the lowest coverage (1.6% and 24%). Only 28% of units were pediatric-exclusive, and less than two-thirds met full quality and training standards. High-cost medicines, limited infrastructure, and shortages of specialized personnel were identified as critical barriers, whereas regional collaboration and national policies emerged as key facilitators. CONCLUSION: The study highlights significant inequities in pediatric HSCT access and capacity across the Andean subregion. Strengthening infrastructure, workforce training, financing mechanisms, and data systems, supported by sustained regional cooperation, is essential to achieve equitable, high-quality transplant care for all children.
Source: Pediatric Blood & Cancer
Authors: Julia Palma, Liliana Vasquez, Lucia Salas, Paola Viveros, Alejandra Mendoza, Natalia Gonzalez, Rodrigo Guerra, Claudia Sampor, Cindy Martinez, Patricia Gallardo, Yaneth Clavo, Daniela Zavando, Olivia Brathwaite, Andrea Salgado, Reyna Copana, Maury Sdenka, Hector Ojeda‐Casares, Omaira Roldán, Marcela Estupiñan, Juan Arturo Sabinés, Essy Maradiegue, Sharon Chavez, Claudia Pascual, Lisette Marmol, Jhonny Carranza, Santiago Lochamin, Nilda Villacrés, Carmen Guerrero, Gisela Vargas, Edgar Rivera, Marcos Hernandez, Cesar García, Luis Beingolea, Mauricio Maza, Piedad Huerta, Silvana Luciani, Maria del Carmen Calle Dávila
Institutions: Ministry of Health, World Health Organization Regional Office for the Americas, Hospital Luis Calvo Mackenna, St. Jude Children's Research Hospital, Clinica Santa Maria, Clínica Medellín SAS, Ministerio de Salud, Ministry of Health and Social Protection, Ministry of Health, Ministerio de Salud Pública, Hospital de Especialidades Eugenio Espejo
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,640
Funder: Pan American Health Organization
OpenAlex ID: W7125388962