Bolivia Strengthens Cancer Care System Following International Review

The ten-day assessment, conducted in August, evaluated the country’s cancer care infrastructure, identifying critical gaps and charting a course for comprehensive development.

Bolivia has taken a major step towards improving its cancer control system with the completion of an imPACT Review mission led by the International Atomic Energy Agency (IAEA), the World Health Organization (WHO), and the International Agency for Research on Cancer (IARC). The ten-day assessment, conducted in August, evaluated the country’s cancer care infrastructure, identifying critical gaps and charting a course for comprehensive development.

Bolivia faces a growing cancer challenge, with cervical cancer accounting for 22% of all female cancer cases, and prostate and breast cancers representing 25% and 17% of cases in men and women, respectively (Globocan 2022). While significant strides have been made in decentralizing care, most infrastructure and human resources remain concentrated in the major cities of La Paz, Santa Cruz, and Cochabamba, limiting access for underserved rural populations.

Cervical Cancer in Focus

Cervical cancer was a top priority of the review due to its high incidence. While Bolivia has expanded human papillomavirus (HPV) vaccination and screening programs, gaps in awareness and access persist, particularly in rural areas.

Recommendations:

Expand high-accuracy HPV testing across underserved regions.

Strengthen vaccination campaigns to reach more of the population.

Integrate cervical cancer screening with broader cancer control efforts for enhanced coordination.

“Cervical cancer must remain a national priority. Expanding early screening and vaccination is vital to saving lives,” said Vice Minister Mariana Ramírez.

Infrastructure and Resource Challenges

The review highlighted disparities in the distribution of medical equipment and staff, leading to long wait times and forcing patients to travel for care.

Technology and Treatment Needs:

Optimize the use of diagnostic tools and medical equipment through agreements between health subsystems.

Invest in radiotherapy and nuclear medicine to provide essential treatment options.

Regularly maintain and modernize equipment to uphold care quality.

"Improving Bolivia’s diagnostic and treatment capacity is both urgent and achievable by making the best use of existing resources and investing in critical equipment," Ramírez stated.

Focus on Pediatric Cancer

St. Jude Children’s Research Hospital supported the imPACT Review by funding a workshop focused on pediatric cancer, particularly leukaemia.

Key Recommendations:

Implement advanced diagnostic techniques like immunophenotyping and genetic testing.

Establish a national pediatric cancer registry for better tracking and targeted interventions.

Data and Regulatory Improvements

Experts recommended upgrading Bolivia’s health information systems to enhance data collection and planning.

Steps Forward:

Standardize hospital-based cancer registries.

Enhance pathology services for accurate cancer trend assessments.

Strengthen regulatory infrastructure for safe use of diagnostic and treatment technologies.

Hortensia Jiménez, Director General of the Bolivian Agency for Nuclear Energy, emphasized the importance of regulatory improvements: “Ensuring technology is used safely and meets international standards is critical for protecting patients and staff.”

Next Steps and National Plan

A two-day workshop involving 80 national stakeholders validated the findings and set the stage for the development of Bolivia’s forthcoming National Cancer Control Plan. The plan will incorporate the mission’s recommendations to track progress and enhance the country’s cancer prevention and care capacity.

Minister of Health and Sports María Renée Castro lauded the collaboration, stating: “The imPACT mission has given us actionable insights to shape an effective, evidence-based cancer control strategy.” Alma Morales Salinas, the Pan American Health Organization Representative, echoed the sentiment: “This mission is pivotal for building a health system that ensures timely, high-quality cancer care for all Bolivians.”

Bolivia’s imPACT Review represents a turning point in its fight against cancer. With a clear roadmap for improving infrastructure, expanding equitable access, and integrating cutting-edge diagnostics, the country is poised to significantly reduce its cancer burden and provide better care for its population.