Abish Romero recently celebrated: 5 years free of breast cancer, after receiving successful treatment in her home country of Mexico.
But the 28-year-old, whose mother died from advanced (late stage) breast cancer several years ago, had to make some tough choices before her care started in 2011.
Abish was working outside of Mexico as an au pair, when she was diagnosed with stage II breast cancer, and had to return home to receive the treatment needed.
“I had no option but to return to Mexico, where free public health insurance (called Seguro Popular) ensures all women diagnosed with breast cancer can be treated with no out-of-pocket expense,” says Abish, who underwent extensive surgery and chemotherapy.
While many nations cannot afford expensive cancer medicines, Mexico is an example of a middle-income country that has taken major structural steps to give sustainable access to treatment for people diagnosed with breast and other forms of cancer. It has done this by reforming and consolidating their procurement policies to achieve price reductions for essential medicines.
The example of Mexico is one that WHO is striving to see emulated globally through implementation of the WHO Model List of Essential Medicines as part of a broader approach to strengthening national health systems.
The example of Mexico is one that WHO is striving to see emulated globally through implementation of the WHO Model List of Essential Medicines as part of a broader approach to strengthening national health systems.
WHO’s Dr Nicola Magrini explains that the WHO Model List of Essential Medicines is not just about drugs, like ensuring that no one is denied health care because they cannot afford to pay for it, guaranteeing access to medicines is key to moving towards universal health coverage and strengthening national health systems. For high-priced medicines, this means policies and practices to substantially reduce costs so they become affordable for the health system.
Essential medicines for universal health coverage
“The guiding principle for expanding the list of cancer medicines was to offer options to countries to be able to tackle the most curable forms of the disease, including childhood leukemia, testicular cancer and lymphoma as well as early breast cancer,” says Dr Magrini, secretary of the WHO Expert Committee on the Selection and Use of Essential Medicines. “We worked hard to prioritize those cancer medicines with the largest magnitude of benefit.”
Mexico launched its Seguro Popular health system in 2003, beginning with treatment for paediatric cancer and expanding later to others, including breast cancer. It has been following the WHO Essential Medicines List during this time. “Today, we cover the most common cancers such as cervical, colorectal, lymphomas, prostate cancer, testicular cancer and ovarian cancer (germinal), and for children all types of cancer,” says Dr Abelardo Meneses, Director of Mexico’s National Cancer Institute. “With this programme, we have helped thousands of people receive cancer treatment, most with low incomes who, in other circumstances, would not have been able to afford the care.”
In Abish's case, where there is a family history of breast cancer, early detection and recommended treatment practices can lead to high cure rates.
“When I go to sleep, I think ‘why me, why am I alive, why don’t others have the opportunity I received?’,” says Ms Romero, who has just completed her Masters of Public Health, and has become a strong advocate for access to care for people living with cancer. “I believe everyone should have access to treatment and life goals, and I think health systems should help them as Mexico’s helped me.”