CLOSING THE GLOBAL PEDIATRIC CANCER SURVIVAL GAP: A PRECISION AND HEALTH-SYSTEMS FRAMEWORK FOR EQUITABLE DIAGNOSIS, ACCESSIBLE TREATMENT, CONTEXT ADAPTED INNOVATION, AND LIFELONG SURVIVORSHIP

Emmanuel Ifeanyi Obeagu; George Okuma Achar; Enayi Onaji

doi:10.22270/ujpr.v11i5.1669

Emmanuel Ifeanyi Obeagu Division of Haematology, Department of Biomedical and Laboratory Science, Africa University, Zimbabwe. Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Department of Haematology and Immunohaematology, Bahir Dar University, Bahir Dar, Ethiopia.
George Okuma Achar Institute of Theology, Africa University, Mutare, Zimbabwe.
Enayi Onaji Department of Pharmaecutical and Medicinal Chemistry, Faculty of Pharmaceutical Sciences, Ahmedu Bello University, Zaria, Kaduna, Nigeria.

10.22270/ujpr.v11i5.1669

Keywords:

cancer survival disparities, childhood cancer survivorship, pediatric oncology, precision medicine, health systems

Abstract

Childhood cancer is increasingly curable, yet profound disparities in survival persist between and within high-resource and low-resource settings. These disparities reflect not only differences in tumour biology but also delayed diagnosis, limited pathology and molecular diagnostics, treatment interruptions, shortages of essential medicines, inadequate transfusion and supportive-care capacity, workforce constraints, financial hardship, and fragmented survivorship services. This narrative review examines a precision and health-systems framework for closing the global pediatric cancer survival gap by integrating equitable diagnosis, accessible treatment, context-adapted innovation, and lifelong survivorship. Precision pediatric oncology is conceptualized beyond genomic medicine to encompass accurate diagnosis, risk stratification, measurable residual disease assessment, individualized treatment intensity, toxicity monitoring, and patient-centred supportive care. Tiered diagnostic pathways, regional referral networks, digital pathology, tele-oncology, task-sharing, essential-medicine strategies, and strengthened laboratory and blood-transfusion systems can expand access while adapting advanced care to local realities. Treatment completion requires attention to transportation, socioeconomic barriers, family education, and financial protection. Equally, survival must extend beyond remission through risk-stratified surveillance for relapse, cardiotoxicity, endocrine dysfunction, infertility, neurocognitive impairment, psychosocial consequences, and secondary malignancies. Sustainable progress requires locally generated evidence, childhood cancer registries, implementation research, equitable research partnerships, and data-driven quality improvement. Closing the survival gap therefore demands coordinated investment across cancer biology, clinical care, health-system infrastructure, financing, workforce development, and survivorship. The goal is not identical care everywhere, but equitable access to effective, safe, context-appropriate, and sustainable pediatric cancer care capable of producing durable survival and healthy adulthood.

Peer Review History:

Received 27 July 2026; Reviewed 8 September 2026; Accepted 5 October; Available online 15 November 2026

Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622, Giza, Egypt, [email protected]