Submitted by Rachel Hollis, RN (Child). MHSc, FRCN, Leeds Teaching Hospitals NHS Trust
The 15th of February is International Childhood Cancer Day, and this year it is particularly significant for nurses looking after children and adolescents with cancer across the globe. 2020 is the year when the World Health Organisation (WHO) Global Initiative for Childhood Cancer (GICC) converges with the WHO and International Council of Nurses’ Year of the Nurse and Midwife. We have an unprecedented opportunity to bring childhood cancer, and children’s cancer nurses, to the attention of policymakers, service providers, physicians, and our nursing community.
Cancer is almost universally thought of as a disease of adulthood, but it is also a leading cause of global childhood mortality from non-communicable diseases, affecting approximately 300,000 children and adolescents annually. In high-income countries like the UK, it is the number one cause of death in children 1 to 15 years of age. However, the burden of childhood cancer falls most heavily on low and middle-income countries (LMIC), with higher populations of children and adolescents and where many are never even diagnosed of their disease; many never reach treatment, and those who do have significantly lower survival rates than those treated in high-income countries, where over 80% now survive.
Over 80% of children and adolescents with cancer live in LMIC, where cure rates may be as low as 20%, and it is the shocking inequity in access to treatment, and the outcomes of care which led to the launch of the WHO Global Initiative for Childhood Cancer (GICC) in 2018, funded by St Jude Children’s Research Hospital in the US. The aim of this initiative is to improve the global survival rate of the commonest childhood cancers to 60% by 2030. To achieve that target, capacity building is required in all aspects of childhood cancer care in all LMIC. The workforce is a critical element of capacity building; nurses together with midwives, constitute the largest group of health workers across the globe.
Expert pediatric oncology nurses are fundamental to providing high quality, safe and effective care to children and adolescents with cancer and their families, and yet nurses in LMIC frequently lack specialized training, and hospitals often have inadequate staffing and resources to provide quality care. This is a major impediment to treatment programs and contributes to low survival rates in these settings. The Nurse Specialists of the GICC is a coalition of nurse leaders from across WHO Regions. The group seeks to advocate for nurses caring for children and adolescents with cancer, with an emphasis on nurses in LMIC. We have published an open-access paper on the ethical imperative to provide a safe work environment and specialist training for nurses working in this field.
On International Childhood Cancer Day in the Year of the Nurse and Midwife, we call upon all engaged in childhood cancer services to acknowledge and support the critical role of nurses and to provide those in LMIC with the training, resources and leadership opportunities they so richly deserve to contribute to the goal of improving both care and cure.