02 May 2023 5min read

Opportunities, gaps and the role of the ATOM Coalition in improving access to cancer medicines in LLMICs

A new analysis by the Access to Oncology Medicines (ATOM) Coalition, published by UICC, takes a closer look at the gaps and opportunities in access-related capacity building programmes in low- and lower-middle income countries. 

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  • An analysis by the Access to Oncology Medicines (ATOM) Coalition of capacity building programmes for oncology medicines in low- and lower-middle-income countries (LLMICs) revealed the need for scalable capacity building efforts that prioritise collaboration and coordination with local stakeholders, including policymakers.
  • There is also a need to strengthen processes and systems in-country, highlighting an opportunity for the ATOM Coalition to engage with national leadership and build relationships with local stakeholders.
  • The initial group of capacity-building countries will help the ATOM Coalition build a strong proof of concept and offer valuable insights to build future initiatives.


A new analysis by the Access to Oncology Medicines (ATOM) Coalition, published by UICC this week, takes a closer look at the gaps and opportunities in access-related capacity building programmes in low- and lower-middle income countries (LLMICs), specifically in the initial 10 countries in which the ATOM Coalition will aim its capacity building activities.[i]

This first-time analysis shares findings from a partner-wide survey and several key informant interviews[ii], combined with a robust assessment of the potential impact and feasibility of a Coalition-led capacity building programme in each of the 10 countries. It provides valuable insights into the current landscape of partner-led capacity building initiatives in these target countries. Finally, the analysis and its findings suggest future opportunities for the ATOM Coalition to enhance current efforts and bridge existing gaps at improving access to oncology medicines.

Scalability from inception

The programmatic evaluation will support the ATOM Coalition in identifying potential opportunities to create impact through capacity building activities, and to better understand the potential scalability of its efforts to deliver long-term, enduring impact.

For Dr Dan Milner, Executive Director of the ATOM Coalition, “such a forward-thinking approach ensures that interventions are not only effective in the short term but also possess the capability for expansion to reach a broader population and generate a more significant impact.”

By incorporating scalable capacity building efforts from the outset, the ATOM Coalition will be better prepared to adapt and respond to evolving needs and contexts in LLMICs, fostering more sustainable solutions, and facilitating knowledge transfer and best practices sharing among partners.

This strategic focus is critical, according to Pat Garcia-Gonzalez, Chair of the ATOM Coalition Counsel and CEO of The Max Foundation, an ATOM Coalition partner. 

“It demonstrates the ATOM Coalition’s understanding that making treatments available and affordable is an important first step, however building resilient, patient-centric healthcare systems is crucial for long-term success in LLMICs.”

The necessity for cooperation and coordination

The survey responses from over 20 partners and interviews made clear that collaboration is vital for the immediate- and longer-term success of capacity building programmes. But it demands strong coordination at both global and country levels. 

“By cultivating collaboration, coordinating efforts, and capitalizing on existing partner initiatives such as Pfizer’s Accord for a Healthier World, which aims to increase access to the full portfolio of medicines and vaccines for which it has global rights, including oncology medicines, in lower-income countries, the ATOM Coalition can maximize the impact of its capacity building activities,” says Caroline Roan, Senior Vice President, Global Health & Social Impact, Pfizer Inc. “Such efforts will complement Pfizer’s own commitment and efforts to close the access gap to life-saving cancer medicines around the world.”

Breast cancer has emerged as a possible area for coordination among ATOM Coalition partners. The survey revealed that over 60% of ongoing capacity building programmes focus on breast cancer, and that such initiatives already exist in all the ATOM Coalition capacity building countries. By leveraging these existing relationships, the ATOM Coalition can potentially build on current momentum and further enhance collaboration within the context of global initiatives, such as the WHO’s Breast Cancer Initiative.

Equally, broadening the scope of current partner-led capacity building programmes to other ATOM Coalition capacity building countries will require a coordinated approach and an emphasis on creating strong partnerships with local stakeholders.

Building systems-level capacity

Capacity building traditionally emphasises upscaling skills or adding or upgrading infrastructure; however, the analysis reveals a lack of capacity building efforts targeted at strengthening processes and systems in-country.

Initiatives that deliver long-term, systems-level impact necessarily require the engagement and participation of country stakeholders.

“What the analysis shows is that most capacity building programmes that were surveyed involve collaboration between the ATOM Coalition partner and medical associations or providers, with limited direct cooperation with policymakers,” says Dr Milner. “To effect more meaningful change, it is essential to involve policymakers in capacity development efforts, ensuring that regulatory and policy frameworks are conducive to improved access to medicines and diagnostics.”

This gap represents an opportunity for the ATOM Coalition to engage with national leadership and forge more formal relationships with local stakeholders as it moves forward in its capacity building strategy.

Aligning with local needs for the future

The initial group of capacity building countries will help the ATOM Coalition build a strong proof of concept. This will also offer valuable insights from different regulatory and health systems to build future initiatives, as the Coalition expands to support more countries in the coming years.

For partners, a country-by-country approach will help to address the needs and training on the ground that align with local realities, while also offering learnings that can be applied and expanded to other countries.

The ATOM Coalition's commitment to strengthen access to cancer medicines in LLMICs brings together a wide group of stakeholders, who offer a depth of expertise and diverse experience. By coordinating across this group and tapping into this ready pool of knowledge, the ATOM Coalition is poised to make a significant impact on access to essential oncology medicines and ultimately improve the quality of cancer care worldwide.


Download the full report

Download the executive summary

[i]  ATOM Coalition 10 Capacity Building countries: Côte d’Ivoire, El Salvador, Honduras, India, Mongolia, Nepal, Pakistan, Senegal, Uganda, Zambia 
[ii] All ATOM Coalition partners, including their network of members, were invited to complete an online survey in October-November 2022. New partners who joined the Coalition while the survey was ongoing were also invited to respond to the survey by January 2023. In addition, key informant interviews were conducted in January 2023 with eight Coalition partners. Those interviews were designed to collect more qualitative data on their specific capacity building programmes and potential integration within the ATOM Coalition’s capacity building implementation plans.

Last update

Monday 08 May 2023

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