ImportanceLimited availability and affordability of cancer drugs contribute to staggering disparities in cancer survival between high-income and low- and middle-income countries (LMICs). As infrastructure for cancer care rapidly develops, there is an urgent need to reduce prices and improve access to cancer medicines in LMICs to advance pharmacoequity globally.ObservationsPrior strategies to expand access to cancer medicines in LMICs have primarily relied on charity or differential pricing and have yielded limited results. Policymakers at the World Health Assembly recently proposed several strategies to increase global access to cancer drugs. Reviewing empirical data and lessons learned from medication access programs for HIV, COVID-19, and other infectious diseases, 3 strategies that multilateral organizations can use to reduce prices of cancer drugs in LMICs are discussed herein. These include (1) building regional technology transfer and manufacturing hubs, (2) expanding and streamlining use of compulsory licenses, and (3) implementing global standards for drug price transparency. Counterpoints to the critiques of these policies are critiqued and how programs can use these strategies to build on existing disease-centered initiatives is discussed.Conclusions and RelevanceLessons learned from the global response to HIV and COVID-19 show that international collaboration and support from the World Health and Trade Organizations can ensure a unified, coordinated agenda for advancing access to care in LMICs. Building on these lessons and implementing similar approaches for cancer drugs can play a critical role in expanding accessibility and affordability of cancer medicines in LMICs. With a growing burden of cancer morbidity and mortality in LMICs, redoubled efforts to deliver essential cancer medications to LMICs would have an immense impact on global cancer control and achieving the United Nations Sustainable Development Goals.

中文翻译：

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推进全球肿瘤学药物公平性


重要性癌症药物的有限可及性和可负担性导致高收入国家与低收入和中等收入国家 （LMIC） 之间的癌症生存率存在惊人的差距。随着癌症护理基础设施的迅速发展，迫切需要降低价格并改善中低收入和收入国家获得癌症药物的机会，以促进全球药物公平性。观察 先前在低收入和中等收入国家扩大癌症药物可及性的策略主要依赖于慈善或差别定价，并且效果有限。世界卫生大会的决策者最近提出了几项战略，以增加全球获得癌症药物的机会。回顾从 HIV、COVID-19 和其他传染病的药物获取计划中汲取的经验数据和经验教训，本文讨论了多边组织可用于降低中低收入国家癌症药物价格的 3 种策略。这些措施包括 （1） 建立区域技术转让和制造中心，（2） 扩大和简化强制许可的使用，以及 （3） 实施药品价格透明度的全球标准。对这些政策的批评进行了批评，并讨论了计划如何使用这些策略来建立现有的以疾病为中心的举措。结论和相关性从全球应对 HIV 和 COVID-19 中吸取的经验教训表明，世界卫生组织和贸易组织的国际合作和支持可以确保一个统一、协调的议程，以促进低收入和中等收入国家获得护理。以这些经验为基础并实施类似的癌症药物方法，可以在扩大中低收入和中等收入国家癌症药物的可及性和可负担性方面发挥关键作用。 随着中低收入国家癌症发病率和死亡率负担的增加，加倍努力向中低收入和中等收入国家提供基本癌症药物将对全球癌症控制和实现联合国可持续发展目标产生巨大影响。