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The need to build on recent progress

have the highest density but are still behind

the standards of high-income countries.^95 The

scaling-up of support professions will be key in

boosting the response to the great demands

of the disease. An initiative in Chile is under

way. “We are working on incorporating nurse

practitioners, who can help augment the

capacity for patient care in cancer teams,” says

Dr Nervi. In the view of Dr Vargas, in the face

of the rise of cancer needs, community-care

strategies should be considered, and these

are being explored in Costa Rica, otherwise

“hospitals will be overwhelmed”.

But in some instances the problem lies in

inefficient use of infrastructure. Dr Mohar

points to underutilised infrastructure in

Mexico, due to the fragmentation between the

public, social security and private offerings.

“There is underutilised infrastructure due

to the fragmentation. We are looking to

forge alliances among the private and public

schemes to share existing infrastructure,”

notes Dr Mohar. In Colombia, Dr Murillo

remarks, there is a need for consolidation

and better infrastructure planning, with many

substandard oncology centres being allowed

to operate. In his view, “there should be a push

for more comprehensive services, perhaps

through an alliance of providers”. Lastly, any

investments in infrastructure will need to be

accompanied by a larger and well-trained

labour force. “An analysis of mammography

revealed that the problem was not the lack

of equipment, but underutilisation and lack

of training of the medical teams,” explains Dr

Ismael.

Solutions to address the infrastructure gaps

are being discussed but need determined

action. Forging alliances between different

healthcare schemes could help solve

underutilisation. The urban-rural imbalance is

a problem across most countries, and leaders

are looking into expanding the health networks

with a combination of primary units and

strategically located secondary units. “There

has been work in opening regional centres

in underprovided areas, with a total of seven

highly specialised hospitals in six regions,”

says Dr Mohar. “More than 1.5m patients have

benefitted within this effort.”

(^95) The Economist Intelligence Unit, “Cancer preparedness around the world: National readiness for a global epidemic”, 2019.

“We are working on incorporating

nurse practitioners, who can help

augment the capacity for patient

care in cancer teams,” says Dr Nervi.