Alleviating Cancer Care Disparities in Latin America and the Caribbean

Gilberto Lopes, M.D., Medical Director for International Programs and Associate Director for Global Oncology at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, has made it his life’s mission to improve cancer control in low- and middle-income countries around the globe. Lopes credits his great-uncle, Fabio Lopes, with inspiring his crusade. Fabio Lopes developed chronic myelogenous leukemia but did not receive the standard treatment because it was not available in the Brazilian public health system.

After a short fight against his disease, Fabio Lopes died. Today, the federal constitution in Brazil guarantees access to health care, yet scarcity of available medications, disparities in their distribution, and the rising cost of medications often lead patients to take legal action to access cancer care. There were about 240,000 health-related lawsuits at several levels in the Brazilian judiciary in 2015.

The discipline of global oncology is about addressing these cancer care problems in under-resourced settings. A working definition of global oncology describes it as addressing biological difference and disparities in cancer prevention, care, research, education and the disease’s social and human impact around the world.

“Today more than 50 percent of cancer cases and 60 percent of deaths due to the disease occur in low- and middle-income countries,” Lopes said. “While in the U.S. two-thirds or more of patients diagnosed with cancer will live beyond five years, in the lowest-resource settings more than 80 percent of patients with cancer will die prematurely due to late presentation and lack of access to treatment.”

Sylvester Comprehensive Cancer Center is making efforts toward alleviating these inequalities focusing on education, research, and patient care through the Global Oncology and International Programs initiative. Created by Sylvester Director Stephen D. Nimer, M.D., and headed by Lopes, the initiative launched in the fall of 2016 to follow UM President Julio Frenk’s strategic direction for the University. Frenk’s vision was to create a program to address disparities in cancer control with a focus on Latin America and the Caribbean.

As part of the research component, the Global Oncology Innovation Grant launched July 10. The innovation grant is an internal, multidisciplinary competition available to three promising investigators at $25,000 each. All are eligible to apply, but junior faculty (associate or assistant professors), postdoctoral fellows, and graduate students are highly encouraged.

“This competition will provide funding to promising investigators to discover new knowledge or knowledge implementation in advancing health systems, outcomes, and economics research related to cancer control and care in Latin America and the Caribbean,” Lopes said. “It is a very exciting opportunity to position the University as a hemispheric leader.”

As an example of the education component, the Global Oncology and International Programs initiative hosted five physicians from Brazil earlier this year for a week-long preceptorship in palliative care. The physicians shadowed Sylvester doctors to further their training and apply the teachings in their home countries.

Lopes also recently met with the Minister of Health from Campeche, Mexico, to discuss various initiatives including establishing a bone marrow transplant unit at the local cancer hospital.

Applications for the innovation grant are due September 1. For grant guidelines and the application, visit

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