29 October, Asunción, Paraguay – Leaders from Paraguay’s Ministry of Health, Instituto Nacional del Cáncer (INCAN), Hospital de Clínicas de la Universidad Nacional de Asunción (HC-UNA), Hospital Nacional de Itauguá (HNI), Hospital Materno Infantil San Pablo (HSP), Laboratorio Central de Anatomía Patológica (LCAP), City Cancer Challenge (C/Can), Direct Relief, and Amgen came together to celebrate the successful completion of the Readiness for Access to Breast Cancer Oncology Medicines Project (Readiness Programme).
Why Readiness for Access Matters to Patients
Cancer is one of the leading causes of death in Paraguay, where care is often fragmented and patients face barriers to timely diagnosis and treatment. Breast cancer is the most common type of cancer amongst women in Paraguay and represents approximately 30% of all cancer types affecting women (Global Cancer Observatory 2022). However, medicines alone are not enough to save lives from cancer as health systems must be ready to deliver them safely, effectively, and equitably.
Since joining C/Can’s in 2017, Asunción has made significant strides in strengthening its cancer care system. Working through C/Can’s City Engagement Process Framework (CEPF), the city has:
- Built and strengthened a local network of healthcare providers, cancer professionals, and policymakers.
- Established shared priorities and standards for breast cancer management across all major institutions, including the development of national clinical management guidelines.
- Created and implemented national quality norms for pathology laboratories, improving diagnostic accuracy and consistency across the system.
These achievements laid the groundwork for the launch of the Readiness Programme in 2022, ensuring the city was prepared to maximise the impact of new resources and partnerships.
“We are grateful for the great support of City Cancer Challenge in the fight against breast cancer in Paraguay, which has driven projects within the framework of an intersectorial collaboration” – Dra. María Teresa Barán
About the Readiness Programme
The Readiness for Access to Breast Cancer Oncology Medicines Project was launched in 2022 as a joint effort between the Ministry of Health, C/Can, Direct Relief, and Amgen. It was designed to complement a donation of six essential oncology medicines with a comprehensive health system strengthening strategy because access to medicines must be matched by system readiness to deliver them.
“Now, with better equipment, training, and software, we process samples every day. Diagnoses are ready in about 48 hours, and full reports are completed within three days. This speed and traceability represent a major improvement in quality for our patients.” – Dra. Fátima Gómez, Director, Pathology Laboratory
The project focused on five key institutions that manage the majority of breast cancer cases in Paraguay’s public system: Instituto Nacional del Cáncer (INCAN), Hospital de Clínicas de la Universidad Nacional de Asunción (HC-UNA), Hospital Nacional de Itauguá (HNI), Hospital Materno Infantil San Pablo (HSP), Laboratorio Central de Anatomía Patológica (LCAP). Its integrated strategy combined two core elements:
- Access to Essential Medicines
- Donation of six essential breast cancer medicines supported by Direct Relief and Amgen.
- Health System Strengthening
- Digital Transformation: Expanded the pathology information system (SIGAP) across four institutions, creating a networked system for secure data sharing. Introduced barcode labelling from operating rooms to improve sample traceability, reduce errors, and enhance diagnostic accuracy.
- Infrastructure & Quality Standards: Renovated and equipped pathology labs at INCAN and HNI to meet international standards. Upgraded cytotoxic drug preparation areas in pharmacies, improving occupational safety for staff and quality of treatment preparation for patients.
- Efficiency & Patient Flow: Supported training and quality control processes that reduced pathology report turnaround times by 60% at INCAN and 40% at HNI. Introduced digital health solutions to optimise care coordination and streamline patient journeys.
- Patient Experience: Renovated treatment facilities, including a new waiting area at HNI and expanded chemotherapy capacity at INCAN, ensuring patients receive care in a safer and more dignified environment.
“For Direct Relief, this was an inspiring challenge. Drawing on our years of experience as a humanitarian aid organisation that works globally to expand access to medicines and healthcare, it was an honour to work on this important project alongside City Cancer Challenge, Amgen, and the Ministry of Health of Paraguay. Our role focused on the capacity of organising the logistics, ensuring drug compliance, and coordinating all project medical donations of specialised products. By doing so, we helped deliver access to local cancer health facilities and target hospitals, strengthening the support of diagnosis and treatment for breast cancer and improving the scope of care for the patients who needed it most.” – Dr. Juan Carlos Alvarenga, Direct Relief .
Results
The Readiness Programme has achieved tangible, measurable outcomes:
- Over 75 breast cancer patients received their entire prescribed oncology medicines free of charge.
- 4 pathology laboratories upgraded to meet national and international quality standards.
- Turnaround times for pathology diagnostics were significantly reduced..
- Laboratory pre-analytical and pre-examination processes improved to ensure sample quality, traceability, and diagnostic accuracy across the institutions.
- Pharmacy infrastructure updated in three hospitals, improving occupational health and safety of healthcare workers and quality of medicine preparation.
- Digital solutions implemented to improve care coordination through information sharing across institutions making the patient journey smoother and institutional planning more effective.
- Improved the patient experience in completing their treatment by improving patient-dedicated infrastructure at main healthcare facilities.
“The impact of the Readiness Project goes far beyond providing medicines, it brought improvements across many areas of our health services. In the pathology laboratory, correct handling and management of surgical samples now ensure precise and timely diagnoses, allowing doctors to offer more effective treatment to patients.
Before the project, mapping and documenting the journey of a sample through the pre-analytical, analytical, and post-analytical stages didn’t exist. The project helped us identify strengths, weaknesses, and opportunities for improvement, and led to renovations, new equipment, and the implementation of a laboratory information system, a dream come true for our team, made possible through C/Can’s support.
The Readiness Programme has left an indelible legacy, providing the foundations for a pathology laboratory that now operates to international quality standards.” – Dra. Cinthia Sosa- Pathologist, National Cancer Institute
“By delivering targeted capacity development interventions co-designed with the local cancer community, our work on timely diagnosis, adequate treatment services, and functioning health systems directly supports the readiness to deliver medicines safely and effectively and monitor their impact on patient outcomes, thereby contributing to the translation of increased availability of medicines into actual, quality patient care.” – Diogo Neves, Lead, Readiness for Access to Oncology Medicines Programme, C/Can.
From Local Action to Global Change
The Readiness Programme in Asunción has demonstrated how collaborative partnerships between government, healthcare institutions, and the private sector can create lasting impact. By combining access to medicines with systemic strengthening of the health system, the project has improved care delivery for breast cancer patients today and built a stronger foundation for cancer care in the future.
Learnings from the project in Asunción are already informing and shaping the expansion of the Readiness Programme to other C/Can cities in Africa and Asia – because quality cancer care should be accessible no matter where you live.
“Through the Readiness Programme, we’ve seen how partnership and system strengthening can create real, measurable change for people living with cancer. This collaboration in Asunción shows what’s possible when access to medicines is matched by investment in training, technology, and infrastructure, a model we hope to replicate in other regions.” – Dr Ponda Motsepe-Ditshego, Vice President, Head of Global Public Health, Amgen.
