City project

Readiness for Access to Breast Cancer Oncology Medicines in Paraguay

Improving diagnostics, treatment and drug delivery processes in the Paraguayan health system for HER2-positive positive breast cancer patients, and strengthening information systems in selected public hospitals. This is to support the avoidance of misdiagnosis and support the delivery of the appropriate cancer drug at an optimal time for patients.
Completion as of Dec 31, 2024
Areas of action
Project lead
Dr Beatriz Hornburg

The challenge

Between 20% and 25% of all breast cancer patients are classified as HER2-positive. This means they express high levels of the HER2 protein, which causes the cancer to grow and spread faster than in patients negative to this expression. Breast cancer identified as HER2-positive tends to grow faster, spread and recur, but is also known to respond better to targeted treatment. 

Due to the fragmented nature of the health system in Paraguay, diagnosis for these patients is slow as care coordinators must provide accurate data to several institutions at once, reach the entire cohort of patients that meet the therapy’s inclusion criteria and rely on a coordinated workflow.

The goal

To implement a quality control structure that strengthens the public healthcare system, encompassing diagnostics, treatment, drug delivery and data systems, so care chains flow efficiently and effectively. This is to help Her-2/neu protein breast cancer patients achieve a faster diagnosis and access targeted therapy. 


The project works with five institutions: the National Institute of Cancer (INCAN), the Clinic Hospital from the Faculty of Medical Sciences of the National University of Asuncion (HC-UNA), the National Hospital of Itaugua (HNI), the San Pablo Women and Childrens’ Hospital (HSP) and the Central Laboratory of Anatomic Pathology. Readiness for access focuses on improving information systems and processes through implementing a patient tracking software, standardising sample handling and reports, the donation of medical supplies, facility renovations, the provision of equipment and the training of human resources.


This project is in collaboration with leading biotechnology company Amgen. Humanitarian aid organisation Direct Relief will provide logistical support to the programme with logistics and delivery of medicines.


Human resource training has led to process and quality improvements in pathology services, including a 60% turnaround time (TAT) reduction for pathology reports at the National Institute of Cancer and 40% at the National Hospital of Itaugua. Medical supplies and electronic devices have been provided, as well as a refurbishment of the mastology waiting area of the National Hospital of Itaugua.

Training is also underway for healthcare workers to use the Readiness Software that will identify the HER2-positive patients who are eligible for targeted therapy, and also collect data for approximately 8’000 patients in the country. The software will also support decision making processes for the national cancer registry that is currently under development in collaboration with the Ministry of Health.  


  • Improvement of the chain of care for cancer patients and the custody of biopsy samples, enhancing safety and reducing waiting times for diagnosis and treatment administration.
  • The development of the ‘Readiness Soft’ software that will track the medical history and treatment plan for HER2-positive patients. This software is interoperable with local systems. 
  • Infrastructure and data processing improvements that improve the efficiency of drug delivery, their preparation and administration. 
  • Quality management training delivered to healthcare professionals across the system, from the point of diagnosis to treatment, improving patient care.
  • Standardisation of pathology reports and the handling of samples. 
  • Infrastructure improvements that include the acquisition of equipment and supplies.


Project Lead
Dr Beatriz Hornburg
Asunción City Manager
Lic. Rosa González
Local Project Coordinator
Dr Maria Carolina Rojas Fariña
Project Consultants Team
Cancer Registry Consultant - Dr Natalia Cabrera, Paraguay
International Oncologist Consultant - Dr Lucía Delgado, Uruguay
Local Oncologist Consultant - Dr David Cabrera
Process Mapping Consultant - Dr Ninfa Alvarez

In the media

Profesionales de salud reciben preparación para captación y seguimiento de pacientes con cáncer.
Health professionals receive preparation for recruitment and follow-up of cancer patients.

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Sumando tecnología para una mejor atención.
Adding technology for better care.

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Asuncion, Paraguay

Readiness for Access to Breast Cancer Oncology Medicines in Paraguay

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