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The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low- and middle-income countries (LMICs) when it comes to receiving evidence-based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence-based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence-informed, patient-centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment-related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence-based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence-informed, and culturally sensitive cancer care.

The region still needs to build its research capacity to inform effective public health policy and practices, say Fabio Zicker and colleagues

Marshall Tulloch-Reid and colleagues argue that development of research capacity in Latin America and the Caribbean requires investment in both individuals and regional institutions

Good governance practices are crucial for advancing research for health in LAC countries, argue Luis Alejandro Salicrup and colleagues

This work had two objectives: (1) to identify the extent of the problem and gaps pertaining to hypertension control in Latin America and the Caribbean (LAC) and (2) to identify the potential role for late-stage (T4) translation research to tackle the current and future hypertension burden in that region. We explored the extent of the problem and the potential opportunities to use late-stage (T4) translation research to address it. We analyzed calls to action and policies implemented within several LAC countries and also at the regional level. Some LAC countries are currently developing comprehensive plans for controlling noncommunicable diseases. Additionally, the Pan American Health Organization (PAHO) is working on implementing a comprehensive plan of action within the PAHO Strategy for the Prevention and Control of Noncommunicable Diseases. These endeavors underscore the need for and the relevance of implementing effective, evidence-based, affordable interventions for treating and controlling hypertension. In these efforts, late-stage (T4) translation research can help to determine the best strategies for delivery of hypertension control. This late-stage (T4) translation research should involve all relevant stakeholders and partners in order to best enhance and scale up appropriate, affordable, and sustainable public health interventions.El presente trabajo tuvo dos objetivos: 1) establecer la magnitud del problema y las brechas en cuanto al control de la hipertensión en América Latina y el Caribe, y 2) determinar la posible función de la última fase (T4) de la investigación sobre traslación de los resultados a productos para hacer frente a la carga actual y futura de la hipertensión en la región. Exploramos la magnitud del problema y las oportunidades de usar última fase (T4) de la investigación sobre traslación de los resultados a productos para abordarlo. Analizamos los llamamientos a la acción y las políticas aplicadas en varios países de América Latina y el Caribe, y también en el plano regional. Actualmente, algunos países de América Latina y el Caribe están elaborando planes integrales para controlar las enfermedades no transmisibles. Además, la Organización Panamericana de la Salud (OPS) está trabajando en la ejecución de un plan de acción integral en el marco de su Estrategia para la prevención y el control de las enfermedades no transmisibles. Estos cometidos destacan la necesidad y la relevancia de las intervenciones eficaces, basadas en la evidencia y asequibles para el tratamiento y el control de la hipertensión. En el marco de estos esfuerzos, la última fase (T4) de la investigación sobre traslación de los resultados a productos puede ayudar a determinar las mejores estrategias para las prestaciones relacionadas con el control de la hipertensión. Esta última fase (T4) debe incluir a todos los interesados directos y asociados pertinentes para mejorar y ampliar las intervenciones de salud pública apropiadas, asequibles y sostenibles.Este estudo teve dois objetivos: (1) identificar o alcance do problema e as lacunas referentes ao controle da hipertensão na América Latina e no Caribe (ALC) e (2) identificar o papel em potencial da pesquisa translacional de fase T4 para combater a carga atual e futura da hipertensão na região. Foi investigado o alcance do problema e as oportunidades em potencial para usar pesquisa translacional de fase T4 para abordar o problema. Foram analisadas convocações à ação e políticas adotadas em vários países da ALC e ao nível regional. Alguns países da ALC estão em fase de elaboração de planos abrangentes para controlar as doenças não transmissíveis. Além disso, a Organização Pan-Americana da Saúde (OPAS) está trabalhando na implementação de um plano de ação integral como parte da Estratégia da OPAS para Prevenção e Controle de Doenças Não Transmissíveis. Esses esforços destacam a necessidade e a importância de implementar intervenções com base científica que sejam eficazes e acessíveis para tratar e controlar a hipertensão. Para tal, a pesquisa translacional de fase T4 pode contribuir para determinar as melhores estratégias para realizar o controle da hipertensão. Este tipo de pesquisa deve envolver todos os interessados diretos e parceiros relevantes a fim de expandir e aprimorar as intervenções de saúde pública que sejam adequadas, acessíveis e sustentáveis.

One of the main objectives of the Pan American Health Organization’s (PAHO) policy on research for health is to develop partnerships to implement appropriate and sustainable health strategies. The policy aims to facilitate the development and scale-up of affordable and accessible products and technologies relevant to the public health challenges of the Americas; develop research groups in PAHO member states with skills that enable the exchange of research knowledge; and facilitate collaboration between diverse stakeholders including the public, government, and the academic and private sectors to tackle national and regional priorities...

While the majority of new cases of cancers occur in the developing world, cancer research funding is not commensurate with the challenge. The largest funders of cancer research are government institutions in developed countries. While some cancer charities are international in scope, most cancer advocacy and charity organizations also fall within national boundaries. Unlike the situation with infectious diseases, there is no Global Fund to Fight Cancer, and international efforts at coordinating funding are nascent.

Biotechnological innovation is gaining increased recognition as an important tool for improving global health. The challenge, however, lies in defining the role of technology transfer to develop therapies for diseases prevalent in developing countries. During the past decade, a large disparity emerged between the developed and developing world in accessing affordable medicines because of the pharmaceutical industry's focus on health areas bearing greatest profits. Discussed herein are several mechanisms that provide partial solutions to this challenge. The Office of Technology Transfer of the US National Institutes of Health has increased its technology licensing pertaining to neglected diseases to partners in developing regions. Establishing partnerships through the transfer of technologies and assisting indigenous institutions build R and D capacity may positively impact policies on protection of intellectual property rights and increase multinational company investments in lesser-developed countries. This will most probably result in the development of more accessible therapies for those in need.