Global vision: How St. Jude is helping transform pediatric cancer care

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It was 30 years ago, but Carlos Rodriguez-Galindo, MD, remembers the moment he first arrived at St. Jude Children’s Research Hospital® clearly.

It was September 1994, and the Memphis campus was undergoing an expansion, the two main research and patient care buildings hemmed in by a maze of construction fencing, scaffolding and excavators.

The Barcelona, Spain-native had come to St. Jude as a junior oncologist in training. Just months earlier, Rodriguez-Galindo had to open an atlas to find Memphis, unsure about the city 4,700 miles away. 

But he’d read about the work St. Jude was doing to improve survival in kids with cancer and was eager to learn more. As he struggled to find a way to enter the campus, he had a flicker of doubt about whether this had been the right move.

“Even though the first few hours on that morning I couldn't figure out where I was going, the moment I walked into the patient care center, it was like my eyes opened: This is it. This is where I am meant to be,” Rodriguez-Galindo said, recalling that moment. “I wanted to get the best training possible and also be in a place where I would feel like I was part of something larger because I was on a journey to be the best doctor I could be to help children with cancer and find cures for them.”

“When I entered, I just knew this was it,” said Rodriguez-Galindo, who grew up in a family of doctors and knew early on he wanted to spend his life in medicine serving patients. “St. Jude to me was like a dream.”

When he began as a young physician at St. Jude, Rodriguez-Galindo said his goal was to start a journey alongside children with cancer that would ultimately cure them of their disease. For him, that meant gradually improving treatment of patients in clinics, while contributing to and developing the science and knowledge to ensure cures would ultimately become a reality for all children.

“That concept of curing childhood cancer and curing every single child that I could see was basically what inspired my career,” Rodriguez-Galindo said.

A promise to erase disparities 

Even as he saw hopeful progress among his own patients at St. Jude and in the U.S., Rodriguez-Galindo grew increasingly concerned about global disparities in childhood catastrophic diseases. About why and how survival rates for children with cancer in low- and middle-income countries were far below the chances for survival in the United States. As it stands now, the survival rate for children with cancer in low- and middle-income countries is less than 30%, compared to more than 80% in the U.S. 

When doctors from resource-limited settings visited St. Jude as part of the institution’s International Outreach Program, Rodriguez-Galindo learned how poor access to lifesaving medicine, gaps in supply chains, lingering geo-political conflicts and inadequate governmental and healthcare infrastructure made the odds for successful outcomes difficult for families of kids with catastrophic diseases. 

Rodriguez-Galindo relished his role as a physician-scientist at St. Jude — advancing science, developing better treatments and taking care of patients — but also felt like there was more that could be done. 

“I had the feeling that whatever I was doing here was not complete. It was not enough until we could complete that vision of the founder of St. Jude, Danny Thomas, that ‘no child should die in the dawn of life,’” he said.

That founding principle was a promise, Rodriguez-Galindo said, to erase the inequalities and disparities that threaten children’s chances to survive catastrophic illnesses.

“There’s only one institution that dreams high enough, powerfully enough to ascend to that dream, and that is St. Jude,” he said.

St. Jude Global 

Since 2018, Rodriguez-Galindo, who is Chair of the Department of Global Pediatric Medicine, has led St. Jude Global, an ambitious effort to improve survival for children with cancer and life-threatening blood diseases in low-and middle-income countries. 

Under the leadership of Rodriguez-Galindo and St. Jude President and CEO James R. Downing, MD, St. Jude Global has worked with partners around the world to pursue its goals of strengthening health systems, helping to train the clinical workforce, building capacity, supporting advocacy efforts, helping to enable resource mobilization and advancing research on childhood catastrophic diseases. 

“Now we can see what it takes to strengthen health systems and policies and how they have been able to address many of the other causes of early mortality for children so that they survive past the first few years of life.” Rodriguez-Galindo said.

 With some other causes of early child mortality improving, focus is turning to the critical problems limiting improvement in survival rates around the world for life-threatening diseases of childhood like cancer. This new focus is leading to new approaches, like a six-year, $200 million investment by St. Jude to dramatically increase access to quality cancer medicines for children around the world. The Global Platform for Access to Childhood Cancer Medicines, created in conjunction with the World Health Organization, aims to reach 50 countries with about 120,000 children in low- and middle-income countries expected to benefit, Rodriguez-Galindo said.

Though other programs for improving access to cancer medicines have been developed over the past decade, the Global Platform for Access to Childhood Cancer Medicines is the largest in scope and most comprehensive, bringing together key institutions like St. Jude, the World Health Organization, UNICEF, the Pan American Health Organization, governments, the pharmaceutical industry, non-governmental organizations and the nonprofit sector.

Ecuador, Jordan, Mongolia, Nepal, Uzbekistan and Zambia will participate as the initial pilot countries. The goal is to scale up the Global Platform, incorporating additional countries over the next few years.

A global movement

Responding to the challenge of disparities in childhood cancer care requires understanding the scope and breadth of the problem, Rodriguez-Galindo said. Recent epidemiological data shows approximately 400,000 children will develop cancer every year around the world, he said, while only half of those are diagnosed. Roughly 80% of the 200,000 children diagnosed live in countries where access to medicines is limited, along with the resources to provide the multi-disciplinary care, Rodriguez-Galindo said. 

“We estimate that globally, only about 30% of children with cancer survive,” he said. “So, I take you back to 1962 when St. Jude opened its doors and most of the children with cancer died. By 1972, we were already showing that 50% of kids with leukemia could be cured. If we look at survival for children with leukemia around the world today, it is not even at the level St. Jude achieved 50 years ago.” 

St. Jude Global Alliance, which started in 2018, is a direct answer to the challenge. It is a network comprised of more than 300 member institutions, including hospitals and non-profits, in more than 80 countries across Latin America, the Middle East, Asia, Africa and eastern Europe.

Together the network has helped do everything from raise the standard of treatment in resource-limited settings, help educate the workforce, improve access to health care and medicines and build capacity for patient and family support and housing during treatment.  

“The St. Jude Global Alliance has done many things, but one of the most important things to me is that it has generated a global movement,” Rodriguez-Galindo said. 

“Once you start that movement, it's unstoppable.”