Lifting the burden: IHP shipments meet critical cancer needs

Kosovo is the smallest country in the Balkans. It’s also the youngest country in Europe, declaring its independence from Serbia in 2008. Kosovo has experienced steady economic growth over the past decade, but it remains one of the poorest nations in Europe, with an estimated 23 percent of the population living in poverty.

PHOTO: James Buck / Project HOPE 2019. Used with permission.

Male Kosovan pharmacist smiles holding a package of cancer treatments delivered by IHP

Kosovo also has one of the youngest populations in Europe, with more than 65% of its 1.9 million population under the age of 30. In 2021 however, 53.6% of young women and 42.9% of young men were not in employment, education or training. Kosovo spends just 8.9% of its GDP on social protection (2019 European Social Policy Network (ESPN) Thematic Report on Financing Social Protection, Kosovo), compared to an average of 28 per cent in the EU. As a result, a large number of the population are left vulnerable, with access to health, education and other social services limited, especially for the most disadvantaged. 

These limited economic resources make it especially difficult for Kosovo to keep up with global health standards — and healthcare suffers as a result.

The increasing burden on healthcare

All of the public health challenges in Kosovo are compounded by a lack of resources. Some of the most basic and essential medicines are either unavailable or too expensive, resulting in dire and sometimes fatal medicine shortages. Our in-country partner representatives have indicated that the government’s budget for healthcare can only cover 60% of the essential medications needed. Without access to the right medicine and supplies, conditions that are entirely treatable can quickly become life-threatening.

Limited health data is available for Kosovo, but the country has one of the lowest life expectancies in the continent. A recent study suggests a high incidence of non-communicable diseases such as hypertension, diabetes, cardiovascular diseases and cancer in the country. Many people live on low incomes, primarily spent on food and daily supplies, leaving little left for medical care.

With the cost of a course of oncology treatment being so high, getting access to medication is often out of reach for many patients who need it the most. "Because of the very limited budgets, the Ministry of Health is not able to support patients in need of expensive medications, and they are left alone to try to find a solution." Vlatko Uzevski, Project HOPE's Regional Manager for the Balkans, told us. "There are cases of people selling everything they have, including their houses, to be able to support family members and buy the medicines that otherwise are not available."

Cancer patients can be especially sensitive to treatment delays. Interruptions to treatment cycles due to a lack of access to necessary medicines or chemotherapy can put them at severe risk of their condition rapidly worsening.

Lifting the burden by resourcing hospitals to treat patients

Getting these medicines to the hospitals in Kosovo to be offered free at the point of use, is indispensable for patients and the oncology staff who treat them. IHP partners with Project HOPE, working together to strengthen the health system by providing essential donated medicine such as the oncology treatments bortezomib, doxorubicin and apalutamide, which are used to treat myelomas, lymphomas, leukaemia, breast, bladder and prostate cancers. Alongside these treatments, we also ship ondansetron, a medication that prevents nausea and vomiting caused by cancer chemotherapy, radiation therapy, or surgery.

A shipment of bortezomib is unpacked by Project HOPE and hospital staff. PHOTO: James Buck / Project HOPE 2019. Used with permission.

Since 2021, IHP has shipped over 4,800 treatments of bortezomib worth over £2.8 million to the University Clinical Center Kosovo (UCCK) in the capital, Pristina. At the clinic, bortezomib is primarily used to treat multiple myeloma and leukaemia cases. “We currently have 62 patients with multiple myeloma who are being treated [here] or [who] are in remission.” Dr Shemsedin Sadiku, Director of UCCK’s Hematology ward, told us. IHP’s shipments are having a noticeable impact on the care of myeloma patients at UCCK. “With your help in these years….we have managed to meet 100% of patient needs, and we have [seen] very good results in the remission of the disease.” Dr Sadiku added.

Bortezomib is usually taken by the patient once a week. The type that IHP ships to UCCK can be administered by the medical staff subcutaneously (by needle injection), which works well in terms of efficiency for the medical staff and is less strenuous for the patient.

A multiple myeloma patient receives her cancer medication via needle injection.

Without the donation of these cancer treatments from Project HOPE and IHP, we would not be able to offer this therapy to the patients in need because of the high value of the product and the inability of the clinic to secure funds.

Dr Gezime Pllana, Chief pharmacist at the Haematology ward at UCCK —

Giving cancer patients an opportunity to fight back

The treatments IHP has shipped to Kosovo since 2021 have been used to provide over 2,340 patients access to free cancer care to give them a chance to beat the disease. Here are the stories of three of these patients:

Arsim

“In 2018, I was diagnosed with multiple myeloma. I was treated and was in remission for 14 months. Three months ago, I kept feeling tired all the time and became concerned. I wanted to get it checked out. I then found out that the cancer had come back.

When I was initially diagnosed with multiple myeloma back in 2018. I needed to be treated with bortezomib, but given this is not on the national medicines list, this means it is not available free of charge by the government. I had to pay between 7,000-8,000 euros out of my own pocket to purchase my treatment.  

I accessed the drug from Croatia as it was cheaper there, and my family and friends helped fund my treatment. We continued that way until Project HOPE and IHP donated bortezomib here in Kosovo, which we could access for free.  

Even though it isn’t good that the cancer has come back, I hope the treatment will work for me and that I can go back to spending quality time with my family. 

I am very thankful for the donation of bortezomib. I also cannot thank the medical staff enough who work here. Please know the donations you provide are in excellent hands. They are managed by incredible doctors and are going to patients like myself who need them."

Fatos

"I am 57 years old and from Labam, which is about 20km from Pristina. I have four sons. I work in our family business selling doors and windows. However, when I fell ill, I had to stop working for a while.

 

I was originally diagnosed with Mantle Cell Lymphoma in 2018 and then went into remission after six cycles. Unfortunately, last year I relapsed and I have been taking treatment for the last 7 months. I am doing very well now. I have had some stomach problems, but overall I am better. I feel like I am living a normal life again. I was afraid before when I was having problems with my blood levels, but I am now in a very good condition. I have started working again. I have to continue the treatment, but I am still feeling much better.

Back in 2018 I had to pay for my chemotherapy which cost around 300 euros a treatment. Now I only have to pay for supportive medicines like vitamins and minerals thanks to receiving my other medication for free.

I am so thankful for my treatment, it has been very helpful to receive these donations because otherwise, it would cost me too much money, and it would be too hard to find and source."

Mimoza

"I am 51 years old and live here in Pristina with my sister. I do not have children, but I am due to get married soon. My Fiancé lives in Germany and I am hoping to travel to Germany soon, but I am still arranging the documents. I love to garden, and I am looking forward to the warmer weather.

Before I was diagnosed, I had high levels of pain in my legs. I visited different doctors before I was referred to the hospital. They performed a biopsy. I have felt ill for years before I came to the hospital. I have a very difficult time taking the stairs. I felt very weak.

When I was diagnosed, I felt very afraid.

Having to pay for my medicines has been challenging. My family has to support. It is not easy to find medicines sometimes.

Now that I am getting better I hope to travel, start new work, take walks and I hope to start living normally again. I am very thankful for the support and the medications you [IHP] are giving me. This has been a huge support for me."

Cancer patients receive chemotherapy treatment at University Clinic Hospital in Pristina, Kosovo

These are the stories of just three of the people we have helped in the area. Through our work, we have grown to recognise the struggles of cancer patients in Kosovo, and we are continuing to work closely with Project HOPE to source and send critical medications for the fight against cancer. "Thanks to this partnership and the donations we are providing, many people are significantly extending their life. But not only that, they also have a much better quality of life," Vlatko Uzevski, Project HOPE's Regional Manager for the Balkans, said, "Without these donations, people have to leave their country and move to other western European countries just to be able to receive the therapy and fight the cancer. This program is literally saving lives, but...it's [also] saving entire families."

Continuous, reliable sources of cancer medications are essential for ensuring that patients in low-and middle-income countries can complete their full cycle of treatment and have the possibility of entering remission. Your support will mean a higher quality of life and stability for not only cancer patients but their families. Please join us in helping these disadvantaged cancer patients get proper treatment.

Together, we can work towards ensuring access to cancer care for those who need it, preventing unnecessary suffering and avoidable deaths. Click here to donate towards our work.

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