Evidence map›Paper›PMID 41761340›Full record

ReviewArthritis research & therapy2026

The challenges and opportunities for equitable global access to medications for paediatric rheumatology in low-to middle-income countries: a review on behalf of the Paediatric Global Task Force for Musculoskeletal Health.

Christiaan Scott, Waheba Slamang, Molly Dushnicky, Emily Hause, Ayodele Faleye, Francis Furia, Octavio Aragon Cuevas, Djohra Hadef, Jane Munro, Clarisse Nzabonimpa and 3 more

Abstract readReview
In one paragraph

Review in Arthritis research & therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Christiaan ScottUniversity of Ottawa, Ottawa, Canada. cscott@cheo.on.ca.
Waheba SlamangTin Soldiers Global, Cape Town, South Africa.
Molly DushnickyMcMaster University, Hamilton, Canada.
Emily HauseUniversity of Minnesota, Minneapolis, USA.
Ayodele FaleyeLagos State University Teaching Hospital, Lagos, Nigeria.
Francis FuriaMuhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
Octavio Aragon CuevasAlder Hey Children's, NHS Foundation Trust and Liverpool John Moores University, Liverpool, United Kingdom.
Djohra HadefUniversity of Batna 2, Batna, Algeria.
Jane MunroThe University of Melbourne/Royal Children's Hospital, Melbourne, Australia.
Clarisse NzabonimpaAga Khan University, Nairobi, Kenya.
Helen FosterNewcastle University, Newcastle Upon Tyne, UK.
Angela MigowaAga Khan University, Nairobi, Kenya.
Paediatric Global Task Force for Musculoskeletal Health

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Advances in medications to treat paediatric rheumatic conditions including juvenile idiopathic arthritis (JIA) and systemic lupus erythematosus (SLE) have transformed outcomes in well-resourced settings. Access to therapeutic agents that are an accepted standard of care in many regions of the world remains unequal. Here we review access to medications through a global paediatric rheumatology lens, examining challenges from drug development to delivery. The high cost of novel medications, combined with complex research and regulatory environments, market forces, the rarity of conditions and policy gaps, drive disparities in low- and middle-income countries (LMICs) where outcomes in children with JIA and SLE are closely linked to socioeconomic status and geography. Data concerning the prevalence of rheumatic conditions in LMICs are sparse, contributing to the under-recognition of disease burden. Clinical trials are disproportionately conducted in high-income countries, limiting global representation and knowledge of safety and efficacy across diverse populations. Additionally, medicines may technically be available, but with barriers that undermine true access. Global and regional organizations, including the Paediatric Task Force for Global Musculoskeletal Health, have advanced education, advocacy, and alignment of medicines with the WHO Essential Medicines List for children (EMLc). However, implementation at the country level remains inconsistent, and essential medicines for treating rheumatic diseases are often absent from national formularies. Addressing these inequities requires coordinated strategies: expanding and harmonizing EMLs, accelerating biosimilar approval and uptake, building a workforce and research capacity in LMICs, and embedding paediatric rheumatology within broader noncommunicable disease and universal health coverage frameworks. We summarize some strategic directions and aspirations within these 5 described arenas, that may help to address the global inequity of drug access.

Indexed as

Antirheumatic AgentsHealth Services AccessibilityRheumatic DiseasesRheumatologyAdvisory CommitteesChildDeveloping CountriesGlobal HealthHealthcare DisparitiesHumansPediatricsResource-Limited SettingsAntirheumatic Agents

Identifiers

PMID41761340
PMCPMC13049950

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.