# Cash for transport and food to stop families abandoning curative treatment

Source: https://onco.cc/ideas/idea-acc-abandonment-stipends/  
OnCo record `idea-acc-abandonment-stipends` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Treatment abandonment is the leading cause of treatment failure for childhood cancer in much of the low- and middle-income world, driven by bus fares, lost income and the cost of food and lodging. Conditional cash, transport vouchers and family accommodation have cut abandonment sharply in Central America, East Africa and India, and should be funded in every curative protocol.

## Summary

Treatment abandonment is the leading cause of treatment failure for childhood cancer in much of the low- and middle-income world, and is driven by transport cost, lost income, and lodging. Programmes providing conditional cash, transport vouchers, and family accommodation (in Central America, East Africa, and India) have cut abandonment dramatically at low cost. The proposal is to make an abandonment-prevention package a standard, funded component of every curative protocol in LMIC centres and to report abandonment as a quality indicator.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Centres implementing a standard stipend and accommodation package will reduce treatment abandonment in paediatric ALL and Hodgkin lymphoma below 5% from baselines often above 20%, with a cost per additional cure under $2,000.
- Rationale: Conditional cash transfers have strong evidence for adherence in TB and HIV; abandonment data from paediatric oncology programmes show large effects from modest support.
- Proposed test: Stepped introduction across a national paediatric network with abandonment rate, event-free survival, and cost per averted abandonment as endpoints.
- Maturity: being-tested-at-scale
- Actor: philanthropy

## Sources

- Bottleneck evidence (Most of the world has almost no cancer care): WHO fact sheet, Cancer: https://www.who.int/news-room/fact-sheets/detail/cancer

## Connected records

- cancers: [Acute lymphoblastic leukaemia](https://onco.cc/cancers/all-leukemia/), [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Patients lack understanding, navigation and agency](https://onco.cc/bottlenecks/b-patient-voice/)
- roadmaps: [Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first](https://onco.cc/roadmaps/paediatric-oncology-roadmap/)

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