Novartis and The Max Foundation Mark 25 Years of Cancer Access in LMICs

Novartis and The Max Foundation marked 25 years of a partnership that has expanded cancer access in LMICs, delivering treatment to more than 100,000 patients with cancer and rare diseases across 71 low- and middle-income countries.

The equity gap the program was built to close has not narrowed on its own. LMICs now account for 57% of new cancer cases but 65% of cancer deaths, according to the American Society of Clinical Oncology analysis cited by Novartis. In 2024 alone, more than 2.4 million people died of cancer in LMICs. Shortages of trained staff, diagnostics, and infrastructure remain the usual bottlenecks, beyond just the price of the medicine.

From one donated tyrosine kinase inhibitor to six products

The partnership began in 2001, when Novartis contributed its first targeted therapy for chronic myeloid leukemia (CML) at no cost to The Max Foundation. That donation became the Glivec International Patient Assistance Program (GIPAP), later rebranded as CML Path to Care and, more recently, Cancer Path to Care. The first patient treated through the collaboration was Raul, diagnosed with CML in Honduras in 1992, when a bone-marrow transplant was the only option. He received treatment in 2002 and later built a family and career near Tegucigalpa.

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The portfolio has since widened from a single CML medicine to six treatments spanning blood cancers, breast cancer, and a rare blood disorder. Novartis’s own access materials identify the current Cancer Path to Care basket as Glivec (imatinib), Tasigna (nilotinib) and Scemblix (asciminib) for CML; Kisqali (ribociclib) and Femara (letrozole) for breast cancer; and Fabhalta (iptacopan) for paroxysmal nocturnal hemoglobinuria (PNH). The company has set a related operational target of more than 30,000 patients actively on treatment each year across more than 70 LMICs through 2030.

That product mix matters for access teams. First-generation TKIs created the original donation template. Later-generation CML agents, a CDK4/6 inhibitor, and an oral complement inhibitor raise a different set of questions: companion diagnostics, chronic oral adherence, cold-chain or specialty-pharmacy logistics, and how donation programs sit beside emerging national reimbursement lists.

Cancer access in LMICs is more than the medicine

The Max Foundation does more than ship product. Novartis credits the nonprofit with physician training, transport support, patient education, and access to diagnostics, the wraparound work that determines whether a donated pack becomes a completed course of therapy. Max Access Solutions, launched in 2017 after GIPAP, is the multi-partner platform through which Max now works with nine pharmaceutical and diagnostics companies, 15 therapies, and a network of hundreds of physicians across hundreds of institutions.

In December 2024 the collaboration added Fabhalta for PNH, with an initial focus on identifying treating physicians and access pathways in 53 countries across Sub-Saharan Africa, Latin America, the Caribbean, and Asia-Pacific. In September 2025, at the Clinton Global Initiative, Max committed to reach 100,000 patients annually by 2031 and signed a further five-year agreement with Novartis covering CML, metastatic breast cancer, PNH, and rare cancers such as gastrointestinal stromal tumors (GIST).

Pat Garcia-Gonzalez, CEO and co-founder of The Max Foundation, put the program’s value in operational terms:

“This is one of the best stories in the history of global oncology as it demonstrated that expanding access to patients in LMICs was possible. Together with Novartis, we are helping more patients, their families and communities every day. Our partnership shows that health equity is driven through actions, not words.”

Dr Lutz Hegemann, President of Global Health at Novartis, set the next 25 years against the first:

“The last quarter century saw unprecedented advances in the treatment of cancer. In 2001, Novartis and The Max Foundation were willing to go first to bring them to patients around the globe. Our challenge for the quarter century ahead is to ensure that these advances reach more patients, in more places. That is the enduring purpose of our partnership.”

What this means for HEOR and market-access teams

For HEOR and market-access leaders, the anniversary reads as a case study in how cancer access in LMICs is delivered where there is no payer, rather than as a corporate commemoration.

First, donation is not a substitute for a launch strategy, but it is part of one. Novartis reports that 100% of new medicines launched have a global access strategy, that 2.2 million patients were reached with strategic innovative therapies in LMICs by the end of 2025, and that the company ranks first in the 2024 Access to Medicine Index. Cancer Path to Care sits alongside Novartis Oncology Access (shared contribution, co-pay, and full donation) and the Community Health Initiatives and Inclusive Health Accelerators expanded in April 2026. Access functions that treat LMIC work as a CSR sidecar will misread how the company now presents evidence of reach to investors, index raters, and ministries.

Second, the binding constraints are in the health system, not just the medicine’s price. Max’s model invests in diagnosis, physician capacity, and treatment persistence. That is the same stack HTA agencies increasingly ask companies to document when they assess whether a high-cost oncology or rare-disease product will deliver outcomes outside trial sites. Real-world persistence, time-to-treatment, and diagnostic coverage from programs of this scale are underused inputs for budget-impact and equity analyses.

Third, the next test is transition, not volume. A 25-year donation franchise that still depends on manufacturer supply succeeded against 2001 baselines. The same dependence is a risk against 2031 targets. Max’s CGI pledge explicitly names country-led financing and system strengthening. Affiliates in SSA, MENA, Latin America, and parts of Asia will face familiar questions from governments: when does donated Kisqali or Scemblix become a listed medicine, under what price corridor, with what local evidence, and with which diagnostic pathway attached?

Fourth, the disease mix has outgrown “CML access.” PNH and HR-positive metastatic breast cancer bring different epidemiology, different specialist networks, and different competitor sets. Companies watching this model, whether as partners of Max or as rivals designing their own LMIC pathways, should assume that multi-indication platforms will be judged on whether they can onboard a new molecule without rebuilding the physician and diagnostic network from scratch.

The original GIPAP bet was that a first-in-class oral TKI could be given safely, at scale, in settings that lacked transplant units and comprehensive reimbursement. Twenty-five years and 100,000 patients later, the bet has paid off on CML. The open question Hegemann posed is whether the same architecture can carry a broader, more expensive, more diagnostic-dependent oncology portfolio to “more patients, in more places,” and whether those places eventually pay for the care themselves.