DISP-07. Determining the impact of sociopolitical systems on the perception and mitigation of barriers to care for pediatric brain tumors in low and middle income countries

Abstract INTRODUCTION Pediatric brain tumors (PBTs), the most common solid tumor in children, present a significant global burden. It is well known that there are various barriers to care for PBTs in low and middle income countries. While numerous publications elucidate socioeconomic, cultural, and infrastructural factors, the influence of political landscape on the motivation of clinicians in improving patient outcomes remains underexplored. Objective: To assess the relevance of sociopolitical perspectives in barriers and advancements in clinical goals and policies surrounding PBTs. METHODS 115 publications from 2015 to 2024 on global challenges and advancements in PBT management were identified from MEDLINE, Scopus, and Google Scholar. The literature was qualitatively coded for the authors’ objectives and perceptions, while political context was determined by the Database of Political Institutions 2020. RESULTS 23 countries from each income classification were included, with 37 presidential systems, 16 parliamentary republics, 15 constitutional monarchies, 14 hybrid governments, 6 military juntas, 2 one-party states, and 2 transitional governments. Authors in countries with public health systems and strong civil liberties report main barriers as outreach and aid distribution, while those in centralized or authoritarian systems tend to focus on strong research and development. In hybrid or transitional regimes, pediatric tumor policies are deprioritized due to competing issues such as infectious diseases, leading to inconsistent or nonexistent epidemiological data and treatment protocols. The governance context influences how researchers address these barriers, whether through infrastructure, innovation, or public-private and international partnerships to help improve quality and capacity of cancer care. CONCLUSION Political dynamics shape barriers and initiatives in PBT care through healthcare policy priorities, funding allotment, public advocacy, treatment development regulations, and health equity. Social justice ideologies ultimately determine the perception of health barriers and efficacy of advancements, particularly in pediatric neuro-oncology due to existing disparities in access to specialized care and personnel.