Rethinking Access for Children with Cancer

“When my 13-month-old daughter was diagnosed with acute myeloid leukemia, our world turned upside down overnight. We moved into the hospital and spent months surrounded by other families fighting the same devastating battle. My daughter, Sophie, survived. Most of the other children relapsed and we very sadly know too many children who passed away”, says Maura Cosgrave, Person With Lived Experience and Project Co-Lead at ACCESS.

This harsh reality fuels the commitment to improve the system – because behind every statistic is a child, a family, and a community forever changed.

Despite remarkable progress in cancer treatments in the last decade, too many children, adolescents, and young adults in Canada are left behind. They face systemic barriers that prevent them from accessing the ongoing care they require, or promising therapies and clinical trials available elsewhere.

Canada’s healthcare system is publicly funded but deeply decentralized. Each province manages its own processes, creating a patchwork of policies and pathways for new treatments. There is no consistent national strategy for bringing innovations to the children who need them most.

The consequence of this structure is profound. Regulatory frameworks designed for adults slow the conduct of pediatric trials. Research infrastructure often doesn’t fit children’s needs. For families living in rural or remote communities, participation in clinical trials can mean uprooting their lives, taking unpaid leave, traveling hundreds of kilometers, or being excluded entirely due to rigid eligibility criteria. For marginalized communities, the barriers are even higher. Language, culture, geography, and income intersect to create an uneven landscape where access is determined by circumstance.

The Innovation Sandbox is a simple but powerful concept led entirely by PWLE: create a safe, structured space to test and refine solutions to these entrenched barriers or challenges. Instead of attempting to overhaul the entire system, the Sandbox brings together researchers, clinicians, partner organizations such as the C17, regulators, and families to collaborate in real time on new models of access and care.

“Think of it as a test-bed for health innovation. Within this space, we can pilot new approaches to clinical trial access, remote participation, cultural inclusivity, and regulatory flexibility. Each idea can be evaluated, improved, and scaled nationally”, Antonia Palmer, Person With Lived Experience, Co-Lead, Ethical, Legal and Societal Issues & Implementation Science research theme, and Project Co-Lead, ACCESS.

By removing the red tape that often stifles progress, innovation can finally move at the pace of children’s needs – not administrative timelines. And that means kids get access to life-saving treatments sooner.

The Innovation Sandbox is about more than research – it’s about equity. Families affected by childhood cancer understand better than anyone where the gaps lie. By centering their voices in the process, the Sandbox ensures that solutions are grounded in the realities of care: the exhaustion of hospital life, the fear of relapse, the logistical and emotional toll on parents and siblings alike.

To ensure success and uptake of the project, the team is in active conversations with Canada’s Drug Agency and Health Canada to explore how the Sandbox can align and help improve existing regulatory and approval processes, helping to identify where flexibility and innovation can safely improve access for young patients.

“The Innovation Sandbox has the potential to become a model for the broader Canadian healthcare system – one that accelerates access to cutting-edge therapies, strengthens national collaboration between provinces, and research institutions”, Maura Cosgrave, Person With Lived Experience and Project Co-Lead at ACCESS.

The stakes are simply too high to maintain the status quo. A child’s chance at survival should never depend on their postal code, the complexity of regulations, or the inertia of misaligned systems. The Innovation Sandbox offers a way forward and space where collaboration replaces silos and to a path where every child in Canada has a fair chance to survive and thrive.