In 2001, Dr Mark Zimmerman, then director of Patan Hospital, was left flabbergasted when a patient of his insisted that free treatment for his cancer was readily available. Forty-year-old Krishna Prasad suffered from Chronic Myeloid Leukemia (CML), a form of blood cancer. Zimmerman was puzzled because he knew the revolutionary drug Krishna named, Glivec (Imatinib), easily cost $30,000-40,000 per annum, and it needed to be taken year after year. And here Krishna was saying he was getting it for free.

Incredibly, what Krishna had discovered through the internet was true. Novartis, a Swiss drug company working with the Max Foundation, was providing this drug pro bono to poor patients with CML in the developing world. In Nepal today, there are over 500 patients with CML being treated with free Glivec. In Kathmandu, Dr Gyan Kayastha helps run the programme from Patan Hospital and Bharatpur also has a similar set up.

For the oncologist (cancer doctor), Glivec has become a poster boy in the treatment of cancer. Unlike many other cancer drugs that kill cells indiscriminately in the human body, Glivec targets specific cells and genes. The target in this case is the Philadelphia chromosome, which characterises and helps diagnose CML. The activity of this chromosome is detrimental to the body and triggers among other things the growth of a massive spleen.

The tremendous expense of developing cancer drugs would be worth it if the drugs cured or even promised a lasting remission of the disease. But the vast majority of new cancer drugs achieve very modest results. Hence the excitement when an anti-cancer drug like Glivec is found to be so exceptionally effective.

Unfortunately, as often happens with drug therapy, resistance to this wonder drug has developed, but thankfully new drugs to overcome this resistance are available. The good news is that the generous people who are supplying Glivec to patients in Nepal are committed to supplying these other drugs for free, too.