Dedicated to accelerating health equity, The Max Foundation is a leading global health nonprofit. It started as a small volunteer group with the goal of providing access to education and support to Latin American families affected by leukemia. Since its founding in 1997, The Max Foundation has pioneered practical, scalable, high-quality solutions to bring life-extending and patient-centered healthcare to more than 100,000 people in over 83 countries, including the introduction of Max GPS, a U.S.-based patient navigation system. A lot has changed since then, but our focus remains the same: helping patients no one else will.
Pat Garcia-Gonzalez, cofounder and chief executive officer of the foundation, arrived in Nepal a couple of days ago. Gonzalez came to Nepal on the occasion of her late son’s birthday and interacted with the patient who was undergoing treatment with the help of the foundation. She has said that the help she gave has been put to good use. She says that despite losing one child, she was able to save millions of children. An interview by Dhan Bahadur Khadka and Romika Neupane :
Talking about The Max Foundation, how did the concept for the foundation evolve?
Yeah, thank you so much. (With a heavy emotional voice, Pat said) So, The Max Foundation was established in memory of Max. Max was my stepson. He was diagnosed with leukemia when he was 14. We’re from Argentina, and at the time when Max was sick, for his type of leukemia, there was no treatment available, only a bone marrow transplant—if we could find a matching donor. So we searched for two and a half years for a donor for Max, but we never found one. He passed away at 17. We started The Max Foundation to help other families avoid going through what we did, to provide a bridge between resources and families. Along the way, we learned that there are many resources, but they can be difficult to find. When you first get a diagnosis, you don’t know anything. So, we started a website—themaxfoundation.org—and opened an email for people to reach out for help. Through that email, we received many messages from all over the world, particularly from low- and middle-income countries, where patients needed treatment that wasn’t available locally. We dedicated ourselves to trying to bring this treatment to these patients.
That’s great. The Max Foundation is doing amazing work in 83 countries, if I’m not mistaken, and it’s been 22 years now.
Yes, it’s been 22 years. We’ve developed a smart model to bring innovative medicines to people because we believe that no matter where you are, you want the best for your family. We’re not God, so sometimes the outcome isn’t what we hope for, but at least you try, and you give your loved ones the best chance. We work with pharmaceutical companies to get support, and with oncologists and hematologists who diagnose the patients. Then, we send the necessary medication to the doctor treating that patient. We are currently helping around 40,000 families every year across 83 countries, working with about 200 hospitals, particularly in low- and middle-income regions.
That’s wonderful. We’re somewhat aware of The Max Foundation’s vision. But why focus specifically on medicines? Why not shift towards prevention or screening programs?
That’s a great question! No one has ever asked me that before. When we started The Max Foundation, we made two philosophical decisions. First, we wanted to be a bridge between resources and patients. Second, we wanted to help those who no one else was helping. Many organizations focus on prevention and screening, but no one was providing medicines. So, every time we had to make a decision, we chose to do what others weren’t doing. That’s why we focus on delivering medicines.
Speaking of medicines, specifically in Nepal, how many areas does The Max Foundation cover for distributing medications?
We have mainly worked in two hospitals: Patan Hospital and BP Koirala Memorial Cancer Hospital. Recently, we opened a program at SushilKoiralaPrakhar Cancer Hospital, where we distribute only one medication. (Sweta Agrawal, Program Coordinator of The Max Foundation, assisted Pat in providing this information). Through Patan Hospital, we distribute 13 medications; through BP Koirala Memorial, we distribute 8, and 1 medication at SushilKoiralaPrakhar Cancer Hospital.
Have you faced any policy barriers during this process in Nepal?
Sweta Agrawal (Program Coordinator): Yes, there are a few barriers. One is the timing of diagnosis—patients in remote areas often can’t access the facilities they need in time and have to come to Kathmandu or Bharatpur for diagnosis and treatment. After diagnosis, their socioeconomic status can also prevent them from continuing treatment. We’ve had to follow up with patients, asking why they haven’t come for their supplies, only to find out they couldn’t afford to travel, or faced road blockages.
Pat added: Another issue is that no one covers the cost of diagnostics. If cancer is suspected, the patient’s family has to pay for confirmation before any support is available. This is an area where policy improvement is needed—there should be funds to help with diagnostics.
Sweta further added: There’s also a lack of awareness. And when a female is diagnosed, especially after marriage, many families don’t support her. In some cases, parents hide a diagnosis to get their daughter married, not wanting to reveal her illness to the in-laws. These are just a few examples of the barriers we face.
The Max Foundation is clearly doing unique work. Have you thought about expanding beyond Patan Hospital to other hospitals or rural areas?
This program started 20 years ago at Patan Hospital, which was chosen by the company that developed the medicine. Seven years ago, we took over the program. We’ve since decentralized to BP Koirala Memorial and Sushil Koirala Prakhar Cancer Hospitals. While we’re mindful of decentralization, cancer requires specialization. Even Patan Hospital, with its excellent setup, faces challenges. Instead of decentralizing and risking a drop in treatment quality, Wechose to support patients with transportation to ensure they receive the best care. However, we do recognize the need for more oncologists, particularly in the public sector.
Shifting from medications, are there any plans to introduce Next Generation Sequencing (NGS) in Nepal?
It’s on my wish list! We don’t have a specific plan yet, but we hope to bring NGS to Nepal. However, it requires significant support, both for the instruments and for ensuring a steady supply of reagents. It would also need to come hand in hand with the expansion of oncology units.
You’ve been in Nepal for three days now. How has your experience been?
I’m so happy to be here. It took me 20 years, but I really wanted to visit the hospitals, meet the patients, and see the systems in place. (With eyes full of tears, Pat said) It has been a dream. Meeting the patients and seeing Max’s legacy continue has been emotional for me. I feel energized to go home with a list of things we need to do to improve. But I’m confident in the strong systems here and in the capacity of the country to manage the program.
Do you have any suggestions for our doctors or physicians?
I do not have any specific suggestions. The doctors are doing a great job, though the hospitals are very crowded. (Dr. Arun added, “But we’re not complaining.”) Pat replied, “Yes, not complaining, even with the crowd, everything is managed so well. And I must mention my colleague Sweta, who has been representing The Max Foundation in Nepal for eight years and is doing an amazing job keeping everything together.”
As you said, you interacted with the patients, what feedback did the patients give you?
Patients are incredibly grateful. They have formed a bond, supporting each other like family. This helps break the stigma of cancer. It was a dream for me to meet them, and it was wonderful.
You mentioned it took you 20 years to come to Nepal. Do you feel your dream has been fulfilled?
It’s more than fulfilled. When I saw Max’s photo on the wall in the consultation room at Patan Hospital, it was overwhelming. I never dreamed that his name and legacy would be in a hospital in Nepal. It’s beyond anything I could have imagined.
Thank you so much for everything you’re doing for our country.
I’m grateful to you for helping raise awareness. In the past, we focused solely on helping patients, but I’ve come to realize that talking about our programs can bring more resources and help more patients. Amplifying our voice is now one of our top priorities. Thank you for helping with that.
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