POINT-OF-CARE TECHNOLOGIES Received 1 February 2016; revised 26 May 2016; accepted 8 July 2016. Date of publication 8 September 2016; date of current version 19 September 2016. Digital Object Identifier 10.1109/JTEHM.2016.2604485 The National Institutes of Health Affordable Cancer Technologies Program: Improving Access to Resource-Appropriate Technologies for Cancer Detection, Diagnosis, Monitoring, and Treatment in Low- and Middle-Income Countries PAUL C. PEARLMAN 1 (Member, IEEE), RAO DIVI 1 , MICHAEL GWEDE 1 , PUSHPA TANDON 1 , BRIAN S. SORG 1 (Senior Member, IEEE), MIGUEL R. OSSANDON 1 , LOKESH AGRAWAL 1 , VINAY PAI 2 , HOUSTON BAKER 1 , AND TIFFANI BAILEY LASH 2 1 National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA 2 National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA CORRESPONDING AUTHOR: P. C. PEARLMAN (paul.pearlman@nih.gov) ABSTRACT Point-of-care (POC) technologies have proved valuable in cancer detection, diagnosis, mon- itoring, and treatment in the developed world, and have shown promise in low-and-middle-income coun- tries (LMIC) as well. Despite this promise, the unique design constraints presented in low-resource settings, coupled with the variety of country-specific regulatory and institutional dynamics, have made it difficult for investigators to translate successful POC cancer interventions to the LMIC markets. In response to this need, the National Cancer Institute has partnered with the National Institute of Biomedical Imaging and Bioengineering to create the National Institutes of Health Affordable Cancer Technologies (ACTs) program. This program seeks to simplify the pathway to market by funding multidisciplinary investigative teams to adapt and validate the existing technologies for cancer detection, diagnosis, and treatment in LMIC settings. The various projects under ACTs range from microfluidic cancer diagnostic tools to novel treatment devices, each geared for successful clinical adaptation to LMIC settings. Via progression through this program, each POC innovation will be uniquely leveraged for successful clinical translation to LMICs in a way not before seen in this arena. INDEX TERMS Cancer, cancer detection, medical diagnosis, cryotherapy, computer aided diagnosis. I. INTRODUCTION In recent years, the emergence of a new generation of low- cost, point-of-care (POC) technologies has transformed the healthcare industry, and is now poised to revolutionize the field of global health. POC technologies, whether used within or beyond a traditional healthcare setting, represent a broad range of innovations whose impacts are felt in lab environ- ments, homes, and treatment centers. In low-resource set- tings, such technologies have the potential to fundamentally increase access to care and open up the possibility of preven- tion/curative treatment for diseases traditionally thought of as death sentences in lower income parts of the world. A world-wide epidemiologic shift has taken place. While the global community focuses on the exemplars, such as the unfortunate spread of Ebola in several West African countries and the rise of other emerging infectious diseases, the drivers of health inequity in the majority of the world are increasingly the more subtle and slow-developing dis- eases commonly associated with the developed world [1]. Of these chronic diseases, cancer, the ‘‘Emperor of all Mal- adies,’’ poses unique challenges to health systems. It is esti- mated that nearly two-thirds of the 8.2 million annual cancer deaths in the world occur in low- and middle-income coun- tries (LMICs) [2]. Moreover, incidence rates in LMICs are VOLUME 4, 2016 2168-2372  2016 IEEE. Translations and content mining are permitted for academic research only. Personal use is also permitted, but republication/redistribution requires IEEE permission. See http://www.ieee.org/publications_standards/publications/rights/index.html for more information. 2800708