When there are breakthrough technologies like xenotransplants, or novel cancer therapies, they’re transformative for diseases and conditions once thought incurable—but they can only save lives if the people that need them can access them. On September 10, TIME hosted the third annual TIME100 Health Leadership Forum in New York City, bringing together the TIME and TIME100 Health communities to discuss equity, longevity, and solution-driven care. The evening featured five expert panels, including The Access Gap: Expanding Pathways to Life-Saving Care.
Moderated by TIME senior health correspondent Alice Park, the panel invited faculty physicians specializing in cell therapies from Oregon Health & Science University and Penn Medicine to take part in conversation with Amy Ronneberg, chief executive officer of NMDP, a global nonprofit connecting patients with lifesaving cell therapies and transplants. NMDP is a sponsor of the 2026 TIME100 Health Leadership Forum. While modern science has solved some access issues, others still remain.
Thousands of patients are not getting referred to transplant centers in a timely manner, those that are oftentimes are facing major barriers from a financial perspective.” Dr. Nemecek, director of Pediatric Cell Therapy and Transplant & Cancer Clinical Research at Oregon Health & Science University, agreed that geography is a big problem for patients who need care. She said it’s a symptom of a bigger problem with the way our health systems have been designed.
The system designs the system for itself, and then we try to adjust it to the patient,” Nemecek says. Because of how specialized CAR-T therapies were designed and tested, there can be natural bottlenecks when it comes to scaling up and disseminating it to a wider audience. Porter, director of the Center for Cell Therapy and Transplant at Penn Medicine, says that advanced therapies like bone marrow transplants or cellular immunotherapies are developed and largely performed at major academic institutions in big cities, usually as a proof of concept.
However, swaths of the population in the country do not live near one of these institutions or have to drive hours to one that has both the technology and the expertise. Now, there are seven FDA-approved commercial CAR-T cells, and the manufacturers have no problem receiving cells from collection centers, manufacturing them, and returning them. The entire process of treatment and testing can take weeks.
Porter and his colleagues recently conducted a pilot study at the University of Pennsylvania with two of their community partners to implement high-end CAR-T cell therapy in a community setting. Over the course of about a year, they’ve been able to treat over 60 patients who otherwise largely would not have had access because they would not have traveled to a big city for it. With science changing fast and treatment outcomes improving, Ronneberg says that it’s more important than ever to “get the education and awareness out to the community,” and provide them with “funds to travel.” As a cancer survivor herself, Ronneberg recalled having a hard time navigating the process even when she had everything at her fingertips—a husband who’s a doctor, resources from her job at the NMDP.
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