Treat the Treatable Appeal
An appeal for national and international action for universal access to affordable and effective cancer care
The rate of new cases of cancer is rising fastest in countries that are least equipped to respond, resulting in terrible suffering and loss of lives and of economic productivity.
Successful programmes in a number of low- and middle-income countries such as Thailand have shown how much can be achieved on an affordable budget using a comprehensive
approach to cancer control combined with universal healthcare access programmes.
We participants in the World Oncology Forum 2014 call on governments and international agencies to learn the lessons of this success and take the following urgent action to protect citizens from needless suffering and premature death, and boost economic productivity and growth.
Governments need to:
1. Prioritise national resources to invest in cancer control.
2. Working with national and/or regional centres of excellence or networks (south–south cooperation) and international bodies (IAEA-PACT, IARC, INCTR, UICC…), develop sustainable cancer services as an integral part of universally accessible health services, with particular emphasis on the role of primary care professionals.
3. Exploit potential synergies within a wider non-communicable diseases (NCD) policy in the areas of prevention, awareness, early detection, and supportive and palliative care.
4. Tailor investment in essential diagnostics, vaccines, medical therapies, equipment, facilities and trained health professionals to offer the maximum benefit for the most people and protect investment decisions from unwarranted influence by vested interests.
5. Use locally developed/adapted evidence-based guidelines to guide all aspects of service delivery at primary, secondary and tertiary levels, and invest in data collection and monitoring, to control quality and costs and promote equal access.
6. Support operational research to understand the factors that help or hinder implementation of cancer control measures in health services.
7. Where resources are highly constrained, prioritise data collection (medical records, cancer registration) early detection, access to X-ray imaging and ultrasound, specialist cancer surgery, basic radiotherapy, generic versions of anti-cancer drugs on the WHO Essential Medicines List (currently undergoing revision) and basic supportive and palliative care.
8. Engage with advocates within professional and patient communities to help mobilise support for expanding and improving cancer control efforts.
International aid agencies and cancer and NCD NGOs need to:
9. Develop a coordinated approach to providing national governments with advice and implementation support, including soft loans, and a global platform for negotiating affordable access to expensive equipment and therapies, learning lessons from the success of initiatives such as the GAVI Alliance. A Global Cancer Fund or Global Cancer Initiative could be one way to achieve this.
10. Help low and middle income countries develop and retain their skills base in all aspects
of cancer control through:
- Working with governments in low and middle income countries to provide health professionals/administrators/data managers/specialist engineers/etc with training and development opportunities within the context of their own health services.
- Negotiating an international agreement with high income countries for a responsible approach to employing health professionals trained in low and middle income countries that would oblige them to help address the impact on the human resources base of the country of origin.
Matti Aapro, Dean of the Multidisciplinary Oncology Institute, Genolier, Switzerland, and Executive Board member of the International Society for Geriatric Oncology (SIOG) and of the Multinational Association of Supportive Care in Cancer (MASCC)
Christopher Booth, Canada Research Chair in Population Cancer Care, Department of Oncology, Queen’s University, Canada
Franco Cavalli, Chair of the Scientific Committee of the European School of Oncology, Italy and Switzerland, Medical Director of IOSI, the Oncology Institute of Southern Switzerland
Eduardo Cazap, Founder and first President of the Latin-American & Caribbean Society of Medical Oncology (SLACOM), executive board member of the National Cancer Institute of Argentina
Thomas Cerny, President of Oncosuisse and Director of the Oncology Center, St Gallen, Switzerland
Alberto Costa, Scientific Director of the European School of Oncology, Italy and Switzerland
Alexander M.M. Eggermont, General Director of the Gustave Roussy Cancer Centre, France
Mary Gospodarowicz, Immediate past President of the Union for International Cancer Control (UICC) and Director of the Princess Margaret Cancer Centre, Canada,
Augustin Lage, Director of the Center of Molecular Immunology (CIM), Cuba
Jonathan Licht, Chief of Oncology/Haematology, Northwestern University, USA
Ian Magrath, Director of the International Network for Cancer Treatment and Research, Belgium
Alex Matter, CEO of the Experimental Therapeutic Centre & D3, A*STAR, Singapore
René Medema, Scientific Director, Netherlands Cancer Institute (NKI), The Netherlands
Hitoshi Nakagama, Director of the National Cancer Center Research Institute, Japan
Jakob Passweg, Chair Swiss Cancer League and head of Haematology, University Hospital Basel, Switzerland
Pier Giuseppe Pelicci, Scientific Co-Director and Chairman of Experimental Oncology Department at the European Institute of Oncology, Italy
Martine Piccart, President of ECCO (European Cancer Congress) and Medical Director of the Institute Jules Bordet, Belgium
Bob Pinedo, Professor Emeritus VU Medical Center, The Netherlands, and chair of Fundashon Prevenshon, Curacao
Luiz Antonio Santini, Director General of the Brazilian National Cancer Institute (INCA) Brazil
Richard Schilsky, Chief Medical Officer and past President of the American Society of Clinical Oncology (ASCO), USA
Paul Workman, Director, Institute of Cancer Research, UK