Cancer Control Opportunities in Low- and Middle-Income Countries (2007) / Chapter Skim
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10 Expanding the Role of the Global Community in Cancer Control
10 Expanding the Role of the Global Community in Cancer Control
Pages 285-304
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From page 285... ...
and international academic community, particularly given a large increase in interest in global health and the establishment and growth of university global health programs. The support of all of these groups strongly influences the health agendas of the recipient countries.
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, the International Network for Cancer Treatment and Research; cancer societies and advocacy groups, such as the American Cancer Society and the international umbrella organization for cancer societies and advocacy, the International Union Against Cancer (UICC)
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The WHO cancer control program has concentrated on the following areas: · Promoting and strengthening national cancer control programs · Building international networks and partnerships for cancer control · Promoting organized, evidence-based interventions for early detection of cervical and breast cancers · Developing guidelines on disease and program management · Advocating for a rational approach to effective treatments for potentially curable cancers · Supporting low-cost approaches to pain relief and palliative care The work of the cancer control program contributed strongly to adoption by the 58th World Health Assembly of a resolution on cancer prevention and control in May 2005, a milestone for the field (see Chapter 1)
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· Global Strategy on Occupational Health for All: The Way to Health at Work, supporting healthier workplaces, including reduction in exposure to carcinogens. · "A Community Health Approach to Palliative Care for HIV and Cancer Patients in Africa," a joint project including five countries1 to improve the quality of life of HIV/AIDS and cancer patients in sub-Saharan Africa.
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From page 289... ...
IARC does not conduct clinical trials or conduct research on other aspects of cancer patient care, nor is it directly involved in the implementation of control measures or legislation aimed at controlling carcinogens. Most of IARC's efforts have been in and about high-income countries, but they have maintained an interest and some specific initiatives directed at LMCs in each major area of emphasis.
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was established as a comprehensive cancer control assistance program, with IAEA leading collaborations with a wide range of partners (IAEA, 2004) (see Chapter 8 for a discussion of PACT's potential role in supporting cancer centers in LMCs)
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government support for international cancer research and training. Most of the international interaction is with other high-income countries, but NCI has a substantial portfolio of work in
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NCI Research NCI supports a wide range of research in all aspects of cancer control and in many LMCs. A few examples include: · A community-based, randomized-control evaluation of low-cost methods for early detection of breast and cervical cancers in women at the Tata Memorial Hospital, in Mumbai, India, including clinical breast examination without mammography, self-examination, and visual inspection of the cervix by trained female health workers
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From page 293... ...
In recent years, training programs also have been held regionally around the world, drawing participants from many countries. The Middle East Cancer Consortium MECC was founded in 1996 as a partnership between the United States and the Ministries of Health of Cyprus, Egypt, Israel, Jordan, the Palestinian Authority, and most recently, Turkey.
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Mission and Strategy INCTR's mission is to build capacity for cancer treatment and research in countries with limited resources through long-term collaborative projects focused on local or regional problems. Projects are designed to bring immediate benefits to patients or to prevent cancer in the population while providing professional education and training as well as opportunities for cancer research.
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Past meetings have included: · Workshop on Chemotherapy Administration and Palliative Care for Oncology Nurses (Yaoundé, Cameroon, March 2003) · Pediatric Oncology Update (with Shaukat Khanum Memorial Cancer Hospital & Research Centre, Dubai, October 46, 2003)
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DEVELOPMENT ASSISTANCE FOR NONCOMMUNICABLE DISEASES, 9952002 In the only analysis of its type, Michaud (2004) examined the share of development assistance going toward noncommunicable diseases (referred to in this report as chronic diseases)
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Heterogeneity is also significant among developing regions: Communicable diseases still predominate in sub-Saharan Africa and part of the Eastern Mediterranean region. Everywhere else -- Latin America and the Caribbean, parts of the Eastern Mediterranean, Southeast Asia, and the Western Pacific, representing 3.8 billion people -- chronic diseases have surpassed noncommunicable diseases.
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nearly tripled between 19981999 and 2002, increasing from $16 million to $43.6 million per year, with most of the increase in funding for tobacco control and mental health. For all other chronic diseases, the increase was from $9.4 million to $14.3 million per year.
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Sweden South Africa Tobacco control 10 1998 Australia Unspecified WHO Tobacco or Health program 75 Canada Unspecified Tobacco policy research 492 Turkey Tobacco control strategies 151 Vietnam Tobacco control political mapping 5 1999 Belgium Kenya Cervical cancer and STDs 65 Canada India International initiative for tobacco 24 policy research Unspecified International initiative for tobacco 134 policy research Unspecified Tobacco and ecohealth workshop 1 Italy India Epidemiologic study of hepatic 22 neoplasia risk Tunisia Technical assistance to Habib Hospital 624 and Cancer Institute of Tunisia United Unspecified Cervical cancer prevention 337 Kingdom 2000 Australia Unspecified Health education for tobacco control 86 Italy Tunisia Technical assistance to Habib Hospital 554 and Cancer Institute of Tunisia 2001 Australia Unspecified Tobacco control capacity-building 51 workshop Belgium Kenya Cervical cancer and STDs 30 Canada Unspecified International initiative for tobacco 171 policy research South Africa International initiative for tobacco 6 policy research Finland Nepal Health education: diseases and 24 disability due to tobacco Sweden Unspecified Tobacco policy cooperation 96 2002 Sweden Vietnam Tobacco control 325 United Unspecified Cervical cancer prevention 173 Kingdom 00 Total Cancer-Related Projects ,0 00 Total All Chronic Disease Projects , SOURCE: Reprinted, with permission, from Michaud (2004)
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Michaud, Harvard Initiative for Global Health. TABLE 10-3 Bilateral Commitments 19952002 for Noncommunicable Diseases by Recipient Region, US$ 000s WHO Region 19952002 Commitment Africa 2,904 Americas 2,088 Eastern Mediterranean 6,416 Europe 5,662 Southeast Asia 1,403 Western Pacific 3,104 Unallocated to region 3,832 Total ,0 SOURCE: Reprinted, with permission, from Michaud (2004)
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Michaud, Harvard Initiative for Global Health. for impact on chronic diseases (Personal communication, O
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The example of institutional "twinning" has involved cancer centers per se, not global health programs, and the expertise required is largely clinical, including clinical research. However, many major universities house cancer centers as well as global health programs.
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There are signs that the balance has begun to change, with recognition by WHO and others that chronic, noncommunicable diseases must be addressed at the same time as infectious diseases. However, the danger is that the common risk factors for other chronic diseases will continue to dominate activities, leaving cancer (which shares fewer risk factors)
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Background paper prepared for the WHO report "Towards a WHO Long Term Strategy for Preention and Control of Leading Chronic Diseases," submitted April 2004. Typescript.
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