Expansion of cancer care and control in countries of low and middle income: a call to action
Paul Farmer a, Julio Frenk b, Felicia M Knaul c , Lawrence N Shulman d, George Alleyne e, Lance Armstrong f, Rifat Atun g, Douglas Blayney h, Lincoln Chen i, Richard Feachem j, Mary Gospodarowicz k, Julie Gralow l, Sanjay Gupta m, Ana Langer b, Julian Lob-Levyt n, Claire Neal f, Anthony Mbewu o, Dina Mired p, Peter Piot q, K Srinath Reddy r, Jeffrey D Sachs s, Mahmoud Sarhan t, John R Seffrin u
a Harvard Medical School, Boston, MA, USA - b Harvard School of Public Health, Boston, MA, USA
c Harvard Global Equity Initiative, Boston, MA, USA - d Dana-Farber Cancer Institute, Boston, MA, USA
e Pan American Health Organization, PAHO/WHO
g Global Fund to Fight AIDS, Tuberculosis and Malaria,
i China Medical Board, Cambridge, MA, USA - j Global Health Group, University of California, San Francisco and Berkeley, CA, USA
k
m CNN,
o Global Forum for Health Research,
q Institute for Global Health, Imperial College London,
s Earth Institute, Columbia University, New York, NY, USA - t King Hussein Cancer Center, Amman, Jordan - u American Cancer Society, Atlanta, GA, USA
The Lancet - 16 August 2010 - doi:10.1016/S0140-6736(10)61152-X
Summary at: http://bit.ly/bSqR9D
“……Substantial inequalities exist in cancer survival rates across countries. In addition to prevention of new cancers by reduction of risk factors, strategies are needed to close the gap between developed and developing countries in cancer survival and the effects of the disease on human suffering.
We challenge the public health community's assumption that cancers will remain untreated in poor countries, and note the analogy to similarly unfounded arguments from more than a decade ago against provision of HIV treatment. In resource-constrained countries without specialised services, experience has shown that much can be done to prevent and treat cancer by deployment of primary and secondary caregivers, use of off-patent drugs, and application of regional and global mechanisms for financing and procurement.
Furthermore, several middle-income countries have included cancer treatment in national health insurance coverage with a focus on people living in poverty.
These strategies can reduce costs, increase access to health services, and strengthen health systems to meet the challenge of cancer and other diseases. In 2009, we formed the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, which is composed of leaders from the global health and cancer care communities, and is dedicated to proposal, implementation, and evaluation of strategies to advance this agenda….”
Supplementary webappendix
Supplement to: Farmer P, Frenk J, Knaul FM, et al. Expansion of cancer care and control in countries of low and middle income: a call to action.
Lancet 2010; published online Aug 16. DOI:10.1016/S0140-6736(10)61152-X.
The global burden of cancer—challenges and opportunities.
Beaulieu Nancy, Bloom David, Bloom Lakshmi Reddy, Stein Richard
A report from the Economist Intelligence Unit, August 2009.
Available online PDF [73p.] at http://bit.ly/b7qbrA
“………Cancer. The word is ripe with meaning. The mystery and stigma associated with the disease is so great that in some societies and cultures the word is rarely used and the illness never discussed. There is tragic irony in that. Cancer is widespread. It is the second-leading cause of death and disability in the world, behind only heart disease. Based on the most complete and current data available, cancer accounts for one out of every eight deaths annually (Mathers and Loncar. 2006). More people die from cancer every year around the world than AIDS, tuberculosis and malaria combined.
Cancer deaths occur with nearly six times the frequency of traffic fatalities on an annual basis, and 42 times the frequency of deaths from injuries suffered in war. While at one time the disease was widely thought to afflict only the elderly in affluent countries—where it was seen as a death sentence—cancer has now moved beyond high income countries of the developed world. In the low and middle income countries of the developing world the consequences of the growing burden of new cancer cases and deaths is expected to continue to worsen ……..”
Content:
Preface
Introduction
Time to act
What this report does
A tool for policymakers
Key facts and fi ndings
Next steps 1
What is cancer?
The health and economic burden of cancer
Cancer incidence, 2009-20
Today–2009
Tomorrow–2020
Case fatality rates, 2002: Who lives? Who dies?
The costs of cancer, 2009
Identifying the cancer funding gap: The best practice treatment and care frontier
Why cancer outcomes vary worldwide
Conclusions
Appendix A: Country data: new cancer cases and costs
Appendix B: Cancer epidemiology: Background and useful definitions
Appendix C: An overview of the spectrum of cancer control
Appendix D: Data sources
Appendix E: Methodology
Appendix F: Notes
Appendix G: Multiple regression analyses
Appendix H: References http://livestrongblog.org/GlobalEconomicImpact.pdf
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