No fewer than seven million people are being targeted by the World Health Organisation (WHO) in the effort to step up cancer services in resource-poor countries. The WHO warns that if current trends continue the world will see a 60 per cent increase in cancer cases over the next two decades, predicting that the greatest increase (an estimated 81 per cent) in new cases will occur in low-and-middleincome countries, where survival rates are currently lowest.
The global health body in a statement published recently on its website saying, this is largely because the countries in question have had to focus limited health resources on combating infectious diseases and improving maternal and child health, while health services
are not equipped to prevent, diagnose and treat cancers.
In 2019 more than 90 per cent of high-income countries reported that comprehensive treatment services for cancer were available in the public health system compared to less than 15 per cent of low-income countries. “This is a wake-up call to all of us to tackle the unacceptable inequalities between cancer services in rich and poor countries,” says Dr. Ren Minghui, Assistant Director-General, Universal Health Coverage/ Communicable and Noncommunicable Diseases, World Health Organisation. “If people have access to primary care and referral systems, then cancer can be detected early, treated effectively and cured. Cancer should not be a death sentence for anyone anywhere.”
Convinced that progress in poorer countries is achievable, WHO and the International Agency for Research on Cancer, IARC, released two coordinated reports on World Cancer Day (4 February), in response to government calls for more research into the scope and potential policies and programmes to improve cancer control. “At least 7 million lives could be saved over the next decade, by identifying the most appropriate science for each country situation, by basing strong cancer responses on universal health coverage, and by mobilising different stakeholders to work together”, said Dr. Tedros Adhanom Ghebreyesus, Director-General, WHO.
WHO highlights a wide range of proven interventions to prevent new cancer cases. These include controlling tobacco use (responsible for 25 per cent of cancer deaths), vaccinating against hepatitis B to prevent liver cancer, eliminating cervical cancer by vaccinating against HPV, screening and treatment, implementing high-impact cancer management interventions that bring value for money and ensuring access to palliative care including pain relief.
“The past 50 years have seen tremendous advances in research on cancer prevention and treatment,” says Dr. Elisabete Weiderpass, Director of IARC. “Deaths from this cancer have been reduced. High-income countries have adopted prevention, early diagnosis and screening programmes, which together with better treatment, have contributed to an estimated 20 per cent reduction in the probability of premature mortality between 2000 and 2015, but low-income countries only saw a reduction of five per cent. We need to see everyone benefitting equally.”
The challenge will be for countries to select treatments balancing considerations including cost, feasibility and effectiveness. Each government is tasked with choosing the appropriate innovative cancer therapies while recognising that established treatments, many of which are very effective and affordable, can provide benefits for cancer without causing financial hardship. To eliminate cervical cancer in the next 100 years and effective strategy is critical, WHO observed.
Vaccination, screening, treatment and palliative care are the key interventions of WHO draft global strategy towards the elimination of cervical cancer as a public health problem, the fourth most common cancer in women. On World Cancer Day, new estimates show that this strategy could save more than 62 million girls and women from cervical cancer death and prevent 74 million cases within the next 100 years – but only if these interventions are used effectively together. The estimates published by the WHO Cervical Cancer Elimination Modelling Consortium (CCEMC) in The Lancet, are based on the draft strategy’s targets to achieve a global coverage of 90% vaccination, 70% screening and 90% treatment by 2030.
By Chigbu Nwaobia