Cancer care – not only for the rich
On addressing cancer control, the WHO’s website says: “The key mission of WHO’s work in cancer control is to promote national cancer control policies, plans and programs that are harmonized with strategies for noncommunicable diseases and other related health concerns. Our core functions are to set norms and standards for cancer control including the development of evidence-based prevention, early diagnosis, screening, treatment and palliative care programs as well as to promote monitoring and evaluation through registries and research that are tailored to the local disease burden and available resources.”
Cancer – a disease that can arguably be called as one of the most complex enigmas in medical science – has been a challenge in many different ways. Not only has it been extremely difficult to elucidate the molecular causes of the disease to develop cost-effective treatments but also training and development of medical professionals in the field, provision of timely and appropriate therapeutic interventions and public education to ensure possible prevention and control of the disease.
This matter warrants an immediate reality check in the lower and middle-income countries (LMICs) where a huge disparity exists compared to high income countries. Nearly 80% of cancer cases occur in LMICs where the infrastructural support is dismal in most regions of these countries. Without public health insurance system, the enormous cost of present day cancer care is beyond the reach for majority of population, especially in the LMICs. As population in these countries is on the rise, without a proper tab on the cancer care in these countries, we risk a huge part of human population suffering without access to medical health care – that will directly affect economic and social development in these regions.
Disparities in Cancer Care in Low- and Middle-Income Countries: Global Health sessions at #ASCO17 investigate https://t.co/urCwy4KZKQ pic.twitter.com/9FgV8ZW86g
— ASCO (@ASCO) June 4, 2017
Diagonal approaches to cancer care – Educating masses on the prevention and providing therapeutic interventions go hand in hand
Cancer care is now a global issue that invokes organizations like WHO to enable local governments to deal with cancer care effectively. But in line with the WHO objectives, local and government structures in India, North east Africa, Mexico and Middle eastern countries have developed diagonal approaches to strengthen the health system by improving human resource development, drug supply, service provision, quality assurance, financing – of which a few are cited below (5).
– Most of the cancer incidences in LMICs are due to cancers that are highly preventable but with limited awareness amongst masses. Various liberating structures and community events have now been in use in combination with didactic education to impart awareness on cancer prevention. While working with people directly, it is imperative to be aware of their lifestyles and cultures to be able to impact the most – a learning useful for the local health workers.
– Better communication between specialist oncologists and primary care providers – doctors and nurses, in local Indian hospitals via WhatsApp based interfaces to consult on complex chemotherapy protocols and management of side effects has enabled easier access to better treatments at local district hospitals.
– While financing cancer care remains a huge challenge worldwide, especially in LMICs, Mexico made a remarkable health reform by introduction of a publicly funded health insurance scheme that covers an increasing list of cancers and encourages preventive measures like timely mammograms.
From educating masses and medical professionals to better health insurance policies – these local experiments serve useful lessons to implement on a larger scale to address disease remediation by combining treatment with preventive measures and better care. While we still await more effective and affordable cancer treatment, there are millions out there who can benefit from the existing pool of knowledge and infrastructure. Let’s at least make sure that we use it equitably without restricting cancer treatment to those born in the first world countries.
References:
1. Cancer Care and Control as a Human Right: Recognizing Global Oncology as an Academic Field, Alexandru E. Eniu, MD, PhD, Yehoda M. Martei, MD, Edward L. Trimble, MD, MPH, and Lawrence N.Shulman, MD, ASCO Eductional Book 2017
2. World Bank definition of 2016
3. Global Health Initiatives of the International Oncology Community, Sana Al-Sukhun, MD, MSc, Gilberto de Lima Lopes Jr., MD, MBA, FAMS, Mary Gospodarowicz, MD, FRCPC, FRCR(Hon), Ophira Ginsburg, MD, MSc, FRCPC, and Peter Paul Yu, MD, FACP, FASCO, ASCO Educational Book 2017
4. Need for Radiotherapy in Low and Middle Income Countries – The Silent Crisis Continues, E.H.Zubizarreta, E.Fidarova, B.Healy, E.Rosenblatt, Clinical Oncology, 2015
5. Thinking Differently in Global Health in Oncology Using a Diagonal Approach: Harnessing Similarities, Improving
Education, and Empowering an Alternative Oncology Workforce, Natalia M. Rodriguez, PhD, Jeannine M. Brant, PhD, APRN, AOCN, FAAN, Dinesh Pendharkar, MD, PhD, MBA, Hector Arreola-Ornelas, MSc, Afsan Bhadelia, MS, Gilberto de Lima Lopes Jr., MD, MBA, FAMS, and Felicia M. Knaul, PhD, ASCO Educational Book 2017
Featured images are by Fuzzy Synapse (on Facebook, Twitter and Instagram) and Supriya Pratihar.
About the author:
Somdatta Karak works with Club SciWri as a project coordinator and Corporate Liaison. She is a doctorate in Neuroscience from Georg August University, Göttingen, Germany and has been a Teach for India fellow (2014-16). She loves putting her analytical skills to build newer and more sustainable solutions, enjoys traveling and communicating and takes every opportunity to expand her horizon.
You can reach her here.
About the editor:
Imit Kaur, Ph.D. is a freelance scientific advisor, medical writer, editor, and an active science blogger. She pursued her PhD in Pharmaceutics and Pharmaceutical Chemistry from the University of Utah. She is experienced in the field of oncology, hematology, pharmacology, nanotechnology and drug development. Follow Imit on LinkedIn (Imit Kaur) or Twitter (@imit_kaur)
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