World Health Organization

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Presentation transcript:

World Health Organization 27 May 2018 Scaling up for treating cancers in LMIC: towards a comprehensive cancer treatment programme Andreas Ullrich MD MPH Geneva Switzerland

1. Cancer burden and response

Cancer burden by type

World Health Organization Population per radiotherapy IAEA data base on radiotherapy http://cancer.iaea.org/agart.asp

Global Cancer Early Detection capacity WHO NCD survey 2011

Cost of Cancer Treatment: Breast Cancer

2. WHO Cancer Control Framework and NCD action plan

Health system for cancer control

Comprehensive approach PRIMARY PREVENTION SECONDARY PREVENTION TERTIARY PREVENTION Comprehensive approach New stakeholders and partners for cervical cancer prevention and control Ministry of health: Immunization, sexual and reproductive health, adolescent health, cancer control, and HIV prevention partners, Ministry of education: school health, Women's groups Community based group to reach girl out of school Interdisciplinary stakeholders and solid in-country coordination needed by MoH

The cancer component of the NCD action plan Every country with a national NCD strategy which includes: Behavioral risk reduction/ HPV/ HBV Cervical cancer screening Cancer registry

Modelling NCD impact of NCD Targets Four main non-communicable diseases BAU Achieving Targets Deaths avoided All cardiovascular diseases -18% 34 11 400 000; 15 900 000 All cancers -3% 7 2 400 000; 2 100 000 Chronic respiratory diseases -16% - 24 1 200 000; 2 500 000 Diabetes +11% - 5 1 100 000; 900 000 Total -10% - 21 16 100 000; 21 400 000 Ezzati Mathers 2014

What we can learn: Behavioural risk reduction alone will not achieve cancer contribution to 25x25 Goal. Early detection + treatment: key element of additional contribution to 25 x 25 Goal Strengthen health care systems at all levels of care

Potential for cancer management Breast screening + treatment + Prostate screening - treatment + Lung screening ? treatment - Colorect screening + treatment + Cx screening + treatment + Stomach screening - treatment +

WHO Cancer Management strategies WHO Essential medicines for cancer treatment strategies WHO Essential medicines for symptom control and palliative care WHO Essential technologies for cancer diagnosis and treatment

A health system for cancer control Using a building block framework Integration into existing health care systems Medicines Workforce Services Governance

Complexity of cancer management

The way forward on cancer management WHO: HQ: normative work on guides tools RO: regional cancer strategies ( AMRO) WCO: developing national NCCPs IARC : cancer causes and prevention research UN Partners: IAEA UNFPA UNICEF: joint country support NGOs: ESMO ASCO UICC …technical assistance and advocacy