Reaching the Summit April 29, 2017 Reaching for a Comprehensive Cancer Program

Housekeeping Break – 10:00 Visit with Exhibitor Lunch – 12:16 Restrooms- CME/CEU Fill out attendance forms Fill out evaluations Leave them at registration table as you depart

Cancer Silent Killer in the Developing World Thomas P. Flynn, MD Foundation for Cancer Care in Tanzania

I have no conflicts of interest and do not intend to discuss off-label use of drugs or devices

Cancer will soon over take heart disease as the major cause of death globally Large declines in mortality are projected to occur between 2002 and 2030 for all of the principal communicable, maternal, peri-natal and nutritional causes, with the exception of HIV/AIDS. Global deaths from HIV/AIDS are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under a baseline scenario that assumes antiretroviral drug coverage reaches 80% by 2012. Although age-specific death rates for most non-communicable diseases are projected to decline, the ageing of the global population will result in significant increases in the total number of deaths caused by most noncommunicable diseases over the next 30 years. Overall, non-communicable conditions will account for almost 70% of all deaths in 2030 under the baseline scenario. Projection: NCDs will cause 70% of deaths in 2030 WHO statistical highlights, 2007

In Africa, cancer is a silent killer. cancer killed: 456,000 people in 2012 510,000 people in 2014 “Cancer cases will increase by 90% by 2030.” International Agency for Research on Cancer In Africa, Ebola killed: 55 people in 2012 7,900 people in 2014 “The Ebola outbreak will be over by August.” UN Ebola Mission Why do we call it a silent killer? Ebola – very tragic but inordinate attention in press. Cancer killed almost 70 times that many people in the same year.

Africa as an Example

Challenges to Delivering Cancer Care in developing world Cultural Definition of illness -> fever Cancer Death Poverty* -> inability to afford care, travel Failure to complete therapy Lack of awareness In general population Diagnosis of cancer not considered by local providers Potential treatment possible * Tanzania – 43% of population lives on $1.25/day or less If one had ability to provide care, there are still challenges

Impossible to Possible Cancer Care MYTHS REALITY Necessary Affordable Possible Appropriate Unnecessary Unaffordable Impossible Inappropriate Much could be done Much should be done Much can be done