1. 19/05/2018
Acción Global para el Control de Cáncer Infantil Dr Oleg Chestnov Asistente Director-General Enfermedades No Comunicables y Salud Mental Organizacion Mundial de la Salud

2. Global challenges in childhood cancer
World Health Organization
19 May 2018
Global challenges in childhood cancer
Reducir la brecha entre países desarrollados y países de bajos recursos
Reducir el daño causado a los sobreviviente debido a los tratamientos prolongados.
Promover la investigación y la evaluación contínua

3. Global burden of Childhood cancer
World Health Organization
19 May 2018
Global burden of Childhood cancer
Over 250,000 new cases and over 96,000 deaths each year
1% of global cancer burden
The majority of cases occur in LMICs
In higher-income countries, it is the second cause of mortality under the age of 15
Lower-income countries have many other “competing” problems, mainly infectious diseases.
Real magnitude in LMICs is not known due to lack of cancer registries

4. Strategies that work for childhood cancer
Causes of childhood cancer are largely unknown.
The most effective interventions include:
- Early detection
- Diagnosis
- Treatment
- Rehabilitation and long-term follow up
- Palliative care

5. Childhood cancer a priority for the global agenda
Children are precious to all societies and cultures at all times
Premature death have an economic impact in families and societies
Great potential for cure but big inequalities between rich and poor countries

6. Childhood cancer inequalities
World Health Organization
19 May 2018
Childhood cancer inequalities
5-year survival rates:
80% in developed countries
10-40 % in less developed countries
Incidence/mortality ratio
5 in developed countries
1.6 in less developed countries
Rates per 100,000 population <15 years old
Source: GLOBOCAN 2008

7. Why these big inequalities
Less developed countries tend to have many other competing priorities and childhood cancer is often neglected
They usually lack social security and universal coverage
Have scarce resources, weak and poorly managed health systems
Specialized services for diagnosis, treatment and even palliative care are often unavailable
Treatment is costly and complex

8. Best Practices of Cancer Programmes in LMICs
Several LMICs countries (e.g Nicaragua, Honduras, Chile) have developed in the last three decades succesful programmes despite challenging socio-economic situations .
These countries have in common:
Capacity building through twining programmes
Strong advocacy
Scientifically-based strategies
Support by childhood cancer parents organizations
Government commitment
Partnerships with dedicated NGOs

9. Key Actions to reduce inequalities
Integration of childhood cancer in cancer control and NCD national policies and programmes
Multisectoral partnerships and twining programmes to support capacity building and standards of care in LMICs
Access to diagnosis, treatment, rehabilitation, long-term follow-up and palliative care
Access to cost-effective and affordable medications and technologies
Awareness of signs and symptoms among parents and health care professional (particularly at PHC level)
Cancer registries that allow to monitor and evaluate childhood cancer

10. The Global Action Plan for the Prevention and Control of Noncommunicable Diseases offer a unique opportunity to advance the agenda of childhood cancer

11. Global Action Plan for the Prevention and Control of NCDs 2013-2020
Vision: A world free of the avoidable burden of NCDs Goal: To reduce the preventable and avoidable burden of morbidity, mortality and disability due to NCDs by means of multisectoral collaboration and cooperation at national, regional and global levels
Global roadmap to realize the commitments from Heads of State and Government and Ministers of Health:
Global Action Plan for the Prevention and Control of NCDs

12. country response for the prevention and control of NCDs Objective 3
To raise the priority accorded to the prevention and control of NCDs in global, regional
and national agendas and internationally agreed development goals, through strengthened international cooperation
and advocacy
Objective 2
To strengthen national capacity, leadership, governance, multisectoral action and partnerships to accelerate
country response for the prevention and control of NCDs
Objective 3
To reduce modifiable risk factors for NCDs and underlying social determinants through
creation of health-promoting environments
Objective 4
To strengthen and orient health systems to address the prevention and control of noncommunicable diseases and
the underlying social determinants through people-centred primary health care and universal health coverage
Objective 5
To promote and support national capacity for high-quality research and development for the prevention and
control of NCDs
Objective 6
To monitor the trends and determinants of NCDs and evaluate progress in their prevention
and control

13. Global Action Plan for the Prevention and Control of NCDs 2013-2020
What have we done so far?
Building a global architecture to support national efforts
UN General Assembly
Commitments from Heads of State and Government
World Health Assembly
Commitments from Ministers of Health
Follow-up
Assignments given to WHO
2011
Global roadmap to realize the commitments from Heads of State and Government and Ministers of Health:
Global Action Plan for the Prevention and Control of NCDs

14. Overarching principles and approaches:
Human rights
Equity-based approach
Universal health coverage
Life-course approach
Evidence-based strategies
Multisectoral action
National action and international cooperation and solidarity
Empowerment of people and communities
Management of conflict of interest

15. Global Monitoring Framework
9 targets for 2025

16. Childhood Cancer within the Global Monitoring Framework

17. Recommendations - Advocate for the integration of childhood cancer in cancer control and NCD national policies and programmes
Reinforce partnerships and twinning programmes to support capacity building and the development of standards of care in LMICs
Facilitate access to cost-effective and affordable diagnosis, treatment and rehabilitation, long-term follow-up and palliative care
Develop tools for implementation with a focus on primary health care strategy and universal coverage
- Establish cancer registries to allow for monitoring and evaluation of childhood cancer

18. Thank you