1. 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

2. 1. Cancer burden and response

3. Cancer burden by type

4. World Health Organization
Population per radiotherapy
IAEA data base on radiotherapy

5. Global Cancer Early Detection capacity
WHO NCD survey 2011

6. Cost of Cancer Treatment: Breast Cancer

7. 2. WHO Cancer Control Framework and NCD action plan

8. Health system for cancer control

9. 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

10. 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

11. Modelling NCD impact of NCD Targets
Four main non-communicable diseases
BAU
Achieving
Targets
Deaths avoided
All cardiovascular diseases
-18% 34 ;
All cancers
-3% 7 ;
Chronic respiratory diseases
-16%
- 24 ;
Diabetes
+11% ;
Total
-10%
- 21 ;
Ezzati Mathers 2014

13. 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

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

15. 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

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

17. Complexity of cancer management

18. 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