Cancer Issues Worldwide

In the final session of the European Cancer Summit 2020, Matti Aapro, President of the European Cancer Organisation, introduced a panel representing some of the most important Organisations and Societies in the area of oncology worldwide to discuss the most important issues in cancer facing everyone today, as well as a Resolution to be voted on at the end.

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Row 1 - HRH Princess Dina Mired (Union for International Cancer Control); Matti Aapro (European Cancer Organisation); Franco Cavalli (World Oncology Forum). Row 2 - Catherine Owen (Bristol-Myers Squibb); Hans Kluge (World Health Organization); Lori Pierce (American Society of Clinical Oncology).


No Country and no Person Left Behind

Hans Kluge, Regional Director for Europe at the WHO, said there remain deep inequalities between countries in the European region and globally. Someone diagnosed with cancer is at greater risk of dying from the disease in Eastern Europe and Central Asia, but there are also differences within countries that stem from multiple causes.

The COVID-19 pandemic hit the most vulnerable, and central to Kluge’s mandate at the WHO is tackling deep inequalities, by ensuring universal health coverage, reduction of risk factors and sharing a strategic focus.

Universal coverage includes early diagnosis and cervical cancer prevention, via increasing vaccine confidence and accessibility. Kluge wants the WHO’s NCD office in Moscow to become a centre of excellence to close the gaps obstructing these efforts. This requires productive solutions and innovations, and he applauds Europe’s Beating Cancer Plan and the EU Cancer Mission, as well as the proposals from DG Employment to reduce exposure to hazardous chemicals.

A WHO ambassador for cancer control will be announced, to complement the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer as a public health problem.[29] The brutal challenge of COVID-19 offers an opportunity to work together, through science, solutions and solidarity, to ensure no country and no person is left behind.


All in the Same Boat

HRH Princess Dina Mired, Past-President of Union for International Cancer Control (UICC), said the European Cancer Summit 2020 is timely as, despite progress in supporting countries around the world, cancer remains the second leading cause of death.

Moreover, any progress has been neither considerable nor timely enough, and many countries cannot handle the burden of the disease. The least developed countries have suffered the worse with COVID-19, with pressure piled on
healthcare systems due to lockdowns and restrictions, supply chain interruptions and the economic impact of the crisis.

Cancer does not wait for the pandemic to end. It thrives when the system is broken. The pandemic revealed too many uncomfortable truths about healthcare systems globally, and the devastating effect of COVID-19 was made worse by a lack of staff, equipment and of a unified political will and strategy.

Over nine million people die from cancer each year, and the poor and disadvantaged are disproportionately affected. Yet no one batted an eyelid. It took COVID-19 to equalise the misery suffered by so many around the world.

It also threw a renewed light on health. We must clean up our own house and reconfigure our health systems to deal with patients in an equitable manner. We are not islands, and we should triple our efforts to help those at the other end of the world and show our solidarity through strategic partnerships.

We need to embrace the elimination of cervical cancer, as that sends a clear message of hope to women. Everyone has given a Herculean effort to fight the COVID-19 pandemic but what is needed now is social cohesion, not social distancing. We may all come on different ships but we are all in the same boat.


Starting on the Road to Recovery

Lori Pierce, President of the American Society of Clinical Oncology (ASCO), said delays in cancer screening in the USA due to the pandemic will lead to worsening outcomes and more cancer deaths. The pandemic also changed relationships with patients, placed financial strains on institutions and widened disparities, with a disproportionate effect on ethnicities.

There have also been rapid policy changes in response to the pandemic, and the ASCO Road to Recovery[34] produces recommendations on research and care by looking at the impacts on delivery systems and what policy changes have helped and should be made permanent. They have also developed a series of goals for cancer research and clinical trials, and for cancer care delivery.

The aim is to develop strategies and prioritise legislation to remove barriers to care, improve federally-funded care and obtain COVID-19 relief, and work with the Biden–Harris healthcare reform platform when the next president of the USA is sworn in.


Be Active, but More Activist

Franco Cavalli, Chair of the World Oncology Forum, said that, playing devil’s advocate, he questions whether things are getting better worldwide in terms of winning the war on cancer. Scientifically, we are winning but globally we are losing.

In 2013, an international appeal to stop cancer detailed ten measures to at least not lose the battle, and it is Cavalli’s belief that the situation today, even before the COVID-19 pandemic, is not better but worse. The pandemic also revealed cancer is not the first priority in most healthcare systems.

The situation in developing countries was already unbearable but the looming financial crisis will make it worse. There is not a lot to be satisfied with, as although policymakers appear to support cancer prevention and screening, it is not happening in many parts of the world.

Cavalli welcomes the WHO’s stance on cancer but says it is not enough. Cancer is more than simply a non-communicable disease in terms of its impact. Yet it is almost never discussed at, for example, the G7, as it would mean also discussing restructuring healthcare systems and introducing universal coverage.

We must continue to be active, but be more activist, like Greta Thunberg. The same effort is needed in cancer, otherwise we will continue to lose the war globally.


Focusing on What Patients Want Most

Catherine Owen, Senior Vice President of Major Markets at Bristol-Myers Squibb underlined the importance of innovation to improve cancer care in partnership with stakeholders. COVID- 19 showed the need for access to real-time and comparable data, and the EU can take the lead in driving the standardisation of data, as well as accelerating efforts to create a data space with clear governance.

For example, the EHDEN project, from the Innovative Medicines Initiative, aims to make the large-scale analysis of health data in Europe a reality by building a federated data network, allowing access to the data of 100 million EU citizens standardised to a common data model.[35] 

In the face of budget restrictions and increasing demand, healthcare professionals need to find better ways of allocating resources and focus on what benefits patients most. Around a fifth of all healthcare spending is wasted on ineffective or obsolete care.[36] However, there are industry partnered initiatives to drive on-the-ground implementation and scale-up good practice.

No value is derived from innovation if patients cannot access it. For example, Bristol-Myers Squibb is therefore carrying out initiatives to improve access in Africa and other regions of the world to contribute to the improvement of cancer care through multi-stakeholder collaboration.


Collaboration in Our DNA

Finally, Matti Aapro announced the signing of a Memorandum of Understanding between the UICC and European Cancer Organisation.

HRH Princess Dina said both organisations have collaboration in their DNA. By joining the global advocacy work of UICC, the Organisation will help support cancer organisations around the world, she said, adding, in the words of the Resolution: If you want to go fast, go alone. If you want to go further, go together.