A Beating Cancer Plan that Reconciles High Ambition with the Art of the Possible

Article by Dr Matti Aapro, President of the European Cancer Organisation, published in the OECI Magazine.

Last year, I started quoting the following proverb attributed as having African origin that states “If you want to go fast, go alone. If you want to go far, go together.” This is what the European Cancer Organisation continues to believe in.

As I write this, we are six weeks out from the much awaited publication of Europe’s Beating Cancer Plan. An initiative whose launch in Brussels, during a live event (one of the last ones), created great excitement on World Cancer Day in February. Since that date it has been wonderful to see the energising of the cancer community that the open consultation activity with stakeholders has created. The challenge now for the European Commission is to perform a political feat that isn’t always conducted successfully. That is, the challenge of organising the best ideas and creating a package that can deliver real change, while simultaneously making its way through the tough obstacles that can too often stymy many a good idea for health cooperation, namely the regular opposition from EU Member States concerned about EU over-reach into health competence.

This tight balancing act has been something that has occupied the thinking of the European Cancer Organisation very much as we have sought, in the name of our 31 Professional Member Organisations and 20 Patient Organisations, to give impactful advice this year on what could form the key underpinnings of the Beating Cancer Plan. A real Plan that is achievable for the Commission to reach agreement with Governments on. Yet a Plan that also will fulfil its promise as a true game-changer in the fight against cancer in Europe. While we have made many very specific recommendations for the content of each Pillar of the Plan, below are three headline messages we have been conveying in respect to the overall philosophy and organisation of the Plan that we think can navigate the Plan through the obstacles just described.

Setting Big Goals for Cancer Care in Europe

To start with, we have argued for some inspiring political goals on cancer, that can serve to unite, galvanise and create accountability for action. There is ample precedent for this at international level, from the UN’s Sustainable Development Goals, to internationally agreed carbon emission goals, to goals set already by the EU in areas such as industrial development, research activity or biodiversity.

So what might EU goals and ambitions on cancer care look like? Well there is a good starting place already with the recently signed off WHO goal of eliminating cervical cancer as a public health problem across the world. With international governments, including all 27 EU Member States having already agreed to this, why not make Europe the international leader in showing how attainable this is by adopting it as an EU goal as well? Indeed, with a growing number of EU countries already vaccinating both boys and girls, we urge a goal of eliminating all HPV cancers as a public health problem. The roadmap to doing this is at our fingertips, by taking the already well known actions on universal vaccination, screening, treatment and education. Indeed, it was in Europe that the link between HPV and cancer was identified. Wouldn’t it be all the more inspiring if Europe too becomes the first region of the world to establish that vaccination and other actions can eliminate a class of cancer? These are the sort of succes stories the public wants to see the EU achieve. See our recent report ‘Viral Protection’ for more information.

Other goals we have suggested include:

• The 70:35 Survivorship Goal (70% long-term survival for all patients with cancer by 2035)
• Doubling survival for poor prognosis tumours such as lung, pancreatic and other cancers, as recommended by OECI President Thierry Philip in a past edition of Tumori Journal
• The common European goal of having at least one comprehensive cancer centre in each Member State and 1 for every 5 million citizens in larger countries, all cooperating in a strong network

We have also urged close attention and consideration to other goals put forward, such as the SIOP Europe strategic goal of achieving zero deaths and zero late effects in respect to childhood cancer, and ensuring that each pillar of the Beating Cancer Plan be well directed towards its own sub-goals, including supportive care and specific action for elderly citizens.

Measuring Success and Engaging the Public

I am sure we can all think of examples from our daily lives where we have witnessed big goals being set yet remaining undelivered. More than one personal New Year’s resolution may come to mind to begin with, I imagine!

Suffice to say, setting big goals alone will not make the difference unless mechanisms and actions are put in place to see them achieved. Thinking back to ‘the art of the possible’, a role that the EU has frequently played in policy terms, without upsetting its member states priority for maintaining independent discretion on national policy, is the role of monitoring, measuring, publishing and advising.

In that vein, another important recommendation we have been making for the Beating Cancer Plan is the provision of a ‘European Cancer Dashboard’. Linked to my point above on setting big goals, this Dashboard should measure year-by-year progress towards goals and sub-goals, as well as agreed parameters for each pillar of the Beating Cancer Plan (i.e. Prevention, Early Detection and Diagnosis,Treatment and Quality of Cancer Care, Survivorship and Quality of Life). It has been my pleasure to work alongside other organisations in the cancer policy sphere, such as the European Cancer Patient Coalition and EFPIA to recently advance other principles that we jointly agree should underpin such a Dashboard:

• The Dashboard should be public-facing, with all citizens considered to be its primary audience. The Beating Cancer Plan can, should, and we believe will, inspire all.
• The Dashboard should constantly evolve, making use of immediately available indicators, with new indicators added as they become available.
• To this end, experts from multi-professional, multi-stakeholder fields should assist in its development, with the patient interest at all times at the very heart of its purpose.

Our suggested European Cancer Dashboard builds upon foundations of work already conducted, taking the EU’s role in monitoring, measuring and providing accountability, to the next level. What gets measured gets done.

Don’t Reinvent the Wheel – There is an Army of Volunteers to Work With

A third key message we have provided to the EU at this time is to have the strongest awareness when constructing Europe’s Beating Cancer Plan of what has already been done.

This message was well received by the EU Health and Food Safety Commissioner, Stella Kyriakides, who has excellent personal knowledge of the cancer field, for many reasons. The European Cancer Organisation, for example, can speak to phenomenal high value activity conducted by its 31 European and international level member organisations, and the 20 patient advocacy groups within its Patient Advisory Committee. When rolling out new European level actions on cancer it is really not necessary to start always from a blank sheet of paper.

In fact, there is often great risk of duplication in doing so. We urge instead to be setting goals and then examining what work already conducted could be further developed to achieve them. I think, for example, of the superb activities of OECI in driving higher standards in cancer care through its accreditation and designation programme. Resource support from the EU to such activities could yield a much greater return on investment than always seeking to start something anew.

Furthermore, in light of the devastating effects of COVID-19, which has impacted on the revenue models of many top quality European healthcare professional and patient organisations, we strongly consider that the new EU4Health funding programme should encompass a core element of solidarity support to help organisations with decades of experience in European health and cancer focused activity to weather this storm. Dedicated elements of activity under the EU4Health programme, related to attaining core goals of the Beating Cancer Plan, with funding accessible to healthcare professional and patient organisations, could be an excellent mechanism for doing so, providing a win-win solution for all parties, must most importantly the advancement of high quality cancer care and control.

I am looking forward to reading the many other contributions to this issue of the OECI Magazine and hope to see soon the day when we can all reconvene to give our assessments of what has been published and the work ahead of us to help the Beating Cancer Plan come to life. Our European Cancer Summit, on 18-19 November will be such an opportunity, albeit not in person.

If 2020 is the year of COVID-19, I think it is the task of all of us to unite, work together and make 2021 the year that Europe’s Beating Cancer Plan will make the EU come alive for citizens again: an organisation demonstrably dedicated to the betterment of lives of all its members and allied countries, showing an example for the world, that we shall help wherever possible.

It remains a deeply exciting challenge for us all to take up and I know we can meet the occasion.