World Cancer Leaders’ Summit 2015

Global cancer partnership

Dr Lisa Stevens - National Cancer Institute, Washington, USA

You’re looking at partnerships, I know, what is the role of partnership in getting over national cancer care planning? If you want to plan cancer care to make it better why is partnership the key word that you’re all looking at?

Thanks, it is actually the key word because it’s no one organisation, no one person’s job. So you need to have a multi-sectorial approach from the Ministry of Health to NGOs to academia in the planning, the implementation and the evaluation of a national cancer control plan.

Partnerships between which partners, what sorts of partners?

You would have individuals from the Ministry of Health if there is an NCD department or particularly a cancer department. If there are hospitals involved primary care physicians need to understand what the role of the national cancer policy is. Academicians can help to provide the evaluation criteria and then NGOs. NGOs often have a huge stake in it because they present patient populations, survivors, folks who might not have survived cancer. So all of these positions need to be considered in developing the plan for the country.

Of course we’re talking about cancer plans globally and you do have a lot of partnerships going on between different parts of the globe, don’t you? How do you achieve that?

It does take a lot of work to build the partnerships and maintain but one of the things I learned today at the summit is that while we want to emphasise international partnerships, either through UN agencies or other global NGOs it’s also really making sure that the national partnerships are strong. So in the case of Peru they have lots of buy-in from the national partners in addition to their partnerships globally.

It seems to me that your ability to charm the people who are controlling these things is very important, isn’t it?

It is very important - again, getting everyone on the same page, having that conversation about what the priorities are, what the largest cancer burden is or what’s actually feasible within a country, what might be the low-hanging fruit.

In cancer control what do you regard as the most important target?

Again it depends on the country’s burden. Many of the cancers that we focus on are breast and cervix because those are a high burden for women. When you look at the high burden cancers for men it varies depending on the part of the world that you’re talking about but it really is do you have treatment available and if so what kind of screening should you implement, national or opportunistic, and then making sure that you also have a palliative care service for those patients who cannot be treated but need to have symptom management.

We’ve been hearing that prevention is important but also a big priority is to get absolutely standard treatments simply available to prolong life and to cure patients.

Again it’s looking at prevention is cheaper, you need to look at the population making sure that those who are diagnosed with cancer have access to medicine, so when you’re again looking at a screening programme what’s the available treatment and linking that into the essential medicines list is key.

You could sell the prevention idea to governments on the basis of cost saving?

You could, it’s a long term sell and so oftentimes that’s not the same Minister of Health who will reap the benefit of the prevention but it’s really an investment in health as opposed to an expenditure.

I imagine that many clinicians hearing you talk will say this is great news, this is very important, but what has it got to do with me, how do I play a part in implementation of this great plan to control cancer in my country?

That’s part of the multi-sectorial approach. So clinicians should have a role and a voice in the development of the plan but certainly in the implementation. Understanding what are the national guidelines, what are the national requirements, what is the country trying to achieve and that’s where clinicians really can play a key role.

What sorts of things typically would they do?

Making sure that the frequency of screening is taking place for a given country, making sure that the appropriate treatments are provided and linking their patients into any type of survivorship or support groups.

So really good medical care but also keeping all the documentation and keying into all of the registries and making sure that no patient goes unnoticed by the data.

Absolutely, that’s key for again understanding how the programmes that have been implemented have had an effect, so making sure that the database, the registry, is kept up to date but also that helps to understand the cancer burden.

And hopefully communicating with people who are going to analyse those data.

Absolutely, yes.

So what’s the take home message coming out of all of this then?

The take home message for me is partnerships must be varied, you must engage at the national and the international level and then make sure that there are contributions in the planning, implementation and evaluation phase of any cancer plan.

Take home message for doctors?

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