Transcript Global Cancer Politics - The Resource and Policy Exchange

Empowerment through
Global Understanding &
Collaboration:
Global Cancer Politics
NEW HORIZONS
in TREATING CANCER
Sponsored by Novartis Pharma AG
Budapest, Hungary
23 – 25 June 2006
Tanya Soldak, MD
Connection between politics,
policy, empowerment, influence
and advocacy
Government
Elected
Representatives
Ministry of Health &
high level Technical
Experts
Hospitals
Health care providers
Doctors Nurses
Politics
Agreement on highest level
Policy
Formulate rules &
guidelines
Health care
system
NGOs
Take action
Champions aren’t made in gyms. Champions are made from something they have deep
inside them…a desire, a dream, a vision. They have to have last-minute stamina, they
have to be a little faster, they have to have the skill and the will. But the will must be
stronger than the skill.” Muhammed Ali, Boxing Champion (1942 --
Health Policy: A definition

Health policy is the way nations, states, cities and
communities distribute resources to competing
interventions and competing populations

Health policy in cancer reflects

how and to whom

health care resources are distributed to address
burden of different types of cancers
.
Global perspective for cancer
policy - WHO recommendations

WHO report - National cancer control programs: policies
and managerial guidelines – 2nd ed., 2002

Worldwide, there are over 10 million new cases of
cancer and more than 6 million deaths from cancer
annually.

WHO formulated the goal of Health Cancer Policy (as
the following:
1) a reduction in incidence and mortality of cancer
2) an improvement in the quality of life of cancer patients
and their families.
Health policy for cancer:
Key Elements

Effective: producing an intended result (reduction in
incidence and mortality of cancer as well as an
improvement in the quality of life )

Comprehensive: health care system integrated
approach and broad in scope with details of care

Evidence based: apply research to the practice

Patient centered: focus on improving patient quality of
life by addressing other needs including:
 Emotional
 Physical
 Financial
Advocacy definition and role

Advocacy: The act of pleading or arguing in
favor of something, such as a cause, idea, or
policy; active support

Cancer Advocate: One who actively promotes
the implementation of good health policy for
cancer, so that People Living With Cancer may
obtain adequate treatment and quality of life
“If I am not for myself, who will be for me? And if I am only for myself, what am
I? And if not now, when? Rabbi Hillel
Effective Advocacy:
Common Barriers

Lack of resources – pharmaceuticals, lab tests,
qualified health care providers

Inadequate cancer policy for some types of
cancer treatments
 policy should address cancer as a long-term
chronic disease

Lack of information and paternalistic attitude
towards cancer patients
Effective Advocacy Strategies:
Cancer Advocacy Organization
3 level approach
I. Politics level (agenda setting)
Congress, government elected representatives

Legislation changes
II. Policy level (formulation)
Ministry of Health:

Promotion of comprehensive national cancer control
programs



Academics (technical experts from teaching and tertiary
hospitals):
Understand and Promote evidence-based interventions.
Develop practical guidelines on disease and programmed
management.
Research, clinical trials.
Effective Advocacy Strategies:
Cancer Advocacy Organization
3 level approach
System level (practitioner/patient at hospitals
and communities)
 Advocate for effective treatment and support
for patient-centered health care – “struggle”
on behalf of every patient

Ensure that providers and other
stakeholders adopt national cancer health
policy
Effective Advocacy Strategies:
Cancer Advocacy Organization

Building international networks & partnerships
(will benefit for all 3 levels)
Example: Belarus -- International networking between US NGOs,
European donors and others, uniting international voices of
cancer patients, their families, and caregivers has proven to be
a powerful tool for improvements in






Attitude
Knowledge
Practice
Policy
System
Services
“I not only use all of the brains I have, but all I
can borrow.” Woodrow Wilson, 28th President
of the United States (1856 – 1924)
Success with 3 Level Approach –
Breast Cancer Case Study



This approach can be applied to different type of
cancers advocacy:
Breast Health Global Initiative developed evidence
based guidelines for countries with limited resources
www.fhcrc.org/science/phs/bhgi/
International collaboration with UICC, WHO,
International Atomic Energy Agency, National
Cancer Institute, Corporate Partners – Amgen, Astra
Zeneca, Bristol Mayers, Pfizer, Non Governmental
Organizations (NGOs)
Improving Knowledge,
Improving Attitude – key for
advocacy
Goal – to get information and involve patient in decisionmaking by providing accurate, relevant and
understandable information.
Information Outlets:







Attending conferences for cancer advocates
Communication with health care providers about research and
medical innovations – communication skills
International, country or community cancer guides
http://www.cancer.gov - clinical trials
http://www.cancer.com/shared/friends.jsp
www.leukemia-lymphoma.org
http://www.plwc.org/portal/site/PLWC - ASCO's People Living With
Cancer website
Management of CML disease in
countries with limited resources
Post-communist transitional health care systems
Belarus
• 600 patients with CML
• 25 have access to Glivec (10 patients recently got
access due to Chernobyl 20th Anniversary action)
• Lab diagnostic: Low accessibility to cytogenic
tests - Philadelphia chromosome detection
Management of CML disease in
countries with limited resources
Central Asia (Kyrgyzstan and Tajikistan):
• 450 patients with CML – KG
• 82 patients with CML -- TJ
• 5 have access to Glivec
• Lab diagnostic: no capacity in the country
(When possible, lab testing is performed in other
countries).
Advocacy Outcomes:
Empowerment and Influence
Lobby policy makers for changes in cancer policy and to make
resources available
Example: Belarus: Clinical protocols were developed and bone
marrow transplantation centers were opened
Practitioner education on latest research findings and dissemination of
results through private/public partnership (NGO - pharmaceutical
company)
Example: Belarus: Lecture series at teaching hospitals to promote
practice of latest evidence based methods
Patient education to clearly explain scientific developments, enabling
patients to gain more control of their destinies
Example: Belarus – brochures for patients on lay language
“Words without actions are the assassins of idealism.”
Herbert Hoover, President, Statesman & Humanitarian (1874 – 1964)