I’m actually the Vice President of Southern Africa AORTIC which stands for the African Organisation for Research, Teaching and Training in Cancer; I’m also the Vice President of the Medical Research Council in South Africa. So we have been invited, actually, to organise a regional meeting and the regional meeting discussing the national cancer control plans in Africa, not only discussing about the plans but perhaps to come up with a strategy or implementation strategies because we don’t talk about only one strategy, we talk about many strategies in order to have functional national cancer control plans.

So have you a master plan that each country adopts or adapts?

A little bit perhaps. It’s very difficult to achieve, I don’t know if this is the ideal situation. Of course, one can ask why again national cancer control plans and want again another session because I think there were another two or three. But you know what is sort of special about national cancer control plans in Africa is perhaps the particular special situation. There are not two NCCPs which are identical, despite the fact that we might have a similar template, similar principles talking about prevention, early diagnosis, treatment, but the situation differs from country to country and especially in Africa. Of course one needs to look at the priorities and the needs of the country.

There are some common needs like trained surgeons, radiation machines, access to opioids.

There are many needs. What is important about a national cancer plan is to make everybody aware about cancer and get the involvement of the government because at the end of the day what is a plan? How many plans do we have in Africa? It’s a question which I ask myself and I can ask many other people and the answers which I will get would be completely different. If we look on the website, and this is the ICCP portal, there are about 14; if we look at the WHO Africa, out of 47 countries, and this is the number which WHO Africa reports, we will have about 22. The question which arises out of the 22 is how many are functional? Less than 17% of them have a budget. Again, if we look at the portal, and that’s perhaps a more philosophical discussion, are we talking about a plan, are we talking about a strategy or are we talking about a problem?

According to the WHO definition, the NCCP is a programme, a public health programme and deals with, of course, reducing the incidence of cancers, mortality, improving the quality of life and so on. If we look at the presence in Africa, again on the same portal, some of the countries will have a plan, some of them will have a programme and some of them will have a strategy. Again, is this specifically designed for cancer, because some of the countries will have particularly a cancer topic and some of them will have it under NCD.

In my mind I would begin with the end in mind. Where do you want to go and how do you go there? Because we know what we want to do but we don’t know how to do it so I think this is actually one of the questions. Again, if you look in terms of a plan, a plan is like a roadmap, it takes you to a certain point and it shows to you where you want to be. A strategy echoes an essential question and the essential question is why? A plan talks about when and who and where while the strategy is why. In an ideal world a strategy comes before a plan. Do we talk about a strategy, a plan or a programme? So I think the situation is really unique in Africa and we’ve got enormous opportunities to transform a negative situation into something positive.