5th International Cancer Control Congress
Tips and lessons learned from established population health based primary cancer prevention program
Dr Sutcliffe English - President, International Cancer Control, Canada
Having worked all my life in oncology and run tertiary academic institutions they’re very focussed on the individual, biomedical care and treatment. Increasingly over the last few years I’ve become more concerned about what we do for the population of patients and how we do things that are medically beneficial to them without the necessity for highly costly treatments that many countries will never ever be able to afford.
So in Canada in 1996 we started working on putting together a national cancer control programme, essentially a strategic plan to control cancer. We held the first meeting of the International Cancer Control Congress in 2005 because we thought at the time the most important thing is that countries need to have strategic plans to control cancer. What we’ve learned over the past ten years is that in reality most countries know what they’re supposed to do; whether they’re very poor or very rich they know what they’re supposed to do. Indeed, you can unload strategic plans from the internet and I can as readily know what’s going on in Tanzania as in Cameroon as in Canada. The truth is whether you actually change the outcomes for the population is more whether you can adapt those plans to the context and the true reality of the country that needs to do them, and whether that country can put together the relationships amongst the various elements of society that are actually necessary to change cancer control.
Cancer control is not really a medical issue, it’s a societal issue, The medical structure in the healthcare system having a very important role to play. It’s a key role, but it’s not the only role and there are many other stakeholders whose presence is essential if you’re going to influence society and how society lives, behaves and takes control of its health.
It’s an interesting paradox. In high resource countries like Canada we have capacity, the difficulty is whether we can actually sustain that capacity because of the costs that will come with cancer and non-communicable disease control. Lesser resource countries in general don’t have the capacity and need to build it. Because they are resource constrained, often the things they do have to be cost-effective to their economy. So a meeting like this is very important as a place where the lesser resourced and the higher resourced actually meet and share what they’re doing. Because the truth is high resource countries have got a lot to learn from what lesser resource countries have to do by circumstance and by economy. It’s not that high resource countries have got it right and they know how to give it to the lesser resource, it’s that the lesser resource need to learn how to do this. They can learn from higher resource countries but that’s not by exporting or importing what high resource countries have, it’s by learning what you need to do in the context of the country in which you need to do it. For most lesser and middle resource countries the greatest gains for them will always come through strategies around social determinants of health, primary disease control, primary prevention and risk factor control. It’s clear they will gain by medical advances but medical advances to treat established diseases like cancer in and of themselves are not going to give them the greatest gains that they can have.