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Published: 12 Dec 2016
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Dr Lawrence Shulman - University of Pennsylvania, Philadelphia, USA

Dr Shulman speaks with ecancertv at the 2016 World Cancer Congress about how ASCO and UICC are working together.

ASCO typically represents clinical advances, where UICC is often more policy focused, and he considers how the two have worked together in bringing cancer care and control plans to a global community.

Dr Shulman also discusses the 'essential medicines list', a collection of the most effective and available treatments for cancer, and how the cost of these proves a barrier to access in low income countries.

The UICC and ASCO are two great organisations, they’ve started in different places at different times but they have a common mission and the mission is to bring better cancer care to all cancer patients throughout the world. Over the last decade those visions have come together, brought the two organisations together in lots of different ways. I have leadership positions at ASCO, I am on their International Affairs Committee and I have worked on their Task Force for Global Cancer Medicine and I’ve worked very closely with UICC, particularly in essential cancer medicines, with WHO and a WHO medical devices project. When you look at the two organisations they really have a unified goal, they work well together and there’s no competition, it’s really a tremendous partnership.

What are your thoughts on WCC 2016?

UICC has grown dramatically over the last decade and I think when you look at this conference it’s really evident for everyone to see that we have representatives from all over the world, we have representatives from places that I work like Rwanda and Botswana and ASCO has a strong presence here as well. It’s just a statement, really, that UICC has grown, ASCO has grown in its support and the two of them are just working closely together in so many areas.

In the last several ASCO annual meetings in Chicago this past year and the year before and I think the year before that UICC has played a major role, we’ve had significant exposure there but we have also gotten a lot of work done. So that we’ve had joint sessions looking global cancer medicine, we’ve tried to move a lot of the work that we’re doing on cancer care and resource-constrained settings and essential medicines for cancer. That type of work has really moved forward during the ASCO annual meetings as well.

Could you talk about the “essential medicines list”?

In 2012 when I was still at Dana Farber we petitioned the World Health Organisation to add trastuzumab and imatinib to their essential medicines list. They were the two medicines that we thought were so important in dramatically improving patients’ lives but they were both at that time patented medicines and very expensive medicines. WHO turned around to us and said that they were going to reserve judgement and asked UICC at that time to review the entire essential medicines list and UICC asked me to chair that effort.

In 2014 UICC and WHO asked me to chair an effort to review the entire essential medicines for cancer list for WHO. We worked hard on that through the entire calendar year of 2014 and produced 29 documents that presented medicines in the context of the diseases where they could be most beneficial and impact on human lives. We had an in-person meeting with WHO in November of 2014 and in December submitted our proposal for the addition of 22 medicines to the essential medicines list with documents supporting that work. In April of 2015 WHO ruled on those documents and accepted 16 of the 22 medicines, rejecting six. In 2016, early this year, WHO asked us again to review the entire list and make new proposals which we’re in the process of doing and we will submit to WHO in December. They will rule on that probably in April or May of 2017 and we’ll see where we stand at that point.

Since WHO has accepted that costly patented medicines are essential medicines for cancer that’s raised significant issues about the cost of cancer medicines particularly in areas like sub-Saharan Africa and Southeast Asia where many countries are very poor and can’t afford these medicines. So as part of our work we are looking at how to make those medicines available to cancer patients in those areas that are affordable for them and literally will save millions of lives.