enhancing private sector engagement to expand access to cancer controlin lmics. 5 sep 2012
TRANSCRIPT
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Enhancing Private Sector Engagement
to Expand Access
to Cancer Care and Control inLow and Middle Income Countries
Felicia Marie Knaul, PhD
Harvard Global Equity Initiative; Global Task Force on Expanded Access to Cancer Care
Mexican Health Foundation, Competitividad y Salud
Tmatelo a PechoUICC Board Member 2012-14
September 5th, 2012
Harvard Faculty Club, Cambridge, MA
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GTF.CCCMembers
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= global health + cancer care
Multi-stakeholder partnership:
government, academia, media, civil society, private
sector, int agencies, health care providers, patients
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History
2009: convened by Harvard Global Equity
Initiative (Secretariat), Harvard Medical
School, Harvard School of Public Health, and
Dana Farber Cancer Institute
2011: dual Secretariat established at Harvard
Global Equity Initiative and Fred Hutchinson
Cancer Research Center/University of
Washington, School of Medicine
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Task Force: 36 leaders from global health andcancer communities
Secretariat: Harvard Global Equity Initiative and the
Fred Hutchinson Cancer Research Center Committees and Initiatives
Technical Advisory Committee
Private Sector Engagement Initiative Strategic Advisory Committee
Working Groups: childhood cancer, womens cancer,
pain and palliation, infection-associated cancer
Members and Committees
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Leadership
HONORARYCO-PRESIDENTS
Her Royal HighnessPrincess Dina Mired
Director-General, King Hussein Cancer Foundation,
Program, Hashemite Kingdom of Jordan
Lance ArmstrongFounder, LIVESTRONG
Lance Armstrong Foundation
CO- CHAIRPERSONS
Julio Frenk, MD, MPH, PhDDean of the Faculty, Harvard School of Public Health
Former Minister of Health, Mexico
Lawrence Corey, MDPresident and Director, Fred Hutchinson
Cancer Research Center
SECRETARIATCO- DIRECTORS
Felicia Marie Knaul, PhDDirector, Harvard Global Equity Initiative
Founder, Tmatelo a Pecho
Julie R. Gralow, MDDirector, Breast Medical Oncology,
Seattle Cancer Care Alliance
Jill Bennett Professor of Breast
Cancer, U Washington School of
Medicine
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GTF.CCC: Mandateto design, promote and evaluate global,
regional and local multistakeholder strategies toimprove the financing, procurement and
delivery of cancer prevention, detection,
treatment and palliation applying innovative
service delivery models appropriate to low and
middle income countries.
Working with local partners, the GTF.CCC
participates in innovative service deliverymodels to scale up access to cancer care and
control, and to strengthen health systems in
developing countries.
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Challenge and Disprove theMyths About Cancer
M1. Unnecessary
M2. Impossible
M3. Unaffordable
M4: Inappropriate
Expanding access to
cancer care and control in LMICs:
Should, Could, and Can be done
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Applies a diagonal
approach to avoid the
false dilemmasbetween
disease silos -CD/NCD-that continue to plague
global health
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115+ authors
56 countries
20+ cases
Closing the Cancer Divide
Book: English
Report: English, Spanish,
Russian, (Arabic)
THE LANCET, 2010: Expansion of cancer care and control
in countries of low and middle income: a call to action
Farmer, Frenk, Knaul, et al
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Investing in CCC:
We Cannot Afford Not To
Health is an investment, not a cost
Economic cost of cancer, 2010: 2-4% of global GDP
1/3-1/2 of cancer deaths are avoidable:
2.4-3.7 million deaths, 80% in LIMCs
Prevention and treatment offer potential, untappedworld savings of $US 100-200 billion
The costs of prevention and treatment are often less
that many fear especially using a diagonal approach
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Outcome-oriented,C
ross-CuttingStrategiesandInterventio
nsin-country GTFCCC: Priority Areas for Action
BY HEALTH POLICY INTERVENTION AREAS
Pediatric
Cancers
Women's
Cancers
Infection-Related
Cancers
Pain and
Palliative Care
Health
Policy
Health Workforce
Delivery and
Technology
Access to Drugs,
Vaccines, Treatment
Financing
Evidence and
Information
Global Stewardship
and Leadership
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Cancer is a disease of both rich and poor;
yet it is increasingly the poor who suffer:
1. Exposure to risk factors
2. Preventable cancers (infection)
3. Treatable cancers: death and disability4. Stigma and discrimination
5. Avoidable pain and suffering
The Cancer Divide:
An Equity Imperative
Face
ts
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7/30/2019 Enhancing private Sector Engagement to Expand Access to Cancer Controlin LMICs. 5 sep 2012
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The cancer transition in LMICs:
breastand cervicalcancer
53%
20%19%
-31%
0%
LMICs High
income
% Change in # of deaths1980-2010LMICs account for
>90% of cervical
cancer deaths and
>60% of breast
cancer deaths.
Both diseases are
leading killers
especially of young
women.
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#2 cause of death in wealthy countries
#3 in upper middle-income#4 in lower middle-income
and # 8 in low-income countriesMore than 85% of pediatric cancer cases and 95% of
deaths occur in developing countries.
For children & adolescents
5-14 cancer is
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Adults
Leukaemia
All cancers
Source: Knaul, Arreola, Mendez. estimates based on IARC, Globocan, 2010.
Children
LOW
INCOME
HIGH
INCOME
Sur
vival
inequa
lity
gap
LOW
INCOME
HIGH
INCOME
100%
The Opportunity to Survive (M/I)
Should Not Be Defined by Income
In Canada, almost 90% of children with
leukemia survive.
In the poorest countries only 10%.
Th t i idi i j ti
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The most insidious injustice:
lack of access to pain control
Non-methadone, Morphine Equivalent opioidconsumption per death from HIV or cancer in pain:
Poorest 10%: 54 mg per death
Richest 10%: 97,400 mg per death
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Priority Areas for Action
GTF.CCC Working Groups
PediatricCancers
Women'sCancers
Infection-Related
Cancers
Pain andPalliative
CareStrategy Activities:
examples of GTF.CCC
work, by strategy
Process-oriented,C
ross-CuttingStrateg
ies
Multi-sectoralengagement
Private Sector
Engagement Group;National and sub-national
task forces
Delivery
(human resources)
and Technology
Pilots and demonstration
projects; training, education
and capacity building
Evidence and
Information
Research and translation of
research and evaluation
Global Stewardship
and LeadershipAdvocacy, Capacity building
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Objectives
1. Respond to the ethical, moral and health objective of
expanding access in LMICs for the sole sake of shared value
and enhanced social and economic development in country
2. Identify effective, collaborative, replicable initiatives
3. Identify global and national projects in which PSE can be an
especially effective catalyst
4. Develop and promote a research agenda that includes shared
value and implementation evaluation
5. Contribute to and develop key data bases on existing PSE
projects and global and in-country initiativates that will
catalyze a level playing field
6. Generate a platform for private sector engagement through
joint learning and experience-sharing that horizontal and
diagonal (with other institutions)
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Be anoptimist
optimalist:Solutions
existExpanding access to cancer care and control in
LMICs: Should, Could, and Can be done
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AGENDA10:00-11:00: Session 1
PSE Engagement in CCC: Opportunities and Impediments
11:00-12:00: Session 2
Private Sector Engagement to Catalyze Global Programs
12:10-13:00: Lunch at the Faculty Club
Presentation: The Diagonal Approach to Health System Strengthening
13:15-14:15: Session 3
Private Sector Engagement to Catalyze National/Local Programs
14:15-15:00: Session 4
Role and Opportunities for Research and Joint Learning
15:15-16:00: Key Inputs for More Effective PSE and the Future Role of the
GTF.CCC PSE Initiative
16:00-16:30: Wrap-up and next steps