Enhancing private Sector Engagement to Expand Access to Cancer Controlin LMICs. 5 sep 2012

7/30/2019 Enhancing private Sector Engagement to Expand Access to Cancer Controlin LMICs. 5 sep 2012

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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


2/21

GTF.CCCMembers


3/21

= global health + cancer care

Multi-stakeholder partnership:

government, academia, media, civil society, private

sector, int agencies, health care providers, patients


4/21

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


5/21

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


6/21

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


9/21

Applies a diagonal

approach to avoid the

false dilemmasbetween

disease silos -CD/NCD-that continue to plague

global health


10/21

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


11/21

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


12/21

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


14/21Source: Knaul, Arreola, Mendez. estimates based on IHME, 2011.

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.


15/21

#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


18/21

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


19/21

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)


20/21

Be anoptimist

optimalist:Solutions

existExpanding access to cancer care and control in

LMICs: Should, Could, and Can be done


21/21

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

Enhancing private Sector Engagement to Expand Access to Cancer Controlin LMICs. 5 sep 2012

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