GLOBAL CANCER POLICY-MAKING
Examples of this type of arrangement are institution-to-
institution (“twinning” agreements), professional society-to-
society e.g. gynecologic oncology societies, government-to- The concept of collaboration – to work
government or through international health/cancer control in association with; to work with, to
organizations e.g. WHO, UICC, IARC and IAEA. help, etc. – is intuitively accepted, but
Institutions and institutional programmes are more likely to not necessarily well understood
have reporting and programme evaluation expectations, which
foster periodic assessment of initiatives and programmes so
that an ongoing relationship builds cumulatively to a
commonly determined goal. support of the attainment of a commonly held vision2.
In addition, the pace of change within a collaborative
Logistics relationship may range from “let it happen” (adaptation in an
In addition to travel, local transportation and accommodation, unpredictable, uncertain, emergent and self-organizing way)
there may be issues of personal security and safety and health through “help it happen” (knowledge transfer and exchange
issues that the individual travelling on their own may through negotiation, influence and enabling) to “make it
underestimate. happen” (re-engineering of processes based on planned,
regulated, programmed and managed managerial
Funding mechanisms)3.
Individuals who engage in this kind of work may be volunteers The goal of a true collaboration is the achievement of a
or compensated or subsidized in some way. Most self-initiated common vision through a respectful relationship based upon
activity is usually self-funded. Universities may offer stipends trust and a genuine desire to achieve mutually defined
for students and faculty; similarly medical and other health objectives through which both parties gain. Elements
professions’ societies may offer stipends for international promoting true collaboration include:
research collaboration or training. Typically such resources ‰ A mutually agreed logic model that underlies the vision of
aim to cover the costs of international travel, ground the collaboration (the why behind the collaboration); the
transportation, and accommodation with a meal allowance. outcomes of collaboration (the content of what is to be
Government and government agencies often work under achieved); the process of collaboration (how will the goals
legislation or regulatory rules that dictate that certain be achieved); the roles, responsibilities and
appropriations can only be channelled to or through other accountabilities of the parties in the relationship (who and
governments or quasi-governmental entities, or conversely through what understandings), and the governance or
may only be channelled to non-profit entities registered in oversight of the collaboration (the source, direction and
lesser-resourced countries. deployment of resources, as well as the evaluation of
Philanthropic organizations are often primarily funding performance).
entities that allocate funds to non-profit (charitable) service ‰ A mutual appreciation of the utility of evaluation to
organizations (many administered by religious entities) and determine “value”, assess achievement of goals,
other nongovernmental organizations. demonstrate outputs and outcomes deriving from the
collaboration, and the circumstances underlying
Establishing meaningful collaboration sustainable change following implementation.
The concept of collaboration – to work in association with; to ‰ An understanding of organizational cultures, leadership
work with, to help, etc. – is intuitively accepted, but not and relationships, and the need for structure and
necessarily well understood. It encompasses a continuum of infrastructure if cultures are being aligned in the pursuit of
engagement from networking (agreement to share a novel endeavour.
information) to coordination (scheduling activities for ‰ An “approving/permissive/enabling” governance and a
common gain) to cooperation (to agree to do defined activities willing, enthusiastic, and enabled health professional team
within a commonly agreed manner) to true collaboration composed of the collaborating parties.
(working together and sharing resources to achieve commonly ‰ An understanding of the resource commitments required,
defined goals). This continuum requires increasing levels of especially the finances. In principle, to achieve the goals of
time commitment, increasing trust between parties, and a the collaboration a commitment to secure the necessary
willingness to modify personal/institutional priorities in resources should be undertaken early on.
CANCER CONTROL 2013 15