GLOBAL CANCER POLICY-MAKING
‰ The donor and recipient parties should be explicit about genetic diversity;
whether the financial resources are “aid” or are to be ‰ exposure to differing patterns of disease, care and
jointly acquired; whether evolution to self-sufficiency with outcomes, and relationship of resource allocations to
the required resources provided by the recipient is an outcomes;
expectation; when and under what circumstances this is to ‰ establishment of operational models to address other
be achieved, and how it will be sustained beyond the project. health and disease states (potential positive “spill-over”
effect);
Factors influencing success, failure, value and ‰ receptivity for collaborators to conduct research and
satisfaction present and publish findings;
Through an approach called SWOT analysis internal and ‰ introduction of alterative care delivery models from
external factors that foster or hamper collaboration and the differing health contexts;
achievement of goals and satisfaction can be identified as ‰ involvement of those with relevant non-clinical health
Strengths, Weaknesses, Opportunities and Threats. professional skills (e.g. health administration, medical
ethics, economics , health technology assessment etc.);
Strengths: characteristics of collaborations that enhance ‰ establishment of on-going health professional exchange
the prospect for success: and training modules;
‰ trust; mutual respect; ‰ structured sabbatical, fellowship and observership
‰ clearly defined vision; bilaterally accepted and agreed logic opportunities to build capacity and foster continuity;
model; ‰ promotion of “legacy” fund-raising to support project
‰ an understanding of true collaboration; implementation and capacity building.
‰ “top-down” and “bottom-up” support and commitment;
‰ acceptance of an evaluation framework; Threats: contextual factors that could undermine success
‰ well-defined, secure budgetary commitments; or sow frustration and/or dissatisfaction:
‰ a framework for incorporation into and continuity within ‰ responsibility for population-based outcomes without
the health system; authority or resources to implement change;
‰ an appreciation of self-sufficiency and sustainability post ‰ shifts in political will, priorities, or level of commitment;
implementation. ‰ changes in institutional or project leadership due to
turnover arising from term of office or political processes;
Weaknesses (or Limitations): the characteristics of ‰ loss of focus because of competing or distracting
collaborations that diminish the prospect for success: priorities;
‰ a short/limited duration for consistent policy leadership ‰ insufficient progress to maintain momentum;
and priority setting; ‰ withdrawal or re-allocation of budgetary resources;
‰ dissimilarity of cancer control systems and professional ‰ inadequate attention to security, safety and health.
practices between collaborators (e.g. salaried versus fee-
for-service compensation); Discussion
‰ absent, ambivalent or insecure leadership in the donor There are both compelling reasons and enormous and highly
and/or recipient organizations; varied opportunities for health personnel – clinicians and non-
‰ distance and language barriers that hamper clinicians – with knowledge and skills to make lasting
communication; improvements in cancer care delivery and cancer prevention
‰ uncertainty of the budgetary commitments; and control in lesser-resourced countries.
‰ unclear vision, absent or contested logic model to define The resource intensiveness and multidisciplinary nature of
outcomes; cancer diagnosis and treatment, and the complexity of
‰ absent or ineffectual professional/team activity (quantity, population-based cancer prevention and control usually
quality, timeliness, enthusiasm); require multidisciplinary solutions where collaborative
‰ “one-off” or ad-hoc activity. relationships constructed and carried out over several years
are essential to success and sustained change. Continuity
Opportunities: contextual factors that enhance the promotes alignment of motivations and focus on the context ,
prospects that collaborations will “add value”: needs and priorities underlying a successful collaboration.
‰ access to populations with differing social, ethnic and With collaborative activity – whether as a volunteer or on a
16 CANCER CONTROL 2013