Regional Prevention and Control of Cancer" (UNASUR) is
illustrative of the leadership required to enhance cancer
control efforts, including the challenge of women's cancer
ICCC-5 propelled Peru and Plan Esperanza into regional
and international forums, including the United Nations,
wherein the main achievements of this strategic health
policy, benefitting particularly the most vulnerable in our
society populations, have been presented (42).
Through the commitment of the National Institute for
Neoplastic Diseases (INEN) and the Ministries of Health and
Finance (of the National Government of Peru), populationbased
cancer control has been assigned public policy and
financial priority according to evidence for beneficial cancer
control interventions, the implementation of systems for
monitoring and evaluation of outcomes and the integration
of social, health and fiscal goals. Through decentralization,
regional capacity enhancement has developed through
INEN, IREN North and IREN South (2010), the subsequent
operationalization of 35 units in ten regions of Peru by 2015,
and the intent to have 204 operational units in 25 regions of
the country, including operational units in metropolitan
hospitals in Lima.
In line with this expansion, the health budget has
increased from 7% of the national public health budget
(2009) to 9.8% (2015) (Table 1). The cancer control budget
has increased from 2.34% of the health budget (2009) to
8.05% (2014) and 7.71% in 2015, a three-fold increase
reflecting political will at the highest level to address cancer
in the population. In this process new stakeholders have
become involved regionally and innovative agencies
(SIS/FISSAL) have become active partners nationwide (28).
In summary, Peru's success can be attributed to the
‰ 1. Active and visible political support at the highest level
in the national government.
‰ 2. Mobilization of "all of society" in their fight against
cancer prioritized high on the national agenda.
‰ 3. Deployment of a pluralistic and equitable
comprehensive population-based national cancer
control plan supported by protected and committed
public funding targeting the most vulnerable population.
‰ 4. Scientific technical exchange with international
experts in the design and implementation of the plan.
‰ 5. Establishing an evidence-based and outcomesfocused,
population-centered plan with identified short,
medium and long-term key performance indicators for
ongoing monitoring and evaluation.
‰ 6. Organizational support and technical management by
INEN, through provision of permanent and specialized
due diligence and decentralized clinical management
services across the country. l
Miriam Salazar (INEN), Carlos Ayestas (MINSA), Milward Ubillus
(INEN), Juan Carlos Chávez (INEN), Ebert Poquioma (INEN),
Carlos Castañeda (INEN), Jorge Dunstan (INEN), Abel Limache
(INEN), Carla Zavala (INEN), Edgar Palomino (INEN), Norma
Rodriguez (MINSA), Jeanni Navarro (INEN), Obert Marin (INEN),
Janeth López (INEN), Melissa Montañez (INEN), Carmen Nuñez
(INEN), Miguel Ruiz (INEN), Humberto Castillo (INSM) y Miguel
Tatiana Vidaurre, Julio Abugattas, Carlos Santos, Marga López,
Henry Gómez, Edgar Amorin, Gustavo Sarria, Javier Manrique,
Roxana Regalado, Duniska Tarco work for the National Institute
of Neoplastic Diseases (INEN) in Lima, Peru.
Kavita Sarwal and Simon Sutcliffe work for the International
Cancer Control Congress Association, Canada.
136 CANCER CONTROL 2015