treatment and care.
Cervical cancer is an example of the disproportionate
burden borne in the developing world. Over 85% of the
275,000 women who die every year from cervical cancer are
from developing countries. If left unchecked, by 2030 cervical
cancer will kill as many as 430,000 women, virtually all living
in low-income countries.14 The reality of cancer cure rates in
children is also reflective of the inexcusable inequities in
access to care and essential cancer medicines that occur
globally. There are an estimated 160,000 newly diagnosed
cases of childhood cancer worldwide each year15 with more
than 70% of the world's children with cancer lacking access to
effective treatment. The result is an unacceptably low
survival rate of ~10% in some low- and middle-income
countries compared to ~80% in some high-income
countries.16,17
In many cases the largest and most unacceptable gap in
cancer care is the lack of adequate palliative care and access
to pain relief for much of the world's population. The
disparities in worldwide use of medical opioids are shocking,
with just four countries - United States, Canada, United
Kingdom and Australia - using 68% of opioids, while lowand middle-income countries together only account for 7% of
global use.18 A short list of medications can control pain for
almost 90% of all people with cancer pain including children,
yet even where opioids are available, cost to the patient and
pervasive overregulation make them virtually inaccessible to
millions in need.19,20
The evidence base from diverse countries is growing to
dispel the myth that effective, quality care is only achievable
for high-income countries, with successful cancer control and
care programmes in many low resource settings now in place
using locally appropriate solutions across the full cancer care
continuum.21
The way forward
Building broad support for solutions for cancer prevention
and control that can be implemented in all resource settings
and within a global development framework will not be easy.
However, by rallying around a defined set of evidence-based
targets and actions, and using these to reach out to nontraditional
partners beyond the cancer and health fields, the
cancer community can create a powerful and united
advocacy push to position cancer in the post-2015 agenda.
The World Cancer Declaration 2013
Originally launched in 2008, the World Cancer Declaration
has helped to bring the growing cancer crisis to the attention
of government leaders and health policy-makers, and to
drive new government commitments in the global fight
against cancer and other NCDs. In light of these
groundbreaking developments in the fight against NCDs,
and with the expiration of the MDGs fast approaching, UICC
saw a growing need to more closely align the Declaration
with the emerging global NCD framework and the dialogue
on the post-2015 development agenda. Based on feedback
from UICC's members, partners and the wider health
community, an updated Declaration was developed and
launched at the World Cancer Leaders' Summit in Cape
Town in November 2013.
The language used in the Declaration has been updated to
reflect current discourse in the public health and
development arenas. Other specific changes to the
Declaration include:
‰ The timeframe for achievement of the Declaration
targets has been shifted from 2020 to 2025 to align with
the GMF. Governments have already committed to take
action to reduce premature deaths from NCDs by 25%
by 2025; UICC believes the advocacy and programmatic
efforts of the cancer community will be more powerful if
we work to and support the same timeline.
‰ The text of the Declaration targets (specifically targets 1
and 7), and list of immediate actions have been enhanced
to acknowledge the importance of the quality of cancer
care and emphasize the principles of equitable access to
effective, safe patient-centred services.
The Declaration provides governments, agencies, civil
society, relevant private sector and other key stakeholders
with a shared vision on which we can unite to form a
collective voice and build collaborative partnerships to
address the global cancer burden.
By more closely aligning the updated Declaration with the
emerging global NCD framework and post-2015
development discourse, UICC believes that the Declaration
targets will resonate more widely, allowing the cancer
community to reach out to non-traditional partners in
development, disability, education, employment and many
other sectors for innovative partnerships.
By connecting the cancer community from the grassroots
levels to national and regional cancer societies and networks
and joining forces with the larger NCD community through
the NCD Alliance, an opportunity has already been created to
ensure that all people with cancer have a voice at the highest
political levels.
The onus is now on the cancer community to build on
this momentum and continue to expand its sphere of
influence to push for national accountability for existing
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