Page 0059

CANCER MANAGEMENT

58 CANCER CONTROL 2014

combined with early detection and treatment to mount an

effective response to a cancer that is rapidly becoming a

leading cause of death in low- and middle-income countries.

Resource stratified guidelines have been developed for

breast cancer that offer alternatives for countries to make

evidence-based decisions in setting priorities and these need

to be applied and integrated into programmes for women´s

health.44 Indeed, if countries ignore the emerging challenge of

breast cancer because it is not associated with a quick,

preventive fix, we are likely to see the emergence of a gaping

cancer divide. If early detection and access to effective

treatment are denied to poor women, mortality will decline

only among the rich countries and the wealthy, while

continuing to increase among poor women.

For both cervical and breast cancer, there are important

opportunities to apply a diagonal approach that will

strengthen health systems and improve women's health and

cancer care and control simultaneously.

5,18,41 This involves

integrating key interventions on women´s cancers such as

education and early detection, into maternal health, sexual

and reproductive health and anti-poverty programmes that

focus on women. It also requires promoting policy dialogue,

research and international action that cut across false

boundaries and silos such as those that have separated

women on women's health with that on NCDs.45

Integrated approaches will help to meet the many facets of

women's cancers that are related to motherhood, sexuality,

menopause, and to face the barriers associated broader

issues of discrimination against women. These actions can

and should be effectively catalyzed through national and

global strategies to curb not only the tide but also the swell of

women's cancers as part of the larger, emerging challenge of

chronic and non-communicable disease. l

Dr Felicia Marie Knaul is Associate Professor at Harvard

Medical School and Director of the Harvard Global Equity

Initiative. Dr Knaul is also Senior Economist at the Mexican

Health Foundation (FUNSALUD), Honorary Research Professor

of Medical Sciences at the National Institute of Public Health of

Mexico, and founder of Cáncer de Mama: Tómatelo a Pecho.

Afsan Bhadelia is a Research Associate at the Harvard Global

Equity Initiative, where she previously served as Research

Director. Concurrently, she is a doctoral candidate in the health

systems program at the Johns Hopkins Bloomberg School of

Public Health. Her research interests include promoting health

equity through chronic care management, women's health and

palliative care.

Hector Arreola-Ornelas is Economic Research Coordinator of

the Health Competitiveness Program in the Mexican Health

Foundation (FUNSALUD). He is also the Coordinator of the

Health Observatory for Latin America. His areas of research

include financial protection, policy and health systems, labour

economics, economic evaluation and health and competitiveness.

Dr Isabel dos-Santos-Silva is Professor of Epidemiology in the

Department of Epidemiology and Population Health at the

London School of Hygiene & Tropical Medicine. Her research

focuses on the causes of cancer as a basis for the development of

appropriate prevention and control strategies, both in high and

low resource settings.

Dr Danielle Rodin is a Resident in the Department of Radiation

Oncology at the University of Toronto and an MPH Candidate at

the Harvard School of Public Health. Her current research

interests are in the area of health equity in the treatment and

palliation of cancer and in the role of radiotherapy.

Dr Rifat Atun is Professor of Global Health Systems and Director

of the Global Health Systems Cluster at the Harvard School of

Public Health. He previously led the Health Management Group

at Imperial College London and was a member of the executive

management team at The Global Fund to Fight AIDS,

Tuberculosis and Malaria.

Dr Ana Langer is Professor of the Practice of Public Health and

Director of the Dean's Special Initiative in Women and Health at

the Harvard School of Public Health. Dr Langer is a reproductive

health expert. She was previously the president and CEO of

EngenderHealth.

Dr Julio Frenk is Dean of the Faculty at the Harvard School of

Public Health and T & G Angelopoulos Professor of Public

Health and International Development, a joint appointment

with the Harvard Kennedy School of Government. Dr Frenk is an

eminent authority on global health who served as the Minister

of Health of Mexico from 2000 to 2006.

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