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GLOBAL CANCER INITIATIVES

13 CANCER CONTROL 2021

between 1999 and 2014, only 12 had registered sales in

more than 10 countries (20). Shortages and lack of access to

older antibiotics in many countries is also a chronic problem,

and the reasons for this includes fragile - sometimes singlesource - supply chains,

regulatory challenges and the lack of

commercial incentives to manufacture, register and distribute

these medicines. Ensuring access to these existing treatments

need to be addressed urgently.

In addition, recent years have seen huge advances in cancer

care, including the new targeted therapies and immunotherapy

for cancer treatment. Similar prioritization of R&D for newer

therapies to address infectious pathogens, which undermine

the effectiveness of both old and new cancer treatments, is

urgently needed.

A number of initiatives do exist that specifically support new

medicines and R&D such as the UK's Global AMR Innovation

Fund (GAMRIF), R&D-funders like CARB-X, non-profit drug

developers such as GARDP and the industry-funded AMR

Action Fund. New approaches to R&D investment and more

collaborative approaches are needed. Several legislative

proposals in Europe and the United States (various subscription

models and the PASTEUR and DISARM acts) have been put

forward to try to incentivize R&D for new therapies. There is,

however, considerable concern that these initiatives will not

take a global nor an end-to-end approach that could ensure

sustainable access for all. These proposals and other novel

collaborative mechanisms should be expanded to ensure

equitable and affordable access in LMICs and HICs alike, so that

cancer patients everywhere receive the medicines they need.

While the current global COVID-19 pandemic has shown

the importance of multi-sectoral cooperation, with active

participation of relevant stakeholders i.e. governments,

civil society, research institutions and industry, the crucial

importance of government leadership should however not be

understated. As the WHO's newly established "Council on the

Economics of Health for All" stated in its recent publication

on the governance of health innovation for the common good:

"The development of multiple coronavirus disease 2019

(COVID-19) vaccines in less than a year shows how much can

be accomplished when human ingenuity and solid medical

research and development capabilities are given extensive

public support. It further notes however that "...this experience

also demonstrates that unless innovation is governed for the

common good, many people remain excluded from its benefits,

limiting the positive impact of health interventions, and creating

unacceptable inequities that potentially exacerbate the health

needs that it is supposed to address".

There is an urgent need for key players to come together

and explore innovative ways to fund R&D for new antibiotics,

increase collaborative networks and ensure there is a

an infectious disease specialist from Apollo Hospitals in India,

pointed out at the LGCW event that many countries have yet

to implement systems to feed national data into GLASS. High

quality data is needed to back up advocacy efforts and convince

policymakers that this issue needs action now.

Other smaller initiatives between governments, private

foundations and the pharmaceutical industry have also been

established towards this end.

Such data collection should also be used to capture the impact

of AMR on cancer care in order to understand the depth of the

issue and reinforce anecdotal evidence from cancer patients

and oncologists who deal with AMR on a frequent basis, with

real-world data.

A Longitude Prize survey among 100 oncologists from across

the United Kingdom, showed that 95% worry about increasing

drug resistance and how it will impact cancer care. In addition,

more than 7 out of 10 believe that drug-resistant infections will

make some cancer treatments obsolete within 10 years (18).

Partnerships in raising the profile of AMR and cancer

Research collaborations to improve data collection and

surveillance, showcasing the evidence-based data through

effective communication, needs to be combined with raising

awareness among the public and policymakers. Currently,

knowledge and awareness within the cancer community of how

drug resistant infections affect cancer care outcomes are low.

It is urgent that the cancer community, oncology professionals,

cancer advocates, programme managers, patient groups and

other stakeholders working in the field of cancer understand

and address the factors that contribute to the development

and spread of AMR (19).

This is a multi-sectoral issue and in order to bring about

policy change through tailored strategies and guidelines,

the infectious diseases community and cancer community

should come together. In this regard, addressing AMR is a

priority for UICC and a task force of experts was convened in

2019 to support evidence generation, identify research gaps

in knowledge of cancer and AMR, share best practices, and

ultimately engage the cancer community to work together

and bring about policy change. Since AMR has become a UICC

priority, UICC and the UICC-led task force on AMR and cancer

care have been very active in raising awareness on AMR among

the cancer community and beyond, through various platforms,

including LGCW and the Cancer Control series.

Partnerships for ensuring access to antimicrobials

Antimicrobials are a key and indispensable part of cancer

treatment. However, access to treatments for infections is not

always a reality. Medicines to treat infections are not available

in many parts of the world. Of the 25 antibiotics developed

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