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GLOBAL CANCER INITIATIVES

26 CANCER CONTROL 2021

health and healthcare delivery, particularly in low-resourced

health settings where cancer is an increasing problem. Global

cancer networks with their multidisciplinary ethos are well

placed to draw on the full breadth of appropriate professional

expertise (e.g. health economists, environmentalists,

agronomists) to address these challenges.

In the past, HIC /LMIC collaborations had a tendency for

the balance of the agenda to be weighed in the direction of the

HIC rather than meeting the needs of the LMIC. Nowhere is

this more clearly illustrated than in the field of research where

leadership, authorship and acknowledgement have primarily

sat with the high-income country partner. Here, a global

cancer network, free from the restrictions and responsibilities

of a single institution, can ensure that the LMIC partner takes

on the leadership role and that their projects focus entirely on

the needs of the LMIC. Similarly, the polarity of fellowships

travelling almost entirely in the direction of the HIC could be

reversed by initiatives driven by global health networks. As

Paul Farmer has noted (9):

"Cancer is everywhere and we need to treat it where we find it.

Eighty percent of the burden of disease in your specialty falls on the

developing world. The pathologies are the largely the same, and the

treatments can be the same, too. The diagnostic and therapeutic

advances of the past half-century have been astounding,

particularly in oncology. The challenge, of course, is delivery. So,

we need to meet it. We need to deliver high-quality care, and we

need to deliver on our promise to care for patients to the best of our

ability and training."

By investing effort in helping build capacity, global cancer

networks can play their part in redressing the balance from

cancer control to cancer care. Cancer is an example of what can

be achieved to improve health by cooperation, collaboration,

and mutual learning across the globe. n

Mark Lodge is a consultant systematic reviewer specializing in

cancer. He joined the International Network for Cancer Treatment

and Research (INCTR) in 2007 and was appointed INCTR's UK

Executive Director in 2008. He has provided technical advice to

the NHS, European Investment Bank and the Commonwealth

Secretariat. He is the Convenor of London Global Cancer Week

and Commissioning Editor for Global Health Dynamics' annual

publication Cancer Control

Kim Diprose has a background in psychology and health

promotion and has worked for 15 years in national roles for NHS

Direct and Macmillan Cancer Support. She joined the UK Global

Cancer Network in early 2021 and worked on the mapping project

and the development and promotion of the network.

gap between the needs of cancer patients in LMICs and the

resources and infrastructure available to meet their needs.

For some years individuals and institutions in high-income

countries (HICs) committed to this cause have been working

alongside colleagues in LMICs to address these inequities and

have made important local progress. However, these projects

have tended to work in isolation and have struggled to create

sustainable models to address these problems.

The three types of Global Cancer Networks described in this

paper provide examples of how individuals and institutions

can be drawn together to develop collaborations in which

expertise, commitment and resources are shared to make a

more strategic and sustainable partnerships in global cancer

control.

The UKGCN, the Canadian Global Cancer Network and

the City Cancer Challenge, in addition to having similar

goals, share important characteristics. Firstly, they are all

organizations which have been developed by workers in the

field who have recognized the advantages of such partnerships.

They have emerged from "the coal face" rather from national

or governmental initiatives. Secondly, they recognize the

importance of equal partnership between colleagues in HICs

and LMICs. There is increasing evidence that those from HIC

health backgrounds who engage in global health activities

benefit from enhanced knowledge, motivation and leadership

skills. Thirdly, the three networks all emphasise the importance

of interdisciplinary cooperation in delivering healthcare.

Finally, they all share the ethos of enabling and supporting

current successful work in the field and have no desire to

influence or interfere with cancer collaborations which are

working well. They see the potential for sharing good practice

between ongoing projects and acting as a catalyst and an

enabler for new programmes.

Different networks inevitably will have differing approaches

to attaining their goals. Rather than this being a drawback,

this is something to be encouraged. Each will bring their own

perspective and experience, and the variety will enrich the

whole.

Where do these global cancer networks stand in relation

to the COVID19 pandemic, the challenge of climate change

and the drive towards decolonization? COVID-19, Climate

change and conflict are all disrupters of cancer care across the

world. Whereas conflict almost entirely has a negative effect,

COVID-19 has illustrated to us our global interdependency

in healthcare and our ability, when forced to develop a rapid

and effective response. Global cancer networks should draw

on the same principles to effectively tackle global cancer.

The need to recognize our global interdependency was

further demonstrated at the recent COP26 summit meeting

in Glasgow. Climate change represents a significant threat to

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