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CANCER CONTROL INTERVIEW

9 CANCER CONTROL 2021

pity on, or for whom we create an environment of fear, then

we're doing them and ourselves a disservice because we're

losing the lessons that they are best positioned to guide us on:

Trust, Solidarity, Mortality, Death with Dignity, Purpose. This is

what matters.

I have a hope for cancer, because it's such a relatable disease,

regardless of where you are in the world. Cancer means

something to a family and to a community, so if there's anything

that will yield solidarity, it should be this disease that we have

dedicate our lives to.

Cancer lays out why Health matters in Life for all to see,

contained in one irreplaceable experience. That's where we

can all draw our inspiration as a community. And that's why, I

think it's such an important thing to discuss these things here

in Cancer Control and during London's Global Cancer Week.

Let us pause. Innovation is where we need to think; progress

for tomorrow is where we need to be. But let's listen to the

lessons of yesterday and today, or we're not going to know

what the value is of the better tomorrow. n

Dr André Ilbawi is a medical doctor, specialized and double-board

certified in surgical oncology. Dr Ilbawi joined the World Health

Organization in 2015 and now serves as the focal point for the

cancer programme at WHO Headquarters in Geneva, Switzerland.

In his current position, Dr Ilbawi is responsible for

implementation of the 2017 World Health Assembly resolution

on cancer prevention and control. He was Executive Editor of the

2020 WHO Report on Cancer and has supported additional WHO

publications on broad topics ranging from guidance on cancer

prevention to access to cancer health products. Dr Ilbawi also led

the development of the WHO/IARC priority setting tool for cancer

control, workforce optimization strategies, and other tools to

support capacity building. He led the launch of the WHO Global

Initiative for Childhood Cancer (2018), now being implemented

in 30+ countries, as well as supported the launch of WHO Global

Breast Cancer Initiative (2021) and implementation of the WHO

Cervical Cancer Initiative based on the World Health Assembly

resolution on the Global Strategy to Accelerate the Elimination of

Cervical Cancer (2020).

and that should be a priority.

And, the value of a broader integrated approach is also

founded on evidence. For example, integrating palliative care

improves quality of life and longevity when compared to

focusing on systemic therapy alone.

If we can shift our emphasis toward broader investments in

health systems, that will accelerate progress in all domains of

health and promote solidarity. We have seen some advocates

take this approach, and I think it is transformative.

And, by broadly investing in health, we enable economic

growth and prosperity for all. I remember, when I was in

college (my goodness!), a professor challenged the common

perceptions of investing in health. He said, "The United States

is criticized for spending 12%-13% of its GDP on health. Why is

that a problem?" It is an extremely important point. The United

States now spends nearly 18%. Effective investments in health

yield dividends in productivity, human capital development,

social cohesion to drive prosperity for all.

These are difficult value judgments to make. But,

increasingly, we're able to show definitively that loss of health

- and cancer is a very good surrogate - has a ripple effect across

the broader community and economy. The consequences for

people with cancer are often that their lives are uprooted,

their out-of-pocket expenditures are high, the indirect costs

are substantial, marital stability suffers, the health and wellbeing of

the children and family suffers. As a community, we

should document these impacts and talk more about what to

do about it. We are failing to create the narrative that captures

the broader impact of cancer - on our lives and on the lives and

well-being of our loved ones.

As a species, for much of our lives we generally don't think

too much about our own death. That's a problem for 'later

on'. But when we get a cancer diagnosis, we can hear Death

knocking on the door, and that's where the shock is, not just

the fear of it, but actually the fear of the whole darkness.

I remember when I first started in medicine, meeting people

with cancer was overwhelming. My first day on the ward, I met

a young woman dying from cervical cancer, in the room with

her young children and husband. It was devastating.

Over time, my perspective changed. People with cancer

understand Life in a way that we should all understand it. And

the more time I spent in cancer, the more humbled and blessed

I have felt to be part of the community that understood Life.

And that, for me, is the value in the cancer community setting

a new narrative. That's why, if we can put the people who are

going through cancer in the centre - truly in the centre - and

actually listen to the experiences that they're having, then we

can begin to understand where cancer fits in Society.

If people with cancer are seen as a population who we invoke

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