Tuesday, July 24, 2012 3:37 PM

Dr. Swain's presidential initiative leading ASCO's efforts and eduational focus on cancer control in developing countries is commendable.  We must be careful, however, to remember that developing countries have a different set of needs and priorities than developed countries.  Often concentrating resources on more basic needs such as providing clean water and a reliable supply of locally grown food should take precedence over developing higher tech solutions for a smaller segment of the population.  When resources are adequate, pursuing improvement in both basic and more complex areas, particularly preventive, can be appropriate.  However,  care must be exercised so that an Americanized solution does not inadvertantly divert attention and resources from problems that affect more people's lives in a profound way on a daily basis.

Wednesday, July 25, 2012 2:34 PM

There is a big challenge between (job work) and Health status in developping countries , what we can do ? Probably by your prestigious Society and the international organism like UNESCO and the active country member we can propopsed an educative spetial training  that can added in national program  target for the different form of the prevention .

Wednesday, August 01, 2012 4:08 AM

I am glad that you have a great vision in equalizing health all over the world for the ones who are in need of it the most and who right now are not able to afford it. I really thank you for such a vision and I know there are a lot more people out there to join hands in your efforts.

I beleive that every human life, be it poor or rich, has the same value. Only the one who knows a cancer patient can have a vision of yours because he is the person who knows that pain and sees that human barrier.

Saturday, August 18, 2012 12:07 PM

I am glad with the very important points cited by Sandra Swain, our new President of ASCO in her topic, “ Global Health Equity,” and the very valuable comments of colleagues. I would like to cite some points:

• Equity is not equality! What is hoped with equity, as Sandra cited, "I think that access to health care should be available to all.” Hence, I see that will lead us to:




• How science could play its role in the question of increasing affordability of cancer care? The approaches that I am strongly with are that who consider in scientific ways the interests of all stakeholders, within the concept of win-win.¹


• How to get value cancer care? Most of this question is tackled in a new book written by Sir Muir Gray, David Kerr, and others. I have had the honor to contribute to this book.²


• The priorities for each community and expectations and hopes of every patient could be different.

Looking at what Sandra cited and what we are aware of, we are applauding the different activities of ASCO and the ASCO International Affairs Committee.     Hence, I see that there is a good base to enhance what we discussed during the last ASCO Conference on Saturday, 2 June, 2012 , Chicago, in a side meeting arranged by the ESMO Developing Countries Task Force (DCTF). The meeting, entitled, "ASCO's Top Five Keys—Choose Wisely and Win-Win Initiatives" (coordinator: Ahmed Elzawawy). Among the issues that we pointed to, is the great need to a sort of internationalization of the ASCO Top Five List in Oncology. What is discussed beautifully with Lowell Schnipper, Chair of the ASCO Task Force for The Cost of Cancer Care, is that what is meant is not to copy the ASCO’s list in different countries, but, vulgarization of its scientific methodology and concept to develop top five or 10 lists of recommendations in order to reduce the total cost of cancer care in scientific ways without compromising the outcome in different communities. We discussed also: How international , regional, and local educational professional conferences could help? Applying this point to ASCO’s (ESMO and other important organizations as well) international courses and symposia , then it is recommended that these points of concepts of the Choosing Wisely campaign and how to get realistic better value of cancer care in each community be highly considered in the content and the objective of these international events and activities around the world. It is important also to develop relevant researches and trials in some countries in different parts of the globe with the technical advice of the international bodies like ASCO or ESMO.     I hope that it would not be offensive and not misunderstood if I say that ASCO, ESMO and others should revise in what they put their logos as participants or faculty in conferences in middle- and low-income countries. It is a pity sometimes that you can’t differentiate between some conferences and symposia and the stand-alone journeys and meetings of pharmaceuticals companies. The difference is that the latter is straightforward and clear in its objectives. I don’t criticize the latter, because it is clear for all; the presenters and the attendees.   There is a difference between a lecture or presentation about the update in knowledge—state-of-art, whatever its cost, and the message or advice to promote or to use a line of treatment when the dose may be 10 to 100 times higher than the (true) salary of a doctor in this country of conference, particularly when there is no evidence that this what could be a better value drug or line of treatment for particular communities or patients.      What could make this latter point not offensive—if some consider it so—is that the final goal goes with the interests of all stakeholders, including manufacturers. Otherwise, the markets in different parts will not be sustainable while the suffering and the burden on cancer patients and the inequity would increase.     The latter point is not out of the issue but it is in its heart. We should all cooperate and collaborate for the equity of cancer care that would be tailored- in scientific ways- with evidences according to different communities and conditions.     Finally, I applaud Sandra Swain, the President of ASCO, as I deeply appreciate the efforts of Michael Link, Lowell Schnipper, Gabriel Hortobagyi, and their colleagues and collaborators in ASCO and the ASCO International Affairs Committee, as well and David Kerr, Martine Piccart, Eduardo Cazap, Adamos Adamou, and all collaborators and colleagues in ESMO DCTF.     Thank you for your attention and please feel free to communicate.      Ahmed Elzawawy, MD Port Said, Egypt  President of ICEDOC, icedoc.org   President Elect of AORTIC aortic.org,  Coordinator of the win-win scientific initiative icedoc.org/winwin.htm   Director of SEMCO semco-oncology.info     e-mail-worldcooperation@gmail.com     References:

1. Ahmed Elzawawy (2012). Science and Affordability of Cancer Drugs and Radiotherapy in the World—Win-Win Scenarios, Advances in Cancer Management, Ravinder Mohan (Ed.), ISBN: 978-953-307-870-0, InTech, Available from: intechopen.com/articles/show/title/science-and-affordability-of-cancer-drugs-and-radiotherapy-in-the-world


2. J. A. Muir Gray (2012) . How to get better value cancer care. Offox Press Ltd, Oxford, UK. (In Press).