By Lewis E. Foxhall, MD, and Zuzanna Tittenbrun, MSc, MA
ASCO’s global initiatives include efforts to address equity in cancer care in parts of the world that are just beginning to develop their care delivery and research capabilities. (View ASCO’s related course offerings.) As many low- and middle-income countries (LMICs) are attempting to balance recovery from the COVID-19 pandemic with many other health needs, they will hopefully soon be able to turn back to efforts to address non-communicable diseases (NCDs), including cancer, that have begun to take an increasing toll.
Country representatives at the United Nations (UN) General Assembly High Level Meetings in 2011, 2014, and 2018 raised concerns related to NCDs and called for LMICs to address this emerging health challenge. Many countries have developed national strategic plans to address NCDs based on the UN recommendations as well as the 2017 cancer resolution adopted at the 70th World Health Assembly in Geneva. Recognizing cancer as a predominant contributor to morbidity and premature mortality, many have also invested often limited resources in focused National Cancer Control Plans (NCCPs) as a framework to implementing evidence-based cancer control strategies.
ASCO is a critical partner in the International Cancer Control Partnership (ICCP; iccp-portal.org), an innovative collaborative of organizations with aligned goals working toward advancing equitable cancer care with a focus on middle- and lower-resource parts of the globe. The vision of ICCP is that all countries have and are implementing resource-appropriate NCCPs that provide a framework for sustainable and equitable delivery of cancer control programs. Its mission to provide leadership, expertise, and guidance to national stakeholders and decision makers in planning and implementing strategies designed to reduce the burden of cancer is delivered through a curated online resource and by providing technical assistance aligned with individual country’s needs.
In response to the limitations imposed by the pandemic, established regional leadership summits organized by ICCP have been replaced by an innovative application of Project ECHO methodology. This was originally developed at the University of New Mexico and has been successfully used in domestic and international settings to provide mentoring to local teams. Over the last year, this approach has engaged representatives from eight LMICs—Cameroon, Eswatini, India, Kenya, Malawi, Nigeria, Rwanda, and Tanzania—that are actively implementing NCCPs. Representatives from Bhutan, Sri Lanka, and Uganda are part of a new cohort of countries that entered the ICCP ECHO program in November 2021.
As an ASCO volunteer serving on the Cancer Prevention and Cancer Survivorship Committees, and now the newly formed Health Equity and Outcomes Committee, I have been excited to work along with Doug Pyle, our ASCO representative, through ICCP to promote cancer control planning through senior public health and government leaders to implement evidence-based prevention and screening strategies that build sustainable cancer treatment systems in areas that suffer a high human and financial burden from cancer.
“ASCO and its members around the world are committed to improving access to quality cancer care. The ICCP is a great way for ASCO to join these efforts with those of other organizations so that together we can have a greater impact,” said Mr. Pyle, who serves as ASCO’s vice president of International Affairs.
The ICCP, with the support of the Union for International Cancer Control (UICC), regularly updates an inventory of NCCPs globally and posts new plans using an interactive map on its web portal. In 2018, the ICCP, with project leadership from the World Health Organization and UICC, conducted a global review of NCCPs and other cancer-related NCCP documents. Upon request from governmental leaders, the ICCP technical assistance team reviews NCCPs and provides feedback using the tool developed for the global analysis. Through its members, it supports outreach to countries in early stages of plan development, and through its portal, it offers education and informational materials for those considering NCCP development.
The ICCP leadership team includes two backbone organizations, the U.S. National Cancer Institute Office of Global Health and the UICC based in Geneva, and over 20 partner organizations. These organizations recognize the value that working collaboratively provides to enhance reach and impact of our combined and aligned efforts to support LMICs and improve cancer-related health equity.
To request ICCP assistance, please visit iccp-portal.org/technical-assistance. If you have any resources related to national cancer control planning to share, you may post those on the ICCP portal, or contact ICCP directly at firstname.lastname@example.org. My colleagues and I would love to hear from other ASCO members and benefit from your recommendations for advancing the cause of NCCPs globally.
Dr. Foxhall is vice president for health policy and a professor in the Division of Cancer Prevention and Population Sciences at the University of Texas MD Anderson Cancer Center in Houston, Texas. He focuses on population health policy and programs addressing equity in access to care and community partnerships for cancer prevention. He is a member of ASCO’s Cancer Care Delivery Council and past co-chair of the Health Equity and Outcomes Committee, among other volunteer service. Disclosure.
Ms. Tittenbrun is the global resources manager at the Union for International Cancer Control (UICC), based in Geneva, Switzerland. She is responsible for UICC resources, works closely with the UICC TNM Committee, runs ICCP’s communication working group, and maintains the ICCP portal. Follow Ms. Tittenbrun on Twitter @ztbrun. Disclosure.