Oct 20, 2016
By Gabriel N. Hortobagyi, MD, FACP, FASCO
Chair, Global Oncology Leadership Task Force
While cancer is a major public health problem in the United States, global statistics indicate that most cancers occur outside the United States, especially in countries with limited resources, and that the burden of cancer mortality is greatest in low- and middle-income countries (LMCs). Many of our international members, who represent more than 30% of ASCO’s total membership, face this global problem every day, often with limited resources and under challenging working conditions.
Recognizing these challenges, and understanding that the strengths of ASCO can make a major difference, the ASCO Board of Directors identified two strategic priorities: improving the Society’s service to non-U.S. members and defining our identity in the international oncology community. The Global Oncology Leadership Task Force was created in June 2014 to help carry out these strategic initiatives. The Task Force is composed of seasoned ASCO volunteers from around the world who have served on one or more ASCO committees with relevance to our international activities. The volunteers were charged with making recommendations to the ASCO Board on how the Society can address unmet needs in global oncology. The Task Force delivered its report in March, and I had the pleasure of presenting the recommendations to the Board at its June meeting. The Board has fully embraced the recommendations and ASCO staff will put them in action in the months and years to come.
The Task Force recommendations support an overall international strategy for ASCO that consists of three mutually supportive pillars: professional development, quality improvement, and research. Each of these domains represents an area of strength on which the recommended actions could build:
- Professional development can cultivate current and future oncology practitioners and leaders who serve as change agents to advance global oncology. Examples of existing ASCO programs include the International Development and Education Award (IDEA) and the Leadership Development Program.
- Quality improvement programs and tools can engage these leaders, members, and other stakeholders to drive improvements in cancer care delivery. Examples of existing quality improvement programs include ASCO’s international training courses, the International Cancer Corps program, and the Quality Oncology Practice Initiative (QOPI®), which is now available outside the United States.
- Research (training, funding, and dissemination) can inform quality improvement strategies and provide a pathway for professional development. Examples of existing ASCO international research programs include the International Innovation Grants and the International Clinical Trials Workshops.
Working with a wide range of stakeholders, ASCO will look to advance the transition of global oncology from a relatively informal field of mainly voluntary activity to a formal field with a strong research component and recognized value to oncology training and practice. Such an initiative builds on ASCO’s existing expertise in supporting the professional development of its members domestically and internationally. The initiative also builds on ASCO’s recent efforts to formalize global oncology through the Journal of Global Oncology (JGO) and the Annual Meeting’s Global Oncology Symposium, which was created at the behest of the Task Force.
In addition, recognizing that the demand for oncology services will exceed the supply of specialists in many LMCs for the foreseeable future, ASCO will work to promote the training of nonspecialists in oncology principles. ASCO can learn from and share models that are currently being pursued in Rwanda, Kenya, and other locations, and build on its existing Cancer Control for Primary Care course, which ASCO organizes throughout the world.
Critical to this work will be ASCO’s continued support of the next generation of oncology leaders, shaping them into strong and effective ASCO members.
Building on its initiatives in value and quality in cancer care, ASCO will pursue new international efforts to support improvements in the delivery of quality cancer care. These efforts will include expanding the international availability of proven quality programs such as QOPI® and QOPI Certification, and developing a new initiative with the Union for International Cancer Control to support quality cancer centers in LMCs. (In 2016, the practice of Dr. Evangelia Razis in Greece became the first practice outside of the United States to achieve QOPI Certification).
ASCO will work with its members, sister oncology societies, and foreign government representatives to more effectively integrate ASCO programs into the health systems and priorities of the countries in which we are active. This may include implementing, on a national level, the ASCO programs and tools that are appropriate to the needs and resources of the country. The guidance and support of ASCO members in these countries will be as important as ever.
The Task Force saw research as providing a key opportunity to tighten the links among ASCO’s domestic and international membership and to glean insights that can impact care not only in resource-limited settings, but also in high-resource settings. Additionally, research funding is one of the keys to supporting future global oncology leaders, advancing the field of global oncology, and identifying future global oncology innovations. ASCO will work with the Conquer Cancer Foundation to expand support for global oncology research. We look forward to sharing those research opportunities, as well as the results of that research, with you.
At the same time, ASCO will disseminate global oncology research through a range of channels. Building on the aforementioned JGO and Global Oncology Symposium, ASCO will be creating a Global Health Track at the 2017 Annual Meeting and will be adding other international opportunities to its meeting portfolio.
Many other ideas were considered and discussed by the Global Oncology Leadership Task Force, but the final recommendations focused on those aspects that leveraged ASCO’s strengths and were commensurate to the resources our Society is able to dedicate to these activities. Although the Task Force completed its work this past March, the ASCO Board of Directors’ interest in and dedication to global oncology will persist. I am confident that as these recommendations are enacted, they will cement ASCO’s position on the international oncology stage, and will help to increase the number of services the Society provides to its international members.