Apr 24, 2018
By Isabel Mestres Mesa and Susan Henshall, PhD, MPH
Today, more than half of the world’s population lives in urban environments, with 95% of urban expansion in the next decades predicted to take place in low- and middle-income countries (LMICs). The scale and speed of urban development means cities are facing the unprecedented challenge of managing the impact of urbanization on the environment and public health, while promoting economic gains and social equity. Yet in the face of these sustainable development challenges, cities are also demonstrating their resilience and driving innovation in the way they design and deliver health services.
Coordinated city-led responses to the growing burden of cancer and other non-communicable diseases (NCDs) are also gaining momentum. One of the clearest examples is the emergence of platforms to support cities with the introduction of smoke-free legislation to curb tobacco use, the single largest preventable cause of cancer death. Other innovative platforms which help cities to reduce exposure to cancer and NCD risk factors are critical. At the same time, there is also an urgent need for cities to address the growing number of cancer cases. Action at the city level is critical to achieve the United Nations’ (UN) global target for a 25% reduction in premature deaths from NCDs by 2025, and achieve the 2030 Sustainable Development Goals adopted by UN member states.
For cities, addressing the complex array of issues that can hinder access to quality cancer treatment can be overwhelming. C/Can 2025: City Cancer Challenge was conceived by the Union for International Cancer Control (UICC) to meet this need.
Launched in January 2017 at the World Economic Forum in Davos, Switzerland, C/Can 2025 is a multisectoral initiative supporting cities to take the lead in the design, planning, and implementation of cancer treatment solutions. As this is the first time such an international coalition of multisectoral organizations has been established to work with cities on improving cancer treatment and care, the aim was to first learn how to best work with cities, particularly those in LMICs where the need is greatest. To this end, activities are already underway with a small group of Key Learning Cities, including Asunción, Paraguay; Cali, Colombia; Kumasi, Ghana; and Yangon, Myanmar. These cities were selected based upon a rigorous set of criteria, including their potential to provide insights on how the international community, local civil society, and public sector can best work together to implement the shared ambition of the city and C/Can 2025.
C/Can 2025 serves as a unique platform to increase the number of people with access to quality cancer care in cities through a truly multisectoral approach. With access to both technical and financial resources, cities are supported to strengthen their capacity, leadership, and accountability in the delivery of cancer care, and engage in the design and implementation of cancer treatment and care solutions that meet the needs of their population.
The goal is to work collaboratively with a network of motivated partners including city leaders, ministries of health, nongovernmental organizations, industry, development actors, health professionals, and patient advocates to accelerate the implementation of data-driven cancer solutions that will have a direct and concrete impact on cancer mortality rates. The C/Can 2025 model is designed to be both scalable and sustainable, ensuring that cities are supported over time to deliver a fully financed implementation plan. Importantly, it also provides a platform for cities to share knowledge and benefit from peer-to-peer learning.
In addition to this work with the four initial Key Learning Cities, we are now scaling up support to a wider network of cities that have a population greater than 1 million to create an active community of cities committed to delivering sustainable, high-quality cancer treatment solutions. At the 2017 World Cancer Leaders’ Summit in Mexico, UICC launched a call to action, inviting these cities to take the lead in reducing inequities to cancer care for their citizens by becoming the next Challenge Cities. A new set of participating cities will be announced during the 2018 World Health Assembly.
We are proud to count ASCO as a founding collaborator of C/Can 2025 and its support has been instrumental at every step of the process. Since the inception of C/Can, ASCO has contributed technical expertise and oversight, joined workshop discussions, and provided guidance throughout the processes at both the global and city level through its members in the Key Learning Cities.
For example, ASCO has been working with UICC and the Center for Global Health at the U.S. National Cancer Institute, together with other cancer experts and organizations from around the world (including the American Society of Clinical Pathology, Fred Hutchinson Cancer Research Center, King Hussein Cancer Center, Tata Memorial Hospital, University of Pittsburgh Medical Center, and many others) to develop a City Assessment Questionnaire. This questionnaire aims to provide an in-depth assessment of the critical core package of interventions for the delivery of a quality cancer care solution in a city. It is being tested currently in the C/Can 2025 Key Learning Cities. Based on the feedback from city stakeholders, this tool will be refined and adapted, with a new version to be made available to C/Can 2025 cities in 2018.
As cities advance through the C/Can 2025 process and enter the implementation phase, ASCO will join other C/Can collaborators in lending a broad range of expertise that will be crucial for the cities to achieve their goals. Specifically, the ASCO network with be critical in:
- Providing technical expertise to help develop solutions to some of each city’s cancer care delivery challenges
- Assisting in the development of the implementation plans
- Identifying potential areas of connection with ASCO International programs and resources, including education and training, guidelines capacity building, and professional development of oncology personnel
- Identifying other resources and opportunities available from ASCO collaborators and sister societies
Ultimately, C/Can 2025 is creating a collective movement of inclusive and impactful multisectoral partners such as ASCO that are willing to work hand in hand with cities all over the world to deliver sustainable, robust cancer treatment solutions.
Ms. Mestres Mesa is the C/Can 2025 director of external relations and partnerships at UICC. Dr. Henshall is the C/Can 2025 director at UICC.
The Union for International Cancer Control’s (UICC) rapidly increasing membership base of over 1,000 organizations in more than 160 countries represents the world’s major cancer societies, ministries of health, and patient groups, and includes influential policymakers, researchers, and experts in cancer prevention and control, as well as more than 50 strategic partners. UICC is dedicated to taking the lead in convening capacity-building and advocacy initiatives that unite the cancer community to reduce the global cancer burden, promote greater equity, and integrate cancer control into the world health and development agenda.