Perspectives on the High-level Meeting on Non-Communicable Diseases

Dec 21, 2011

Interviews with UICC President Eduardo L. Cazap, MD, andASCO’s International Affairs Committee Chair Tanja Čufer, MD, PhD

U.S. Secretary of Health and Human Services Kathleen Sebelius addresses the High-level Meeting of the General Assembly on the prevention and control of non-communicable diseases. | U.N. PHOTO/MARCO CASTRO

As a result of the United Nations (U.N.) High-level Meeting on Non-Communicable Diseases (NCDs), held September 19-20, 2011, a Political Declaration was unanimously adopted as a demonstration of commitment by countries around the world to reverse the epidemic of cancer and other NCDs.

The Declaration contains an agreement to establish specific targets by 2012 for combatting NCDs and a mechanism for measuring progress towards those targets. In addition, it includes commitments to increase access to safe, affordable, and effective quality medicines and palliative care services, and calls for increased resources for NCDs through domestic, bilateral, and multilateral channels. Prior to this outcome, ASCO worked with the Union for International Cancer Control (UICC), the American Cancer Society, the American College of Cardiology, and others to advocate for a robust, impactful meeting.

In the interviews that follow, Eduardo L. Cazap, MD, and Tanja Čufer, MD, PhD, discuss meeting highlights as well as next steps.



Interview with Dr. Cazap

AC:What were your hopes going into the meeting?

Dr. Cazap: Cancer is not mentioned in the U.N.’s Millennium Development Goals, it is not a priority in many countries, and many countries have no cancer plans or good cancer registries. My main objective was to have cancer and other NCDs added to the global political agenda. After this summit and the approval of the Political Declaration, cancer and other NCDs are now undoubtedly at the top of the agenda.

I am satisfied with the call for national plans for the prevention and control of NCDs in the Political Declaration. I also think the recommendation about increasing access to hepatitis B and HPV vaccines as part of national immunization programs to prevent infection-related cancers is a positive one. However, there remain areas where commitments fall short of expectations. The Declaration lacks specific targets, including no overall goal of reducing preventable deaths.

AC:What do you see as near-term and long-term impacts of the meeting?

Dr. Cazap: This meeting was only the first step in what must be a long-term collaboration among multiple stakeholders to improve global health. Initial steps must include the implementation of national cancer plans, if they do not exist yet, and the promotion of cancer registries. Data and cancer plans are the backbone of any cancer control strategy.

Looking at the long-term picture, it will be necessary to create realistic timelines to implement best buys, investments in innovative research and preventive health strategies, improvements in surveillance, and agreement on targets.

AC: What opportunities do you see for ASCO as a result of the meeting?

Dr. Cazap: ASCO has a network of recognized cancer experts all over the world. ASCO members must continue collaborating at the local level and providing expert advice to local stakeholders. In addition, ASCO must continue networking with sister organizations.

AC: If you could describe onepersonal highlight from the meeting, what would that be?

Dr. Cazap: When I was nominated as President of UICC, my goal was to put cancer on the global agenda. At that time, four years ago, that was quite an idealistic vision. Now I am extremely happy that this almost-impossible objective has become a reality.

AC: Is there anything else you would like to mention?

Dr. Cazap: There is a general misconception that the issue of cancer and other NCDs is limited to low- and middle-income countries. Many developed countries have pockets of populations with limited or no access to proper cancer control and care.

Cancer is not only a medical problem; it is a problem of human development. The extremely complex and multifaceted cancer crisis cannot be solved alone by the medical community; it is mandatory to consider a multi-stakeholder approach.



Interview with Dr. Čufer

AC: What were your hopes going into the meeting?

Dr. Čufer: The topic of NCDs being included in the summit agenda was already a huge achievement by itself. In preparation for the Political Declaration, member states had to determine within their own national frameworks what was already being done in regard to fighting the threat of NCDs and what still has to be done. While preparing the draft statement related to cancer, ASCO worked under the umbrella of UICC and strived to include defined and measurable goals for cancer control as well as timelines for reaching these goals. Sadly, these goals and timelines were not included in the final Declaration. However, it does include an agreement by all member states to prepare by 2012 a global monitoring framework for NCDs and a set of voluntary global targets and indicators. Member states also agreed to hold a comprehensive review of progress in 2014.

AC: What do you see as near-term and long-term impacts of the meeting?

Dr. Čufer: With the Political Declaration including an obligation for member states to further evolve their work and efforts in controlling NCDs, the long-term hope is to meet the goal established by the World Health Organization to reduce avoidable deaths from NCDs by 25% by 2025.

AC: What opportunities do you see for ASCO as a result of the meeting?

Dr. Čufer: Through its recognized expert membership, ASCO must continue playing a significant role in preparation of national strategies. ASCO already organizes multidisciplinary courses and partners with Health Volunteers Overseas (HVO) on the International Cancer Corps Program. The Society must spread these activities to an even wider area.

ASCO’s International Cancer Prevention Working Group will be of enormous value given the importance of primary prevention stated in the Political Declaration. In the field of research, the activities already initiated by the International Affairs Committee will certainly help to promote improved outcomes.

AC: If you could describe onepersonal highlight from the meeting, what would that be?

Dr. Čufer: Seeing the unity on how to tackle the pressing issue of NCDs from all national representatives without regard to differences in economic background, political orientations, levels of development, and other social and economic factors. I also perceived an openness and willingness to collaborate on these issues.

AC: Is there anything else you would like to mention?

Dr. Čufer: In the field of primary prevention, a large effect can be achieved by educating the lay public, which requires only a small amount of funding coupled with political commitment.



Dr. Cazap is UICC President and a member of ASCO’s Board of Directors, Cancer Prevention Committee, and Strategic Planning Committee. He is also Past Chair of the International Affairs Committee.

Dr. Čufer is a Professor of Oncology at Medical Faculty, University of Ljubljana, Slovenia, and Senior Consultant at the University Clinic Golnik, Slovenia. She is also the 2011-2012 Chair of ASCO’s International Affairs Committee.

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