Health initiatives in developing countries need to make cancer a major new target as patients survive infectious diseases such as tuberculosis and live long enough to get tumors, researchers and care advocates said.
While low- and middle-income countries accounted for 15 percent of new cancer cases in 1970, that number rose to 56 percent in 2008 and will climb to 70 percent by 2030, researchers and public-health advocates including Paul Farmer, head of the global-health department at Harvard Medical School in Boston, wrote today in the Lancet. Among the authors is Lance Armstrong, the cyclist who won the Tour de France seven times.
The 23 authors of the Lancet article called for greater prevention, diagnosis, and treatment of cancer in developing countries, in efforts similar to those now undertaken to fight AIDS. The world needs demonstration projects to build cancer clinics and train caregivers, programs to slash the price of drugs, and new financing mechanisms for treating the disease, the report said.
“The problem now is that we’re literally being victims of our own success,” Julio Frenk, dean of the Harvard School of Public Health, said on a conference call today. “More people are surviving to ages where they can be susceptible to chronic diseases like cancer. We need to mobilize the same policies and economic resources that fueled the first renaissance of global health, mostly around AIDS, TB and malaria.”
Today, 5 percent of global cancer resources go to low- and middle-income countries, which represent almost 80 percent of the life-years lost to cancer, according to the report.
Programs to address infectious diseases such as HIV, TB And malaria have made advances, Frenk said. In 2008, more than 4 million people were receiving antiretroviral drugs to treat HIV, the world’s leading infectious killer, representing a 10-fold increase from five years earlier, according to the World Health Organization in Geneva.
Africa receives less than 0.2 percent of cancer resources and accounts for 6.4 percent of new cancer cases, the Lancet authors wrote. North America and Europe accounted for 55 percent of global cancer cases in 2008, according to the WHO.
The Lancet article calls for actions to fight chronic illness similar to those put in place to combat infectious disease. The steps included the expansion of treatments for multidrug-resistant tuberculosis and AIDS in poor countries. Efforts to curb tobacco use, improve diet, reduce environmental risk, and increase screening and vaccination of cancer-causing infections such as human papillomavirus and hepatitis B should be undertaken, the authors wrote.
To oversee this plan, the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries was launched in November by the Boston-based Dana-Farber Cancer Institute; the Harvard Global Equity Initiative in Cambridge, Massachusetts; Harvard Medical School; and the Harvard School of Public Health, also in Boston.
“We have treatments available to patients in developed countries and not to patients in low- to middle-income countries, and that is just no longer an acceptable disparity,” said Lawrence Shulman, chief medical officer of Dana-Farber, on the conference call.
Armstrong, the cyclist, is a cancer survivor and the chairman of the Austin, Texas-based Lance Armstrong Foundation. His Livestrong Global Cancer Campaign initiated a pilot program this year, in South Africa and Mexico, to raise awareness about the disease and reduce the stigma associated with it.