Disease Control Priorities, 3 rd Edition CANCER
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1 Disease Control Priorities, 3 rd Edition CANCER
2 Volume 3: Cancer Editors: Hellen Gelband Prabhat Jha Rengaswamy Sankaranarayanan Susan Horton Publication: November
3 Disease Control Priorities History 1993 World Development Report Disease Control Priorities in Developing Countries, Second Edition 2006 (DCP2) Disease Control Priorities, 3rd Edition (DCP3) 3
4 Disease Control Priorities, 3 rd Edition DCP3 Volume Topics 1. Essential Surgery Reproductive, Maternal, Newborn and Child Health Cancer Mental, Neurological, and Substance Use Disorders Cardiovascular, Respiratory, Renal and Endocrine Disorders HIV/AIDS, STIs, Tuberculosis and Malaria Injury Prevention and Environmental Health Child and Adolescent Development Disease Control Priorities: Improving Health & Reducing Poverty - #dcp3 4
5 Multiple Volumes, Common Elements Costing of Essential #dcp3 Burden of Disease Universal Health Coverage 9 DCP3 Volumes Policies, Platforms & Packages Intervention Effectiveness Uniform Economic Evaluation 5
6 DCP3 Overall Summarize and synthesize evidence of the effectiveness and comparative evaluation of global health interventions. Strengthen the capacity of evidence based priority-setting in global health. Introduce new methods for assessing the equity and financial protection considerations of health and #dcp3 5
7 World Bank country income groupings, /11/2015 7
8 Cancer burden Cancer already major cause of death in LMICs, and will continue to increase as a percentage of deaths, driven by population ageing and greater decreases in mortality from other causes Global Cancer Deaths: 8 million worldwide 4.4 million in people < million in middle-income countries 0.3 million in low-income #dcp3 8
9 Top 10 causes of death worldwide, /11/2015 9
10 Estimated cancer incidence and mortality, /11/
11 Incidence and mortality before age 70: selected cancers 11/11/
12 Global breast cancer mortality, women, /11/
13 Age-standardized cervical cancer incidence and mortality by country income group, /11/
14 Prevention Most urgent priority in cancer (and other NCD) control: tobacco cessation and preventing young people from starting smoking Increased tobacco taxation will help to reduce cancer incidence and generate substantial extra revenues for governments. HBV vaccination (including birth dose) HPV #dcp3 14
15 Retail price of most popular brand and excise tax 11/11/
16 Treatment Most other common cancers are not preventable (other than tobacco-related and virus-related cancers), but many cases of early cancer can be effectively treated eg, breast, cervical, and colorectal cancers are common and curable if treated early. Most childhood cancers are also curable. 11/11/
17 Palliative care Cancer death is often accompanied by severe pain in the last months of life. Strong opioids, the bedrock of palliative care pain control, is unavailable to most people who die from cancer (and other painful diseases). In 2006, of the global population: 66% lived in countries with no opioid consumption 13%, low consumption 4%, moderate consumption 11/11/
18 Opioid consumption per capita by WHO region, /11/
19 Essential Package 11/11/
20 Cost-effectiveness of selected interventions 11/11/
21 Cost of essential package Cost of essential package = US$20 billion per year 3% of total public spending on health in LMICs: 2 6% in upper-middle-income countries 5% in lower-middle-income countries 13% in low-income countries Annual expenditure per capita: $5 7 in upper-middle-income countries $1 7 in lower-middle-income $1 7 in low-income countries Potentially feasible in all but low-income countries without external support. 11/11/
22 Essential cancer services should be included in universal health coverage: Eventual coverage of all people for essential services, but cost-ineffective services should not be covered for anyone Global initiatives needed: reduce the costs of key inputs (drugs, radiotherapy, testing) expand technical assistance and human resource development promote cancer research 11/11/
23 THANK YOU For more information visit: #dcp3
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