Michel Sidibé Executive Directr, UNAIDS Speech Opening Ceremny 2016 Wrld Cancer Cngress 31 st Octber 2016, Paris, France Cngratulatins and grateful thanks t the rganizers - Unin fr Internatinal Cancer Cntrl, Ligue cntre le cancer and - Alliance des Ligues Francphnes Africaines et Méditerranéennes cntre le cancer (ALIAM) against cancer. 1. I am nt surprised t be in France tday I am nt surprised that this large cngress against cancer is taking place in Paris tday in the presence f President Hllande himself. In particular, the theme f the cnference: Mbilising Actin, Inspiring Change Mrever, we return frm the replenishment meeting f the Glbal Fund in Canada, at which France, despite the ecnmic crisis and numerus develpment and climate change pririties, cntinues t champin cmmitments t the fight against disease, including AIDS. [1.3 billin dllars prmised] Everything began with President Chirac, wh made the fight against cancer ne f the three pririty actin areas f his five-year term. He said: it's an essential human issue, given the suffering f thse affected and their lved nes. In his wrds: Cancer shuld als be fught s that nrmal life can cntinue, bth during and after the disease. 2. Integratin time President Chirac understd that fighting disease is nt just health systems and hspitals, it is abut peple. We must place peple at the centre. This has been AIDS activists' greatest accmplishment. The transfrmatin f an epidemic initially characterized by fear and discriminatin int a scial mvement fr human rights as well as health rights. We have succeeded in making it a scial demand, whether fr patients r fr the treatment. We have successfully changed the very nature f the disease and it is time t draw lessns frm the fact. Fr bth AIDS and cancer, cmmunity mbilizatin, activism and advcacy play a key rle. The peplecentred services prvided by cmmunities are at the heart f health care. Cmmunities understand that
we cannt treat individual health cnditins in islatin, and we cannt ignre the scial determinants f health. Thrughut the wrld respnse t AIDS, we have seen hw integrating HIV diagnsis int ther health services has been fundamental. Integratin int maternity health services has prevented millins f babies frm being brn with HIV. We very sn learned that we were treating peple afflicted with HIV, nly t let them die f tuberculsis. Cllabratin and integratin between the HIV and tuberculsis prgrammes has led t a strng increase in HIV diagnses in tuberculus patients. Integratin f HIV preventin int sexual and reprductive health services, as well as a rightsbased apprach t the gender dynamics that deny wmen cntrl ver their bdies, is very imprtant. This is the srt f transfrmatin that we wuld like t see in every cuntry. 3. A sil mentality apprach can nly aggravate the situatin f wmen living with HIV - ne cncrete example f this is cervical cancer We knw: That wmen living with HIV are fur t five times mre at risk f cervical cancer than HIVnegative wmen The majrity f wmen affected by cervical cancer are between 15 and 39 years ld. Mst (85%) new cervical cancer cases (530 000 per year) and 88% deaths (265 000 per year) ccur in lw-incme and middle-incme cuntries. Half f the wmen with cervical cancer in Africa tday will die. This is unacceptable fr a disease which is very largely avidable thanks t a vaccine against HPV (human papillmavirus) as well as curable if diagnsed and treated prmptly. But factrs such as their place f birth, level f pverty and lack f access t the vaccine, diagnsis r treatment widely available t yung wmen in rich cuntries, leave them with little chance. Preventing and treating this cancer ges beynd bilgical and medical interventin. It is imperative t empwer wmen and girls, t break the patriarchal structures and eliminate sexist and sexual vilence, nt nly in rder t further the health and rights f wmen and girls but als t ensure that their families, cmmunities and natins prsper. I wuld like t take this pprtunity t cngratulate the numerus First Ladies wh are cmmitted t fighting female cancers as a natinal issue cncerning wmen's rights and wmen's health. Prgress has been made. The Pink Ribbn Red Ribbn public-private partnership, f which UNAIDS is a partner and c-funder, in cllabratin with the United States President's Emergency Plan fr AIDS
Relief (PEPFAR) amng thers, is wrking with natinal gvernments, NGOs, multilateral rganizatins and the private sectr t imprve the preventin and treatment f cervical cancer, and t prvide services fr the early detectin and treatment f cancer in sme f the African cuntries mst affected by HIV. Certain cuntries have paved the way: Integrating HIV and Cervical Cancer In 2006, Zambia used its HIV prgramme infrastructure t intrduce the Cervical Cancer Preventin Prgram, a nurse-driven cervical cancer screening and treatment prgramme that was integrated int public sectr clinics as a rutine health-care service. Within five years, the prgramme prvided services t ver 58 000 wmen. HPV vaccinatin prgramme In February 2014, the Suth African gvernment made histry and was praised when it became the first African cuntry t intrduce an HPV vaccinatin prgramme with its wn funds. It intrduced an HPV vaccine free f charge t all nine- and ten-year ld schl girls. 4. Beynd service integratin, we must cme up with sustainable slutins fr peple - guarantee universal access t care and universal health cverage Our great success with AIDS was t make access t treatment a glbal public gd. In 2000, the cst f ne year f antiretrviral treatment was $10,000. Were this the case tday, it wuld cst us $170 billin per year t treat 17 millin peple. This is the equivalent f three times the level f Official Develpment Assistance (ODA) allcated t Africa. But this is nt the case tday. Thanks t innvatin and the pressure exerted n pharmaceutical cmpanies t reduce prices and make the market mre cmpetitive, we treat 17 millin peple fr 1.7 billin dllars. Issue f exrbitant csts f medicinal prducts applies directly t cancer: Amng the exrbitant prices, ne might cite the case f Keytruda, a new medicine effective against melanma, the cst f which is estimated at ver 100,000 eurs per patient per year. The Ligue cntre le Cancer ften reminds us that the pharmaceutical industry determines its prices accrding t the ecnmic capacities f the market. Access t universal treatments means prtectin against catastrphic health expenditure. Critical link between health, inequalities, injustice, cnflicts and vulnerabilities.
150 millin peple slide int pverty each year paying fr health services frm their wn pckets. Questin f availability, but als f physical and financial accessibility 70 per cent f wrld ppulatin = n access Sierra Lene: 1 dctr fr 45,000 Liberia: 2 dctrs fr 100,000 USA: 1 dctr fr 400 Universal access t integrated health services must be guaranteed fr bth nn-transmissible and transmissible diseases. This discussin is nt nly abut medical fees r prximity t care, it is abut scial justice, the right t health and the redistributin f pprtunities. We must guarantee the demcratizatin f access t treatment t ensure that n-ne is left behind. We must build peple-centred health systems. This means cmpletely changing ur apprach t service delivery t reinfrce the interface between health service prviders and cmmunities, making use f nn-cnventinal capacities. 5. Nne f this will be pssible withut radical refrm f the glbal health architecture This architecture is bslete and tday n lnger enables us t address these issues. There can be n wrldwide health security withut effective management f the risks t individual health. Tday we face ever mre fragmented slutins and ever less integrated investments. I cannt say it ften enugh: we need a Fund fr glbal health. We just need a bdy such as UNAIDS, develped t make use f its capacities t supprt natinal gvernments and give advcacy, and its expertise at the intersectin between human rights and health, thereby nt nly cntinuing t be leader in the fight against AIDS, but als taking wnership f glbal health issues. It is t France that we we the prgress that has been made regarding the visibility f universal health cverage - thanks t this cuntry's cmmitment at a natinal, reginal and internatinal level, as the universal health cverage target adpted in the sustainable develpment bjectives shws. This indeed shws that the underlying debate is ne abut equity - which cnslidates peple's capacity t live rather than just survive, and enables them t becme active citizens cntributing t the
ecnmic grwth f their cuntry. Withut this, n develpment, even less sustainable, and the bjectives that we adpted just a few mnths ag will remain vain prmises. The time has cme t unite the frces f the wrldwide AIDS mvement with ther allies. It is time t reaffirm the need fr cllabratin and partnerships between bdies, sectrs and mvements, in rder t guarantee that ppulatins have universal access t integrated preventin, treatment, care and health management services that are rights-based, equitable, just and efficient and delivered by innvative health systems. Our cllective effrts t transfrm this architecture will have a wider and lnger-lasting impact and culd save mre f ur lives.