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Conversations about Global Cancer Challenges

Posted by On December 7, 2012
I recently participated in a Facebook conversation about global cancer challenges hosted by the Public Radio International program, “The World.” Between December 3 and 7 “The World” featured five stories by veteran health reporter Joanne Silberner, who documented the growing challenge of cancer in developing countries. Over the course of the series, “Cancer’s New Battleground: The Developing World,” Silberner placed global cancer challenges into political, social, and economic context. Her reports also provided inspiring portraits of women and men working in such diverse places as Uganda, Haiti and India to carry out cancer research; provide prevention, screening and treatment options; and, importantly, relieve the suffering of those with advanced cases. The Facebook event offered a chance for researchers, practitioners, patients, and advocates around the world to ask questions of many of the experts Silberner featured and to engage in their own conversation. Many of the topics resonated with Pink Ribbon Red Ribbon’s (PRRR) experience and objectives. One issue which generated considerable comment was the extent to which the global health establishment’s traditional focus on communicable diseases, such as HIV/AIDS or malaria, obscures or competes with newer efforts to address health challenges associated with non-communicable diseases, such as cancers. Some in the conversation observed that the global community’s historic focus on communicable diseases has created stand-alone or “vertical” programs, which can be difficult to integrate with newer activities because of seemingly inflexible institutional structures or funding streams. In such a context, participants commented, people with “just cancer” are out of luck. But others emphasized that even activities initially focused on single diseases have the potential to strengthen entire health systems. Certainly at PRRR we have seen this play out. In Zambia for example, PRRR partners are building on U.S. PEPFAR-supported HIV/AIDS programs to support the government in expanding cancer services, including cervical cancer screening and treatment, for female patients. This work uses existing HIV/AIDS programs as a platform from which to provide comprehensive care for women at one site, rather than create new initiatives and require women to travel to multiple facilities to seek health care. Another topic was the extent to which the stigma associated with a cancer diagnosis poses obstacles to effective, life-saving interventions. For example, some of Silberner’s interviewees reported difficulties in convincing women to plan for regular breast or cervical cancer screening exams, because the women were afraid of what a cancer diagnosis might mean for their status within the family or community. Raising awareness and reducing stigma and discrimination regarding women’s cancers is one of PRRR’s primary objectives. Experience in sub-Saharan Africa has demonstrated that integrating cancer prevention, screening, and treatment services into other health programs can show women that such activities can become a routine aspect of health care. Indeed, PRRR partner Susan G. Komen for the Cure has developed and is executing a global education and outreach campaign to provide women with the information they need to make positive decisions about breast and cervical cancer prevention, screening, and treatment for themselves and their families. While all of the pieces within the “Cancer’s New Battleground” series are fascinating, I found the reports – and online discussion – about breast cancer in Haiti and cervical cancer screening in India to be particularly compelling. Nearly three years after the devastating earthquake of January 2010, Haiti is working to address emerging cancer challenges, even as the government, with the support of international organizations, bilateral aid agencies, and other partners, works to rebuild the entire health system. And in India, which has been a hub of high-tech research and development, the relatively low-tech screening procedure involving visual inspection with acetic acid, followed by cryotherapy, is showing promising results. PRRR partners have been documenting positive results with similar kinds of screen and treat procedures in low resource settings. The PRI series of reports on global cancer challenges can be accessed here. I encourage readers to listen to this set of compelling and inspiring stories when they have a chance and to add their own voices to the conversation. This post was written by Katherine Bliss, Program Director of Pink Ribbon Red Ribbon.