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    • #HealthyMeans Living Longer

    It's time to turn the tide on worldwide epidemic of cancer

    Where you live shouldn't determine if you survive the growing tidal wave of non-communicable diseases, writes the American Cancer Society's Sally Cowal in this guest commentary for #HealthyMeans.

    By Sally Cowal // 03 November 2014
    Dr. Courtney DiNardo uses new technology at the University of Texas' Cancer Center that helps physicians observe and develop cancer treatment plans, match patients with clinical trials and recognize adverse effects during ongoing care. Photo by: IBM Photo / CC BY-NC-ND 

    There’s a tsunami gathering on the horizon, and it’s nothing like the 2004 storm in the Indian Ocean or the seismic waves that struck Japan in 2012.

    The world is largely ignorant of the coming tsunami of cancer and other noncommunicable diseases such as heart disease and diabetes. And although tremendous progress has been made against cancer in the United States, with 1.3 million lives saved since mortality rates began to fall 20 years ago, people living in low- and middle-income countries aren’t benefitting from this progress. Globally, cancer is rising like a giant tidal wave.

    In 2012, the worldwide burden of cancer rose to an estimated 14 million new cases per year and 8.2 million deaths. Within two decades, estimates are expected to be 22 million new cases annually and 13 million deaths.

    The American Cancer Society is pivotally involved in the fight against cancer and is working to turn the tide on this worldwide epidemic.

    Disproportionate cancer care access

    More than 60 percent of the world’s total cases occur in Africa, Asia and Central and South America. Even worse is the lack of early detection and access to treatment, which means 80 percent of patients are in the advanced stages of disease when they receive cancer care and most don’t have access to pain relief.

    Additionally, the cancer tsunami is an economic one. Cancer costs are burdening the richest countries and are way beyond the reach of developing countries. In 2010, cancer’s economic cost was estimated to reach $1.16 trillion. According to a study by the Harvard School of Public Health and the World Economic Forum, chronic disease could cost the world $47 trillion in lost economic output in just two decades if left unchecked. Put another way, this amount could eradicate $2-a-day poverty for more than half a century among the 2.5 million people who currently live on that income.

    The American Cancer Society is in a unique position to make and lead progress. Building on the society’s mission to “save lives by helping people stay well and get well by finding cures and by fighting back,” we are currently doing similar work in the global arena. Already, our robust global health program is helping to make measurable, meaningful progress.

    Elevating cancer on the global health agenda

    In 2011, the United Nations held its first high-level meeting on NCDs. American Cancer Society CEO John Seffrin had a seat at the table with worldwide leaders and 30 heads of state. The meeting adopted a political declaration to elevate cancer and other NCDs on the global health agenda. However, we need to put economic resources into that fight and engage the private sector. Of the $23.9 billion currently invested in assistance for health in low- and middle-income countries, only 1.1 percent, or $270 million, presently fights NCDs.

    Implement proven cancer-fighting tactics

    Our focus is on “best buys” and measurable results where we believe the policy environment and our connections can do the most good, using our best practices to help LMICs in the fight against cancer. This includes Argentina, Brazil, the Caribbean, Colombia, Ethiopia, India, Kenya, Mexico, Nigeria and Uganda. No other voluntary organization has the expertise — gained through fighting cancer for more than 100 years — to lead initiatives supporting country-level advocacy on NCDs than the ACS.  

    Our work includes the Meet the Targets program, which supports 10 grantees in nine priority countries to implement proven cancer-fighting tactics. In Brazil, for example, the grant supports a campaign for a national anti-tobacco law; in Uganda, it supports efforts to develop the country’s first palliative care policy. We have also engaged five partners through the Africa Tobacco Control Consortium to prevent and reduce tobacco use. Through our Treat the Pain program, the society promotes access to pain relief.

    Global health strategies working with international partners

    We have four global health strategy areas:

    1. Prevent cancer

    We must reduce exposure to cancer risk factors, which are alcohol, poor nutrition, obesity and physical inactivity and, particularly, tobacco. Eighty percent of the world’s smokers live in LMICs. Tobacco is poised to kill 1 billion in this century if left unchecked. Africa is slated to become “the future epicenter of the tobacco epidemic,” according to a recent ACS report.

    We must vaccinate against human papillomavirus and hepatitis B, two infectious diseases that cause cancer. We must screen for treatable cancers, such as cervical and breast cancer. Cervical cancer is the fourth-most-commonly diagnosed cancer in women. The developing world bears the burden of 85 percent of these cases and 90 percent of the deaths.

    2. Save lives

    We must diagnose cancer earlier when it is more treatable, and improve access to effective treatment. For example, only 5 percent of those who need chemotherapy in sub-Saharan Africa receive it.

    3. Diminish suffering

    Less than 12 percent of people dying from cancer in LMICs have access to opioids, despite the fact that the World Health Organization considers morphine an essential medicine.

    4. Build a grass-roots global army

    We need to empower countries to help themselves by increasing the capacity of cancer organizations within our target countries, sharing fundraising strategies to create sustainable funding platforms and advocate for global health funding.

    The fight against cancer is a matter of equity and human rights. At the American Cancer Society, our mission is to create a world with less cancer. As a career diplomat, I’ve traveled and lived all over the world. Where a person lives should not determine if they live. Together, through a global grassroots approach, we can make progress in the fight, with the goal of providing access to quality health care and to prevention and treatment services that can save millions of lives.

    Want to learn more? Check out the Healthy Means campaign site and tweet us using #HealthyMeans.

    Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.

    Read more #HealthyMeans articles:

    ● In Africa, tobacco presents a looming threat to healthy living
    ● An unparalleled opportunity to improve the health of the most vulnerable. Will we take it?
    ● Weighing dollars and 'sense' of health care priorities 

    • Global Health
    • Social/Inclusive Development
    Printing articles to share with others is a breach of our terms and conditions and copyright policy. Please use the sharing options on the left side of the article. Devex Pro members may share up to 10 articles per month using the Pro share tool ( ).
    The views in this opinion piece do not necessarily reflect Devex's editorial views.

    About the author

    • Sally Cowal

      Sally Cowal

      Sally Cowal is senior vice president for global health at the American Cancer Society. Before joining the organization, she served as senior vice president and chief liaison officer at Population Services International and director for external relations at UNAIDS. She is an accomplished U.S. diplomat having served in India, Colombia, Israel, and Mexico. She also became U.S. Ambassador to the Republic of Trinidad and Tobago.

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