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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EThis article discusses the historical significance of the United Nations (UN) High-Level Meeting, the outcomes of the May 2013 65th World Health Assembly, the role of nongovernmental organizations (NGOs), and critical objectives to take advantage of the new global cancer paradigm.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eaffordability of care\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EPutting Cancer on the Global Agenda\u003C\/h2\u003E\u003Cp id=\u0022p-2\u0022\u003EJohn Seffrin, PhD, American Cancer Society, Atlanta, Georgia, USA, discussed the historical significance of the United Nations (UN) High-Level Meeting, the outcomes of the May 2013 65\u003Csup\u003Eth\u003C\/sup\u003E World Health Assembly, the role of nongovernmental organizations (NGOs), and critical objectives to take advantage of the new global cancer paradigm. \u201cWe are seeing the beginning of a tsunami of avoidable, often preventable noncommunicable diseases,\u201d Dr. Seffrin said. \u201cCancer could become the number one leading cause of death in the not-too-distant future.\u201d\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EDr. Seffrin shared that the outcomes document from the UN High-level Meeting essentially says four things: 1) Cancer and noncommunicable disease will be the health, disease, and disability challenge of 21\u003Csup\u003Est\u003C\/sup\u003E century; 2) we have the knowledge and technology to prevent this; 3) economic development and noncommunicable diseases are inextricably linked; and 4) the problem is not one any single sector can solve alone \u2014 and the private sector will be particularly crucial. Dr. Seffrin also cited a recent study from the World Economic Forum and the Harvard University School of Public Health that notes the potential for a $47 trillion expected loss in economic output just in the next two decades from noncommunicable disease. The historic UN meeting served as a wake-up call for global leaders, Dr. Seffrin said.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe 65\u003Csup\u003Eth\u003C\/sup\u003E World Health Assembly recently called for a 25% global reduction in premature deaths from noncommunicable diseases. The UN political declaration stated the World Health Organization (WHO) must develop targets (specific measures that can be used to hold countries accountable), indicators, and goals by the end of 2012. There is strong support for the four main cancer risk factors: tobacco use, alcohol use, unhealthy diet, and physical inactivity.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003ENGOs are in a position to provide data and evidence that might not be available in governmental and commercial sectors. They can objectively represent and advocate for patients, engage civil society, and take action without restraints from government or commercial entities. The Noncommunicable Disease (NCD) Alliance is the largest health coalition ever formed, with about 2000 participating organizations.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThree objectives for moving forward include a need to leverage the NCD Alliance, inclusion of noncommunicable diseases in the UN millennial goals, and emphasis on the need for action in this arena to ensure world economic stability, prevent suffering, and save lives.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EPerspectives in Cancer Care and Future Strategies\u003C\/h2\u003E\u003Cp id=\u0022p-7\u0022\u003ELawrence N. Shulman, MD, Dana-Farber Cancer Institute, Boston, Massachusetts, USA, related his experience in building cancer care infrastructures in low income countries, with a focus on his work in Rwanda. Dr. Shulman emphasized that partnerships among institutions, governments, and industry are keys to success. The cancer care components on which the program focused were education, prevention, screening, early detection, diagnostics, treatment, palliative care, and survivorship.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EDr. Shulman discussed the principles used to guide development of a cancer care program in low-income countries:\u003C\/p\u003E\u003Col class=\u0022list-ord \u0022 id=\u0022list-1\u0022\u003E\u003Cli id=\u0022list-item-1\u0022\u003E\u003Cp id=\u0022p-9\u0022\u003EDevelop a cancer care program within the context of the existing healthcare infrastructure.\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-2\u0022\u003E\u003Cp id=\u0022p-10\u0022\u003EDevelop essential services like pathology, surgery, and chemotherapy, to successfully diagnose and treat patients.\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-3\u0022\u003E\u003Cp id=\u0022p-11\u0022\u003EDevelop a supply chain for affordable drugs, vaccines, and other critical services.\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-4\u0022\u003E\u003Cp id=\u0022p-12\u0022\u003EDevelop cancer care services that can be administered by physicians, nurses, and other healthcare workers, with specialist back up via electronic communication.\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-5\u0022\u003E\u003Cp id=\u0022p-13\u0022\u003EDevelop social support, clean water, and adequate nutrition for successful care.\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-6\u0022\u003E\u003Cp id=\u0022p-14\u0022\u003EDevelop a prioritization plan, directing resources to where they are most needed. Cancers where the greatest impact can be made: 1) diseases amenable to risk reduction; 2) diseases curable with early detection and treatment; 3) diseases curable with affordable chemotherapy; and 4) diseases palliated with systemic treatment (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cp id=\u0022p-15\u0022\u003E\n                  \n               \u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/7\/NP.2\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Cancers Where An Impact Could Be Made.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1171521486\u0022 data-figure-caption=\u0022Cancers Where An Impact Could Be Made.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/7\/NP.2\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/7\/NP.2\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/7\/NP.2\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16936\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-16\u0022 class=\u0022first-child\u0022\u003ECancers Where An Impact Could Be Made.\u003C\/p\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from L. Schulman, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-7\u0022\u003E\u003Cp id=\u0022p-17\u0022\u003EDevelop specific disease-based protocols to direct interventions and care based on principle #5.\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-8\u0022\u003E\u003Cp id=\u0022p-18\u0022\u003EExpand partnerships with ministries of health, NGOs, academic cancer programs, private sector entities, foundations, and donors.\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-9\u0022\u003E\u003Cp id=\u0022p-19\u0022\u003EDevelop a research agenda and infrastructure specifically designed to address questions applicable to cancer care in these settings. Prospective studies are needed to understand the effectiveness of interventions.\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-10\u0022\u003E\u003Cp id=\u0022p-20\u0022\u003EDevelop ongoing local training in cancer care.\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-11\u0022\u003E\u003Cp id=\u0022p-21\u0022\u003EDevelop a sustainable program.\u003C\/p\u003E\u003C\/li\u003E\u003C\/ol\u003E\u003Cp id=\u0022p-22\u0022\u003EThe program\u0027s activities in Rwanda have been conducted in close collaboration with the Ministry of Health. National cancer protocols are being developed and approved by the Ministry. The key to developing a successful program is to integrate prevention, screening, and treatment. Programs need to be developed in parallel with important policy work.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2012 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/12\/7\/NP.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzngld\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzngld\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}