Going Global

Chair’s Remarks, Annie Young, UKONS Chair

Wherever we work in the UK at the moment, it is the season of reform—service improvement, restructuring, transformation and hopefully, progress. What an incredibly eventful but somewhat uncertain time for UKONS members. In England, the National Cancer Director, Prof Mike Richards, along with UK experts, is leading on the Cancer Reform Strategy (see page 6). A few UKONS members are involved in workstreams feeding the Cancer Reform Strategy and also the forthcoming ‘End of Life Strategy’, again steered by Prof Mike Richards and Prof Ian Philp, National Director for Older People’s Services. As well as discussing death and dying with patients, we need to consider a wider societal perspective—‘death happens’—and promote dialogue with our family and friends about what death means to them and us, in order to better prepare and carry out individual wishes.

These strategies are going to strongly influence UK action on cancer care, but cancer is, of course, a global challenge. As chair and because of UKONS’ special interest and work in cancer and palliative care in the developing countries, stemming from our inaugural conference, I have been asked to participate on your behalf in a ‘Cancer Control in Africa’ meeting. To be held in London on May 10th& 11th 2007, the meeting will include over 20 African health ministers (including those from Benin, Botswana, Burundi, Cape Verde, The Gambia, Ghana, Kenya, Madagascar, Malawi, Mauritius, Nigeria, Rwanda, Seychelles, Uganda & Zambia) and some UK government ministers.

According to the World Health Organization (WHO), 12.5% of all deaths worldwide are currently caused by cancer, a greater percentage than is caused by HIV/AIDS, TB and malaria combined. There is often a misperception that cancer is associated with wealthy nations andlimited to the effects of diet, lack of exercise and smoking. In fact, more than half of new cancer cases occur in developing countries, where the disease is a leading cause of morbidity and mortality. The International Agency for Research on Cancer (IARC) predicts that cancer rates will dramatically increase in the coming years, from 10 million new cases in 2000 to 15 million in 2020.

70% of all new cancer cases are foreseen in developing countries, where governments are least prepared to address the growing cancer burden and where survival rates are often less than half those of more developed countries. In the developing world, one third of cancers are potentially preventable and another third are treatable if detected early. As we know, in many developing countries, governments and institutions face a wide spectrum of serious health problems and cancer is often not a priority in limited resource settings. Currently, a cancer diagnosis in the developing world means a painful and distressing death in most cases.

This meeting will focus on how best to bring comprehensive cancer care to the African countries that need it most, and I’d be grateful for your input prior to the meeting. I would ask UKONS members with experience of working with cancer patients in the developing world or who are interested in the global challenge of cancer, to let me know your thoughts on both caring for cancer patients in developing countries and on bringing cancer control programmes to Africa. Please ‘enlighten us’ via our UKONS website (www.ukons.org), e-mail me at a.young@bham.ac.ukor give me a ring via our secretariat, Kirsten Wicke at Succinct Communications—01494 549100. I will input your ideas at this important meeting.

I wish you well with your work objectives over the next few months.