Advancing the right to health for people living with cancer

People living with cancer should enjoy the same fundamental rights as everyone else, including the right to the highest attainable standard of health (ohchr.org). This encompasses non-discrimination and autonomy (the right to control one’s body and health free from interference), as well as the right to a system of health protection available to all, based on the four essential standards of healthcare of the AAAQ framework: availability, accessibility, acceptability and quality.

In many parts of the world, however, cancer patients face significant barriers in accessing reliable information about health and services and affordable quality care and treatment. A primary reason is the lack of access to affordable and appropriate health care. This can be particularly challenging in low- and middle-income countries (LMICs), where cancer care is often inaccessible or unaffordable.

Even when health services exist and are available, effective access to health services can be denied to people in countries around the world due to socioeconomic factors such as geographical location, low socioeconomic background, prejudices and assumptions based on age, gender, ethnicity and physical or mental ability. This is the “care gap”, which UICC has drawn attention to on many occasions, including for the past two World Cancer campaigns.

A major barrier to enjoying the right to health is financial constraints, which can limit access to cancer treatment. Cancer treatment is often expensive and patients may be unable to afford the cost of treatment. Even when cancer treatment is available, patients may be required to pay out of pocket, which can cause significant financial burden and impact their quality of life and that of their families. In extreme cases, people may experience financial toxicity, unable to pay even for the basic needs, and fall into – or further into – poverty.

Additionally, inadequate healthcare infrastructure, including a lack of trained healthcare professionals, equipment, and medicines, can further limit access to quality cancer care.

Another significant issue is inadequate access to pain medicines for cancer patients. Pain is a common symptom of cancer and patients often require appropriate pain relief to manage their symptoms effectively. However, access to pain relief is severely limited due to multifaceted and systemic barriers, particularly in low- and middle-income countries, with some three-quarters of the world’s population unable to access effective pain relief medication such as codeine, morphine or other opioids, which are widely available in high-income. The lack of access to pain relief can cause significant suffering and negatively impact the quality of life of people living with cancer.

To ensure that the rights of people living with cancer are respected requires a comprehensive approach that includes universal health coverage and national cancer control plans. Universal health coverage (UHC) is a key strategy to ensure that all individuals, regardless of their financial status, have access to quality cancer care.

National cancer control plans (NCCP) involve comprehensive strategies for the prevention, early detection, treatment and care of cancer patients. Well designed and implemented NCCPs ensure that cancer care is integrated into the broader healthcare system and should incorporate UHC, ensuring that all individuals have access to the necessary healthcare services without facing financial hardship. NCCPs should also, of course, be informed by the overarching principle of the right to health.

Ensuring that patients’ rights are respected also involves understanding the legal obligations of states, implementing national cancer control plans and empowering patient voices through legislation. Indeed, WHO should be releasing in May a Framework for Meaningful Engagement of People Living with Noncommunicable diseases (NCDs) and Mental Health conditions, which aims to provide Member States with greater knowledge and ability to involve patients and their representatives as active participants in decision-making processes.

State parties have legal obligations under international human rights law, such as Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR), to respect, protect and fulfill the right to health. The Committee on Economic, Social and Cultural Rights in General Comment No. 14 further elaborates on these obligations, including the duty of states to adopt legislation ensuring equal access to healthcare and health-related services provided by third parties (ohchr.org).

The McCabe Centre for Law and Cancer in Australia, launched by UICC in 2012, is a leading organisation that advocates for the rights of cancer patients. The centre works to strengthen laws and policies related to cancer prevention, treatment and care, with a particular focus on low- and middle-income countries. The center provides technical assistance to governments, civil society organisations and other stakeholders to support the development and implementation of laws and policies that promote the rights of cancer patients.

Cáncer Warriors de México Foundation, led by Kenji Lopez, a lawyer and member of the UICC Board of Directors who lost his mother to cancer, created for instance a Twitter campaign in 2021 that made cancer control a centrepiece of Mexico's elections. Cancer Warriors Foundation in the Philippines, led by Carmen Auste, one of three civil society representatives in the National Cancer Council of the Philippines, whose son was treated for brain tumour, was successful in obtaining reduced prices of up to 70% for children cancer medicines at private hospitals and maintenance medicine.

Addressing the issue of patient rights and the right to health for cancer patients requires a comprehensive approach that prioritises the needs of patients and promotes equitable access to quality cancer care for all. It also encompasses the need of multisectoral cooperation between the cancer and NCD communities and organisations working to include human rights considerations in health policy designs.