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09 December 2022

Closing the gap in cancer care: The right to health is the reason, UHC is the means

Universal Health Coverage (UHC) is grounded in the fundamental human right to health. Put into practice, it can provide all populations with access to quality health services. UHC Day is commemorated every 12 December.

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There is a growing global discussion about health disparities and the need for more robust systems that can respond to the needs all populations. There is still a long way to go, however, before the ideals of health, human rights and equity are fully translated into policies that effectively offer everyone – whoever they may be and wherever they may live – access to the health services they need.

The fact that everyone should enjoy the right to the highest attainable standard of physical and mental health is a fundamental human right – and applicable “without distinction of race, religion, political belief, economic or social condition” (and one could certainly add: gender, sexual orientation, age, physical and mental aptitudes).

Yet, in practice this is not the case. Half the world’s population lacks access to the full range of essential health services and many are unable to receive basic cancer care.

As 30-50% of all cancers are preventable, governments can also considerably reduce the number of deaths due to cancer and other non-communicable diseases (NCDs) by providing reliable information on cancer risks and by addressing modifiable risk factors such as tobacco and alcohol consumption and the drivers of obesity. WHO’s “best buys” offers policymakers a list of the most cost-effective and other recommended interventions for the prevention and control of noncommunicable diseases.

Furthermore, investment in quality cancer care comes with high return A global investment of around USD 600 billion over 30 years in comprehensive interventions for childhood cancer could avert 6.2 million deaths (with a 3-to-1 return on investment). An average of USD 0.20-0.40 per person per year is needed in low- and lower-income settings to finance cervical cancer elimination. And it is estimated that improving screening, treatment and quality of care for 11 cancers globally would produce nearly USD 3 trillion in lifetime economic benefits at a cost of USD 233 billion over ten years (2020-2030). A return of over 12 dollars per dollar invested.

Of course, the political will to prioritise cancer as a national public health problem is essential for governments to commit to targeted and cost-efficient investments in cancer prevention, diagnosis treatment and care. Many countries in low- to middle-income regions have demonstrated this commitment to cancer care: Jordan, Pakistan and Rwanda are just a few examples. Essential to generating and channelling political will is the continued work in advocating for strong, resource-efficient national cancer control plans (NCCPs).

Leveraging UHC to reduce disparities in access to quality care

Underlying government actions to ensure that everyone can access quality healthcare, regardless of where they live or their socioeconomic situation, is the need for Universal Health Coverage (UHC). 

The past 20 years have seen considerable progress in expanding essential health services and increasing interventions to reduce mortality related to infectious diseases such as HIV, tuberculosis and malaria.

Now, however, the burden of non-communicable diseases (NCDs) such as cancer, heart disease, high blood pressure and diabetes has been increasing steadily due in part to lifestyle changes (unhealthy diet, lack of physical exercise, alcohol and tobacco use). In many low-income settings such as sub-Saharan Africa, deaths due to NCDs is set to surpass those due to infectious diseases by 2030.

This growing NCD burden means that no country can yet claim to have fully achieved UHC. For cancer advocates, UHC planning provides an opportunity to call for alignment with national cancer control and NCD plans.

UICC actions to advance UHC

UICC is actively engaged with partners, members and the wider health community to mobilise support behind the integration of cancer care for all populations into NCCPs and Universal Health Coverage schemes. 

UICC has partnered with UNITAID, Expertise France and Jhpiego through the SUCCESS project to scale-up interventions in four target countries (Burkina Faso, Côte d’Ivoire, Guatemala and the Philippines) to help them achieve cervical cancer elimination goals.

For breast cancer, UICC has a dedicated programme that aims to share knowledge, strengthen its members’ organisational capacities, support national action and build bridges between cancer leaders, healthcare providers, foundations, governments, multilateral agencies and the private sector.

UICC is also engaged in improving access to and the availability of essential cancer medicines and diagnostics. In 2015, UICC convened a review of the cancer medicines on the WHO Model List of Essential Medicines (EML) and this review put in place a disease-based approach for cancer medicines. Furthermore, UICC supports members in encouraging governments to implement a national list of essential medicines.

UICC also led the creation in May 2022 of the Access To Oncology Medicines (ATOM) Coalition, a new global initiative of 39 partners (as of end 2022), created not only to improve access to essential cancer medicines in LLMICs, but also to increase the capacity for diagnosing cancer and for the proper handling and supply monitoring of these medicines.

The second UN High-Level Meeting on UHC will take place next year in September, providing an opportunity for the cancer community to work with Governments and other partners to expand their national health insurance schemes and implement the necessary technical packages, tools and initiatives that can improve access to affordable quality care for all populations.

Looking ahead to this milestone event, UICC is organising a special focus dialogue on UHC and cancer care on 14 December. Speakers from different regions around the world will explore how different organisations are working together to assist in the implementation at the national, regional and international levels of pro-equity policies and what opportunities exist to leverage UHC to close the care gap in cancer services for marginalised groups. 

Last update

Friday 09 December 2022

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