The World Cancer Declaration, launched in 2008, is a tool to help bring the growing cancer crisis to the attention of government leaders and health policy-makers in order to significantly reduce the global cancer burden by 2020 through 11 key targets.
It represents a consensus between government officials, public health experts and cancer advocates from around the world who are committed to reducing the global cancer burden, promoting greater equity, and integrating cancer control into the world health and development agenda.
Targets: by 2020
- Health systems will be strengthened to ensure sustained delivery of effective and comprehensive, people-centred cancer control programmes across the life-course for all, in all countries
- Population-based cancer registries and surveillance systems to measure the global cancer burden, and the impact of national cancer control programmes will have improved significantly
- Global tobacco consumption, overweight and obesity, unhealthy diets and alcohol intake, and levels of physical inactivity, as well as other leading exposures to risk factors will have fallen significantly
- Populations in the areas affected by HPV and HBV will be covered by universal vaccination programmes
- Public stigma towards cancer and cancer patients will improve and damaging myths and misconceptions about the disease will be dispelled
- A greater proportion of cancers will be diagnosed when still localized through the provision of targeted, population-based screening and early detection programmes and high levels of public and professional awareness about important cancer warning signs and symptoms
- Access to accurate cancer diagnosis, appropriate multidisciplinary treatment, supportive care, rehabilitation and palliative care services, including availability of affordable essential medicines and technologies, will have improved for cancer patients in all countries
- Effective pain control measures, and distress management, will be available to cancer patients in all countries
- Compensation, incentives and training opportunities for health workers in different aspects of cancer control will have improved significantly, particularly in low- and middle- income countries
- There will be major reductions in premature deaths from cancer, and improvements in quality of life and cancer survival rates at all stages of life, in all countries
Progressing towards the 2020 targets
Through its member organisations, now more than 760 in over 154 countries, the Union for International Cancer Control (UICC) promotes partnerships and international collaboration aimed at accelerating progress towards achieving the 2020 targets.
At the global policy level, we have already seen remarkable progress. In 2011 heads of state and government adopted the United Nations Political Declaration on the Prevention and Control of Non-communicable Diseases (NCDs), a landmark document which acknowledges that the global burden and threat of NCDs constitutes one of the greatest challenges for development in the 21st century. Following up on core commitments in the Political Declaration, governments have since adopted a Global Monitoring Framework for NCDs, a Global NCD Action Plan 2013-2020, and agreed to establish a Global Coordination Mechanism and UN Interagency Task Force on NCDs. With these building blocks in place, we can be confident that new commitments and opportunities for collaboration in cancer prevention and control will continue emerging in the lead up to 2020.
Making an impact on the “25 by 25” goal
The Global Monitoring Framework for NCDs includes a set of 9 global voluntary targets and 25 indicators, with the overall goal of reducing premature deaths from NCDs by 25% by 2025. The NCD targets and indicators cover common risk factors including tobacco, alcohol abuse, physical inactivity, and obesity, but also address the full care continuum for cancer including planning and surveillance, HPV and HBV vaccination, early detection and screening for breast and cervical cancers, access to essential medicines and technologies, and palliative care. The achievement of the 2020 World Cancer Declaration Targets will therefore have a significant impact on the realization of this 25 by 25 goal – which according to the International Agency for Research on Cancer (IARC) translates into approximately 1.5 million lives saved from cancer deaths by 2025. (*Please note that a complementary factsheet highlighting relevant NCD targets and indicators will be part of a revised advocacy toolkit for UICC members to accompany the refreshed Declaration)
The Political Declaration on NCDs clearly recognizes the primary role and responsibility of governments in responding to the challenge of cancer and NCDs, but also the essential need for the efforts and engagement of all sectors of society to generate effective responses.
The priority actions laid out below are addressed to all stakeholders, in particular governments, and structured around the six objectives of the Global NCD Action Plan 2013-2020, which has been recognized by Member States and UN agencies as a common roadmap in the fight against cancer and NCDs.
1. Raise the priority accorded to cancer prevention & control in global, regional and national agendas and internationally agreed development goals
- Place cancer and other NCDs as priority health issues in the post-2015 development agenda by generating evidence and disseminating information demonstrating that cancers are both a cause and an outcome of poverty, and constitutes a major threat to national economies
- Commit to effectively communicate to governments and national, regional and global policy makers that cancer control policies, resources, and funding urgently need to be aligned with the health, social and economic burden caused by cancers, particularly in low and middle income countries
- Forge sustainable multisectoral partnerships to promote cooperation among all stakeholders (governmental agencies, intergovernmental organisations, civil society and the private sector) to increase national investment in the prevention and control of cancer
2. Strengthen national capacity to accelerate country responses to cancer
- Take a whole-of-government and whole-of-society approach to ensure that all major stakeholder groups are involved in the development, updating and resourcing of national cancer control plans
- Increase efforts to empower and involve cancer patients in both cancer control planning and patient-led self-care at a local and national level
3. Reduce modifiable risk factors for cancer
- Increase efforts to reduce exposure to common cancer risk factors, in particular:
- Tobacco consumption: Encourage full implementation and enforcement of the Framework Convention on Tobacco Control (FCTC)
- Unhealthy diets: Engage all stakeholders in creating and promoting healthy diets
- Harmful use of alcohol: Encourage implementation of the global strategy to reduce the harmful use of alcohol
- Physical inactivity: Increase population levels of physical activity
- Develop and implement policies that will create health-promoting environments that reduce population-level risk factors, are culturally sensitive and conducive to the adoption of healthier behaviours, enabling and encouraging people to make informed choices
- Develop and implement measures to reduce people’s exposure to infection-driven, environmental and occupational carcinogens
4. Strenghten and orient health systems to address prevention and control of cancer
Screening and Early Detection
- Ensure the availability and access to affordable early detection programmes for which there is evidence of efficacy in the population in question, including screening for breast, cervical, colorectal, skin and oral cancers. Undertake pilot projects that are designed to evaluate the feasibility and efficacy in populations in which the screening technology has not yet been proven.
- Undertake research and introduce training so that behavioral and social factors contributing to delay in seeking early detection can be understood and reduced. Engage high- risk populations at the individual, community, and societal level so that high-risk behaviors can be reduced through self-determination, underpinned by systems of patient-centred care
Treatment and Care
- Promote the development and use of cancer management guidelines that are relevant to local needs and resources, and encompass provision of clinical, mental health and supportive care.
- Take steps to tackle the many barriers to optimal pain control. Work with all stakeholders including governments, civil society and private sector to address the over-regulation of pain medicines. Cooperate with international organisations, including the International Narcotics Control Board and the World Health Organization, to ensure that global implementation of the UN’s international drug control conventions do not unduly interfere with legitimate efforts to advance access to pain medicines for cancer patients in pain
- Work with the pharmaceutical industry to increase access to the full spectrum of cancer medicines that are affordable and of assured quality
- Increase the number of health professionals with formalized expertise in all disciplines of cancer control and all levels of the health service by providing specialist training opportunities and fellowships to enable professionals to study in specialist settings; Raise awareness about the impact of health worker emigration on the ability of countries to provide adequate levels of cancer care and work collectively to address global and national health workforce shortages and the resultant deepening of inequity
5. Promote and support national capacity for research and development for prevention and control of cancer
- Increase investment in independent basic and applied cancer research across fields and disciplines such as psycho-oncology, behavioural medicine and operational science to accelerate the translation of research findings into clinical and supportive care, as well as scale up to population-based public health practice
- Encourage cancer research organisations in different countries and across divergent fields of professional expertise to collaborate, share data and define complementary research objectives to optimise the use of the limited funds available for cancer research and reduce duplication of effort
6. Monitor the trends and determinants of cancer and evaluate progress in its prevention and control
- Improve surveillance of cancer morbidity, mortality and prevalence by establishing population-based cancer registries which are crucial for the development and monitoring of successful National Cancer Control Plans, and for identifying priorities in public health
- Support efforts of the Global Initiative for Cancer Registry Development in Low- and Middle- Income Countries (GICR) to develop national capacity to produce reliable, high quality information on the burden of cancer
- Use cancer registry data to evaluate differences in cancer incidence, survival and access to treatment among social groups and thus contribute to programmes aimed at reducing inequalities in health outcomes