Noncommunicable Diseases: More Than a Health Crisis

Linda Brookes, MSc; Eduardo L. Cazap, MD, PhD

Disclosures

September 02, 2011

In This Article

Setting Specific, Measurable Goals

The most important result of the UN Summit will be an outcome document, the "Zero Draft," stipulating measurable goals and dates by which those goals are to be met by participating states. [Editor's note: On August 11, negotiations with government leaders over the goals to be included in the outcome document hit a wall , with the United States and the European Union opposing many of the target-oriented resolutions on the grounds that they would be responsible for the bulk of the action items. Negotiations over the terms of the outcome agreement (or Zero Draft) will resume shortly before the Summit.]

"We want a document that will force governments to implement actions and also to report periodically about the progress or the obstacles," Dr. Cazap declared. "The value of the document will be the inclusion of cancer, which is not on the political agenda in many countries of the world," he pointed out. Cancer is not specifically listed among the UN's Millennium Development Goals for 2015.[3] "This is a major issue," Dr. Cazap said, "because if a national cancer institute or a key organization in a country wants to get funding for prevention or for education from an institution like the World Bank, one of the first questions they will be asked is whether the initiative is included in the Millennium Development Goals. If it is not, then the possibilities for funding are more limited."

Richer nations that contribute the most to the United Nations budget are reluctant to support an action they believe will increase their contributions and have a severe impact on their own economies, says Dr. Cazap. This is a misconception, he pointed out. According to a recent study by the American Cancer Society and the Lance Armstrong Foundation (LIVESTRONG),[4] the global economic cost of cancer and the calculated economic impact of death and disability as a result of cancer worldwide in 2008 was US $895 billion, representing 1.5% of the world's gross domestic product.

"However, it is not a question only of money," Dr. Cazap said. "It is more important to think in terms of better allocation of existing resources. Specifically for cancer, there is a need to improve data with cancer registries and to develop efficient and cost-effective national cancer plans that are today available in only a few countries."

Dr. Cazap stressed that today more than 50% of total costs of cancer treatment are spent in the 2 last weeks of life. "That is not efficient and it is not humane. It is not beneficial for the healthy because the economy is focusing impractically on palliation or end of life, and many resources are not allocated to the early stages of the disease or at a time when the population is healthy and should be maintained as healthy as possible. We expect that the document will put into motion this process and we expect that periodic evaluations and reporting will make this process more real at the local scale."

Dr. Cazap contends that a strong document from the United Nations will put pressure on governments to implement efficient actions to adapt their healthcare systems for prevention and early detection and to apply diagnosis and treatment procedures that are efficient and valuable, "not only for the people," he says, "but for national economies."

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