New Report: Closing the Cancer Divide

Over 2.4 million cancer deaths in developing countries could be avoided each year by using prevention and treatment interventions that are affordable and widely available, according to a report released on October 28.

The new report, Closing the Cancer Divide: A Blueprint to Expand Access in Low and Middle Income Countries, is from an international group of experts organized by the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, and supported by a consortium of organizations that includes Partners In Health, Harvard School of Public Health, Dana Farber Cancer Institute, and Brigham and Women’s Hospital.

Once considered a problem only in wealthy countries, cancer is now a leading cause of death in low and middle-income countries. About 55 percent of the world’s 12.7 million new cases and 65 percent of the 7.6 million cancer deaths each year occur in these nations.

“The chance for a cure, the chance to live, should not be an accident of geography,” says Her Royal Highness Princess Dina Mired of Jordan, who serves on the Global Task Force that published the report.

The report was released at the Harvard Medical School symposium, Closing the Cancer Divide: The Global Equity Imperative of Expanding Access in Low and Middle Income Countries. The film Delivering Hope by LIVESTRONG was also presented at this symposium (watch on the player above).

Integrating treatment and prevention efforts

The report includes recommendations for combatting cancer using both treatment and prevention interventions. For treatment efforts, the report especially focuses on pediatric cancer, as deaths due to children’s cancers are among those that could be curtailed most easily. Costs of treatment for certain common cancers are as little as $100 per course in developing nations. About $115 million could completely cover the costs of drug treatments for unmet needs for cervical cancer, Hodgkin’s lymphoma, and acute lymphoblastic leukemia in children in low and middle income countries.

	A patient in Rwanda receives chemotherapy for cancer. Costs for treating some common cancers cost as little as $100 per course in developing countries.

Prevention has been an important focus of efforts developing countries. Reducing risk factors, such as tobacco usage, can help prevent many of the cancers of tomorrow. However, the report states that prevention activities are part of an integrated strategy, which also includes treatment.

“Developing countries face a double cancer burden that includes preventable cancers and the emerging challenge of all other cancers that cannot be prevented,” says Dr. Felicia Knaul, Director of the Harvard Global Equity Initiative, one of the organizations in the Global Task Force collaboration. “Cervical and breast cancer account for almost as many deaths and maternal mortality and most of these deaths could be avoided.” 

“The belief that treatment may be reserved for those in wealthy countries whereas prevention is the lot of the poor might be less repugnant if we had highly effective preventive measures,” adds PIH co-founder Dr. Paul Farmer.

Relief from pain

“Pain control, an issue for all cancers and many other diseases, offers the most distressing and insidious example of the cancer divide,” writes the report authors. Although pain relief medications like morphine are relatively low-cost, they remain largely inaccessible to patients in developing countries. This means that most people with cancer worldwide suffer tremendous pain — needlessly — before they die, the report’s authors say. For example, Saharan Africa records 1.1 million deaths in pain, and yet only uses enough medicinal opioids to treat just 85,000 people. Worldwide, although middle and low-income countries make up 85 percent of the world’s population, they only use less than 6 percent of the morphine consumed globally.

Read the full report, which includes a road map for improving cancer care in low and middle income countries, including practical, country-specific and disease-specific recommendations.

Read an overview of the report. 

Learn more about PIH’s work to treat and prevent cancer and other chronic, non-communicable diseases.