SciDev.Net

In 2005, the World Health Assembly called on WHO member states to tackle their growing rates of cancer by developing rigorous cancer control programmes. To help guide the process, the WHO developed a series of six modules that provide practical advice for programme managers and policy-makers on how to advocate, plan and implement effective cancer control programmes, particularly in developing countries.

Individual modules focus on planning; prevention; early detection; diagnosis and treatment; palliative care; and policy and advocacy. As of May 2008, all but the one on policy and advocacy have been published.

Worldwide, cancer kills more people than HIV/AIDS, malaria and TB put together. In developing countries where chronic diseases are now growing alongside infectious diseases, new strategies need to be developed.

This article outlines how to develop an effective cancer strategy in African countries on the basis of discussions at the recent African Cancer Reform convention. A cancer control plan clearly needs to take into account African countries' financial constraints and the authors outline six key essentials that would offer most health gain for money invested. These are: setting up cancer intelligence units to collect data on cancer incidence; controlling tobacco use; early diagnosis and prevention; offering treatment wherever possible; palliative care when treatment is no longer useful; and training and educating future generations of African oncologists.

Developed countries can offer crucial expertise and experience and collaborate on cancer information networks. Educating local communities about a disease that is relatively new but growing quickly will also be essential to stop it spiralling when many cancers are preventable or treatable when detected early enough.

In 2003, the Gates foundation infused new vigour into global health efforts by declaring that the 21st century's "grand challenges" included developing new vaccines and overcoming drug resistance. This new grand challenges initiative, launched by a collaboration of top global chronic disease experts, identifies priorities in tackling diseases like diabetes and cardiovascular disease, and explains in detail how research should be directed to meet each challenge (a challenge was defined as a critical barrier that if removed would help solve an important health problem).

To distill the range of opinions and priorities, the coordinators sought input from 155 stakeholders from different countries and disciplines. The initiative requires the participation of agencies like the WHO, individual governments, and non-governmental organisations as well as civil society and business if it is to succeed. The authors point out that the Gates initiative was linked to large funding, whereas this project will rely on multiple funding agencies to coordinate on these priorities.