Building Synergies

In 2011, the global community adopted the Global Action Plan (GAP) for the prevention and Control of Non-communicable Diseases (NCDs). The GAP urged countries to set national targets to address premature death from four major NCDs (cancer, cardiovascular disease, diabetes, and respiratory disease). Built into the GAP is the opportunity to address various risk factors across NCDs that contribute to premature mortality, known as “best buys”. (Figure 1)

In addition to focusing on these proven strategies, countries can turn to successful programs in maternal and child health and HIV prevention and control, among others, to reach the target population to promote cancer prevention and control. Adequately funded and staffed National Cancer Control Plans are the best approach to address the cancer burden in the existing health context. (Figure 2)

The growing cancer burden in low- and middle-income countries necessitates building on existing infrastructure. (Map 1 & 2) In Rwanda, cervical cancer control has been successfully integrated into women’s health services. In Kenya, leaders built on the existing HIV-treatment infrastructure to screen and treat women for cervical cancer.

The American Society for Clinical Oncology trains primary care physicians in countries with limited oncology infrastructure to recognize the signs and symptoms of cancer, and to better integrate cancer services into existing resources. Partners who can help country planners see the whole health landscape, including cancer, are critical in supporting this integration at the country level. For example, the International Cancer Control Partnership was formed by the US National Cancer Institute and the Union for International Cancer Control to support country development of national cancer plans or to encourage countries to include cancer control activities within their NCD plan. The International Cancer Control Partnership portal contains resources for plan development, including examples of plans that integrate across the health system.

Essentially, cancer cannot be addressed alone. It shares many common risk factors with other NCDs, and the health systems that work to prevent and treat NCDs as well as infectious diseases can be leveraged to effectively incorporate cancer control.