ADVOCACY A Global Cancer Plan

As the G20 Rio Summit approaches, we are calling on leaders to prioritise a coordinated global response to the cancer challenge facing the world and consider a Global Cancer Plan

Cancer is a truly global health challenge.

Between 2022 and 2050, the number of new cancer cases is expected to increase by 77% in Asia, 85% in
Latin America and the Caribbean, and 139% in Africa. This will create new pressures on health systems and economies globally, including the G20’s largest economies. It is estimated that between 2020 and 2050, cancers will cost the world economy $25.2 trillion in international dollars.

Common challenges

Leaders across the world face shared challenges in dealing with the accelerating burden of cancer:

• Late diagnosis and poor prevention. Too many people are diagnosed with late-stage cancers, severely impacting their treatment options and outcomes. In lung cancer, for example, 60 out of 100 patients in the United States are alive five years after diagnosis if the cancer is treated earlier; less than 10% are alive when diagnosed later. In Latin America, 30–40% of breast cancer cases are diagnosed late. Moreover, 30–50% of all cancer cases are preventable. For example, despite being highly preventable, the burden of cervical cancer is alarming in the Latin American region. In 2018 alone, over 56,000 women were diagnosed with cervical cancer, and over 28,000 lost their lives due to it.
• Funding shortfalls. Diagnosing and treating more people with earlier-stage cancers when they are more treatable is a priority for many governments. While new diagnostics and treatments have the potential to transform outcomes, they also present funding challenges, not only because of the new options for tackling cancer but also because these innovations require the right infrastructure and experienced physicians to make the best use of them. Funding shortfalls for modern cancer care result in patient access and outcome disparities. In Europe, countries that spend the least on cancer care also have lower access to new treatments and higher mortality rates.
• Technology gaps. We have never had as many tools to fight cancer as we do today. From artificial intelligence tools to support diagnostics and clinical decision-making to precision radiology and personalised medicines, the pace of cancer care innovation is striking – but there are big gaps in access to these technologies. Many health and regulatory systems do not always have the capacity and experience to keep pace with technological change. This can lead to lags in the adoption of innovation. For example, it is estimated that an innovative cancer treatment receiving regulatory approval in the US in February 2024 may not be available to Latin American patients until the second half of 2028. While funding is one important aspect, there is also a need to strengthen health systems, especially in low-income and lower-middle-income countries, so that innovation is accessible to all patients.
• Expert workforce shortages. Shortages in the cancer workforce is a shared and interconnected global challenge. By 2030, there is a predicted shortfall of 18 million health workers, predominantly in lower-middle-income countries. The expected shortage of health workers in the European Union is anticipated to reach 4.1 million in 2030. This includes 0.6 million physicians, 2.3 million nurses and 1.3 million other healthcare professionals. While individual countries will look to address shortfalls domestically, there is a need to take a global look at this challenge, as increasing recruitment of experienced cancer specialists from low- and middle-income countries to meet domestic shortages in high-income countries can exacerbate shortages in the former.

A coordinated global solution

There has been an increase in local, country, regional and global cancer strategies and initiatives, demonstrating recognition of the need to address the alarming growth in cancer rates. We have seen a rise in the number of national cancer control plans (121 as of January 2023), and the introduction of bold policies to standardise cancer strategies across regions such as the EU Beating Cancer Plan.

Additionally, collaborations across sectors, such as the City Cancer Challenge partnership with MSD, aim to tackle the growing cancer burden at a municipal level by working with local actors in six cities across countries in Latin America, including Brazil, Peru, Colombia, Mexico, Argentina and Paraguay. After conducting a needs assessment, the partnership helps to implement a cancer care roadmap in each city and seeks to address priority gaps in care and build local capacity.

A call to action

In global health, the increased focus on non-communicable diseases by the World Health Organization and United Nations is a welcome step. However, we are calling on global leaders to go further – to support the development of a Global Cancer Plan to tackle the unique challenges of cancer across all territories.

A Global Cancer Plan has the power to secure the global political attention proportionate to the level of burden created by cancer across the world, while supporting individual countries to develop context specific solutions. It would provide a holistic framework with recommendations on how to address common policy challenges like those outlined above. The process of building the plan would enable learnings and best practices to be shared, encouraging open conversations about how they have tackled key issues.

Most importantly, it would prioritise cancer as a critical global health issue, highlighting the need for action.

*Merck & Co. Inc., Rahway, New Jersey, United States of America and its affiliates.