Address by the Regional Director at the Regional Workshop to accelerate cancer prevention and control

25-26 June 2019, New Delhi, India

Member State representatives, technical experts, distinguished participants and partners, ladies and gentlemen,

It is a privilege to address this gathering at what is a crucial time for the Region’s NCD response generally, and its cancer response specifically.

We are now just five years away from 2025, the global and regional deadline for reducing premature mortality from NCDs by 25%.

Though our progress has been strong, as befits one of the Region’s Flagship Priorities, more work is needed, especially in light of the commitments made at last year’s High-Level Meeting on NCDs at the UN General Assembly.

I am nevertheless certain that with your steadfast resolve we can meet the targets assigned to each NCD, as we must.

That includes for cancer, which is the focus of this two-day workshop.

Since 2015, when Member States endorsed a Regional Committee resolution on the need for comprehensive cancer control, and then in 2017, when the World Health Assembly endorsed a similar resolution, momentum has been steady, with Member States implementing key initiatives to prevent, detect and control the disease.

This has included increased tobacco control, as per the MPOWER package’s recommended policies.

It has included the initiation and scaling up of HPV vaccination and pre-cancer screening to help prevent and treat cervical cancer.

It has included expanded multisectoral efforts to increase physical activity and the consumption of a healthy diet.

And it has also included the roll-out in many countries of the WHO PEN package, a crucial tool to help detect cancer at the primary level.

WHO is now working with Member States to address the harmful use of alcohol, which increases the risk of cancer.

We are also supporting efforts to better meet the needs of children with cancer. As you may be aware, children with cancer in low- and middle-income countries are four times more likely to die of the disease than in high-income countries.

The Region’s work on cancer is indeed commendable. It is also very much needed.

Despite the Region’s overall cancer burden being lower than global trends, a disproportionate two-thirds of patients die before the age of 70, meaning they die prematurely. This reflects delays in diagnosis and care that lower the likelihood of survival.

Also disproportionately high is the fact that an estimated 35% of all cancers in the Region are linked to risk factors that are completely avoidable. Tobacco use, for example, accounts for a staggering 22% of all cancer deaths.

While this reflects an ongoing tragedy, and one we must continue to address, it also demonstrates the opportunity we have to forge substantial progress.

This workshop is aimed at doing precisely that, with a focus on identifying key policy levers to sustain and accelerate our Region’s cancer response, with each Member State developing their own roadmap to meet the 25x25 target and our 2030 Sustainable Development Goal commitments.

Importantly, the roadmaps will be tailored to each Member State’s context and epidemiological burden, with clear timelines and specific indicators to gauge progress and ensure accountability.

The roadmaps will also comprise accelerators pertaining to several key areas of work, from governance to prevention and early detection, and from treatment and palliative care to the health workforce, information and financial protection.

As you can see, there are many levers that have the potential to hasten progress. But allow me to highlight three areas of focus that hold immense potential.

The first is integrating national cancer control programmes into health systems at every level. While tertiary services are important, they are expensive and most effective when a cancer is detected early. To make that happen, effective cancer screening services must be available at both secondary and primary facilities, while health workers must be trained to identify the signs and symptoms that could lead to a positive diagnosis.

The second is for Member States to scale up the implementation of policies that prioritize cancer prevention across sectors. That could mean pursuing the plain-packaging of tobacco products or regulating alcohol consumption. It could also mean strengthening immunization programmes to ensure everyone receives the hepatitis B vaccine and all girls below the age of 15 receive the HPV vaccine.

And the third is strengthening palliative care to ensure patients’ dignity and rights are upheld in the event of end-stage cancer. To this end, the provision of palliative care must be recognized as an ethical responsibility, and part of a health worker’s professional duties. Access to palliative care medicines, which are part of WHO’s essential medicines list, should meanwhile be increased as a matter of priority. At present, not one of the Region’s Member States provide oral morphine at the primary level.

Representatives, distinguished participants,

As I mentioned at the outset, we are at a crucial moment in our Region’s battle to prevent and control NCDs, including cancer.

As populations age and lifestyles change, the threat of what is being called an NCD tsunami looms ever larger.

Owing to your work, however, we are holding that threat at bay.

To continue to do so, and to accelerate towards our targets and commitments, we must plan well, and plan comprehensively.

This workshop is your opportunity to do that.

I urge you to take full advantage of it, and to develop roadmaps that are fit for purpose and which get us from where we are to where we need to be. In doing so, you can count on WHO’s full support.

I trust you will work with singular purpose and steadfast resolve over the coming two days. The health and well-being of the Region’s near two billion people demands as much.

I wish you a productive and engaging workshop and a comfortable stay in New Delhi.

Thank you.