Are the Global NCD Commitments Advancing Cancer Prevention

and Screening in Latin America and the Caribbean?

Silvana Luciani Advisor, Department on Noncommunicable Diseases

and Mental Health, Pan American Health Organization

Population: 640 million GNI/capita: US$ 14,529 Life expectancy: 78 years Under 5 mortality: 20/1,000 lb Maternal mortality: 61/100,000 lb Total deaths: 3.8 million NCD deaths: 2.2 million

Source: PAHO: Health Situation in the Americas, 2016

Overview of Latin America and the Caribbean

Incidence Mortality

Source: Ferlay et al, Globocan 2008, International Agency for Research on Cancer.

1.1 million new cases

Cancer in Latin America and the Caribbean

603,000 deaths

Mortality & Morbidity

Risk Factors National Systems Response BEHAVIORAL BIOLOGICAL

25% reduction

10% reduction

10% reduction

30% reduction

30% reduction

25% reduction

0% increase

50% coverage

80% coverage

Premature mortality

Harmful use of

alcohol

Physical inactivity

Salt/ sodium intake

Tobacco use

Raised blood

pressure

Diabetes & obesity

Drug therapy

(heart attacks & strokes)

Essential meds. &

basic tech.

Global NCD Commitments 9 Targets for 2025

Title of the Presentation ‹#›

Number of countries (%) National cancer plan 15/34 (44%) Budget line for cancer 8/15 (53%)

Primary prevention

Tobacco policy 29/34 (85%) HPV vaccine 18/34 (53%) Hepatitis B vaccine 34/34 (100%)

Screening

Cervical cancer screening 31/34 (91%) Breast cancer screening 28/34 (82%) Colorectal cancer screening 8/34 (24%)

Chemotherapy generally available 28/34 (82%) Radiotherapy generally available 24/34 (70%) Palliative care services 10/34 (29%) Cancer registry 16/34 (60%)

Source: PAHO/WHO National Capacity Survey for NCD Programs, 2015

Cancer Program Status in LAC

Regional Initiatives for Cancer Control PAHO/WHO

Women’s Cancer Initiative, UN Inter-Agency Task Force, IAEA imPACT missions

IARC cancer registry hubs in Latin America and in the Caribbean

USA NCI cancer control leadership forum

South-South Collaboration RINC, HCC, APEC project, ULACAAM, bilateral arrangements

International initiatives ICCP, CCA,PRRR, BCI 2.5, PATH project

Highlights of Accomplishments Advocacy and raising priority of cancer Plans created, partnerships and resources mobilized Dissemination of scientific evidence, knowledge

transfer, exchange of information Tools, guidance, capacity building, training Local champions and leaders emerging

Multiple public health priorities in the face of limited resources

Equity gaps

Health system barriers coverage, access to specialized care, adequate workforce,

equipment and supplies, etc.

Socio cultural barriers, including stigma

Persistent Challenges

NCD agenda has elevated attention to the cancer problem

NCD accountability framework useful to improve cancer programs, policies and services

More international support and technical cooperation has been generated

Some progress, but slow

Many gaps remain

Conclusions