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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