- Zuzanna Tittenbrun & Sonali Johnson - Switzerland
A goal without a plan is just a wish – the importance of national cancer control plans
Cancer is a challenging disease for all health systems, and the lack of a national cancer strategy can make it more difficult for them to be accountable and aware of best practices. A global health partnership is helping countries to fill this gap.
The views expressed are those of the author and do not necessarily
reflect the position of Re:solve Global Health.
Cancer is a growing burden globally, yet many countries still lack national strategies to help them address the problem. Having a clearly articulated national cancer control plan (NCCP) is crucial to helping health systems fight the disease and NCCPs can be successfully incorporated into broader efforts to combat non-communicable diseases (NCDs).
In 2017, the World Health Assembly resolution recommended that countries develop National Cancer Control Plans to guide all cancer prevention and management activities undertaken in a country to address the national cancer burden. The cancer resolution instructed the WHO to work with Member States and collaborate with non-State actors to develop partnerships to scale up cancer prevention and control.
In 2017, the World Health Assembly adopted a cancer resolution, entitled “Cancer prevention and control in the context of an integrated approach” which identified priority actions for countries to implement to systematically strengthen cancer services. These priorities are to be embedded in national cancer control plans (NCCPs), which can be defined as a strategic public health document(s) serving as a roadmap for cancer prevention and control nationally. The NCCPs are designed within the context of a country’s cancer burden, risk factors, prevalence, available resources, sociocultural environment and healthcare system.
Publicly available plans contribute to better accountability and can serve as a tool to increase political will for their implementation. The ICCP web portal serves as a repository of publicly available national and regional cancer control plans, as well as non-communicable disease plans. Featuring newly published plans on the ICCP portal provides visibility to NCCPs and brings attention to cancer control efforts in a given country. In 2013, the first year of the ICCP portal, the repository featured 91 NCCPs (including regional, state and past plans as well as different language versions of the same plan) from 42 countries; in March 2021 there were 315 plans from 109 countries. UICC staff regularly monitor national cancer control plans and NCD plans, and engage with Ministries of Health, UICC members and ICCP partners involved in NCCPs development.
The portal features an online library of more than one thousand resources on topics spanning the cancer control continuum from prevention to survivorship and end of life care. Over time, it has become a one-stop shop for national cancer control planners and policy makers searching for guidance and relevant resources. Over the last five years, it has seen a steady growth of visitors from almost every country in the world.
Although the number of countries with NCCPs has increased globally over the past two decades, it is inspiring to see countries such as Cameroon and Malawi following up on the commitments from the 2017 WHA cancer resolution and launching their first NCCPs. However, there are still many countries that do not have a national cancer control plan, or countries where plans exist but are not implemented. This is often linked to a lack of political will and insufficient resources, especially when plans have not been costed and resources for implementation have not been identified or allocated. This problem has been highlighted in a global review of NCCPs and other cancer-related documents conducted by the ICCP in 2018. Our review demonstrated that while 55% of countries listed the need to budget cancer-related plans, only 10% of these provided details about how the plan would be costed or resourced. The plans living on shelves in Ministries of Health do not contribute to reducing the cancer burden. Rather, NCCPs are a key step in adopting a strategic, long-term approach to cancer control; evidence has shown that well-structured plans combined with strong governance contribute to improved cancer outcomes, but it is the implementation of the NCCPs which is key.
The ICCP’s mission is to provide leadership, expertise and guidance to national cancer planning stakeholders and decision-makers in their efforts to develop, implement and evaluate data-driven, stakeholder-informed country-level national cancer control plans. Beyond the portal, this mission is realised through technical assistance around the development, implementation, and monitoring and evaluation of national cancer control plans. The ICCP partners provide assistance with updating expired NCCPs, undertake detailed reviews of draft NCCPs and provide suggestions for improvement, share expertise and facilitate connections to experts in specific areas of cancer control. Since 2020, the ICCP has offered a tele-mentoring programme for those countries that are in the process of implementing their NCCPs. The virtual community of practice coordinated by the is based on the Project ECHO technology-enabled collaborative learning model, where participants from country teams and experts in global cancer control are engaged in virtual knowledge exchange, sharing challenges in NCCP implementation and learning from experts and peers in monthly sessions.
Recently, the ICCP has strengthened collaboration with the United Nations organisations, particularly regarding technical assistance. For example, collaboration with the WHO and the International Atomic Energy Agency has taken place around national cancer control planning efforts, which facilitates information sharing between organisations and avoids the duplication of efforts. The collaboration also allows ICCP to work towards a common goal of improving cancer control globally through the development and implementation of evidence-based NCCPs. The ICCP continues to advocate for strong NCCPs as effective cancer control planning guides for countries, helping them to make the right investments to improve cancer outcomes.