It gives me great pleasure to be with you today and to attend part of the Fortieth Session of the Governing Council of the International Agency for Research on Cancer. This Agency, established 34 years ago in 1965, is a centre of excellence, to stimulate and support research on cancer at the international level and continues to carry out its task successfully. The contributions made in epidemiological and basic research, environmental carcinogens, evaluation of carcinogenic risks, diet and cancer, and genetic alterations are internationally recognised and appreciated. The interaction and cooperation between IARC and its parent Organization, WHO, has greatly increased this last year, and we look forward to increasing efforts to implement public health action based on research. At the same time, knowledge gaps in public health – especially in noncommunicable diseases – will be fed into the research agenda in order to optimize our common efforts to improve the health and wellbeing of people.

As we enter a new century, the challenges the Agency faces today will increase. Cancer is now placed much higher on the priority list as a major public health problem at the global level. It is now responsible for a huge disease burden and causes considerable human suffering, especially in developing countries where more than half of cancers occur. Increasing life expectancy will also augment the burden from cancers that typically affect the elderly. This burden will increase further and, by 2020, it is estimated that there will be up to 20 million new cases of concern per year, and 70 per cent will occur in countries which have only 5 per cent of the global resources available for cancer control.

WHO is responding to these challenges in several ways. When I took office in July, my first concern was to make sure that WHO's structure at Headquarters reflected more accurately the business we are in. Fifty-two separate programmes have been grouped into nine clusters and thirty-two departments. One important new cluster is the cluster on Noncommunicable Diseases. Noncommunicable Diseases are responsible for nearly half of global deaths, and the proportion is increasing. The cluster will develop strategies which will address several major lifestyle selected diseases through their common risk factors. Special emphasis will be given to cancer and to cardiovascular disease, and to promoting international investment in tobacco control.

We have strengthened this cluster by doubling its core budget, and by creating two more positions at the Director level for an integrated approach to surveillance, prevention and management. Cancer control will be an integral part of the work of these three departments. It is only through an integrated approach that meaningful, cost-effective strategies and interventions can be developed at the national level.

As we restructured towards this new vision of an integrated NCD surveillance, prevention and control, we became convinced that the best option was to locate the Cancer Control Programme within the cluster itself, while maintaining very close collaboration with the research facilities here at IARC.

However, moving the Cancer Control Programme into the NCD cluster does not mean a weakening of specific cancer control activities. The integration and joint work with other departments and clusters in WHO will contribute to a considerable strengthening of cancer control activities.

Much is known about the causes, preventive interventions and clinical management of cancer, and this knowledge base is increasing rapidly. There is however, an enormous gap between this knowledge base and public health efforts that are effectively applied in populations. Preventive strategies could potentially prevent one quarter of all cancers by integrating existing knowledge into practice. One third of the cancer burden is curable using today's technology, and this proportion can be confidently expected to rise over the coming years. For incurable cases, effective palliation of symptoms, especially pain, should be a basic human right. An important challenge for the International Agency for Research on Cancer and the newly established Noncommunicable Diseases Cluster is to bridge this gap by applying new knowledge and promoting a more comprehensive integration of research achievements into public health gains.

An effective mechanism for incorporating scientific and research advances into practical action is the development and implementation of national cancer control programmes. An integrated approach to primary prevention, promoting early detection activities, and strengthening curative treatment and palliative care represent the core of WHO's strategy for cancer control. New knowledge and strategies to strengthen these basic components of cancer control are a priority that should be addressed urgently because of the rapidly growing incidence of cancers and the social and economic consequences of this increasing burden in Member States. WHO will strengthen its role in coordinating international work in cancer control and will give maximum support to global action in the primary prevention, early detection, clinical management and care of patients. This is an essential part of the work of the new Noncommunicable Diseases Cluster. The Cluster is committed to intensify its activities in cancer control and to strengthen its assistance to Member States in developing national cancer control programmes and in providing technical support to Member States in this area. Collaboration with Ministries of Health and key decision-makers will help to increase commitment to cancer control at the national level and support the development of preventive interventions. Formulation of evidence-based clinical practice guidelines on treatment and quality care will lead to increased cure rates. Reinforcing WHO's palliative care strategy and strengthening the existing global network will also improve the accessibility to basic care and pain relief to the millions of patients with incurable cancers.

The role of the WHO Programme on Cancer Control (PCC) is to advise Member States on strategies for cancer prevention and control. Countries will need clear guidelines on prevention and care that are realistic, humane and affordable, including terminal care. Cancer shares several risk factors as well as similar intervention strategies with other noncommunicable diseases, such as cardiovascular diseases, diabetes and chronic obstructive lung disease. There are also other areas where experiences in cancer control can be shared with other departments including the Tobacco-Free Initiative.

I have launched a renewed effort on cancer killer number one, tobacco, by establishing the Tobacco-Free Initiative. Globally, comprehensive tobacco control policies and programmes targeting both prevention and cessation will help to stop the growth of today's tobacco epidemic. Since tobacco causes about one third of all cancer deaths worldwide, IARC's role in tobacco control is vital and I am confident that your ongoing contribution and collaboration with the Tobacco Free Initiative to strengthen the evidence base for action will grow stronger as the struggle against tobacco accelerates.

IARC, resisting all external pressures, continues to do excellent research on tobacco and lung cancer. The release by IARC last month of new evidence about the impact of cigars and pipes on lung cancer was particularly important for two reasons. First, the joint press statement by IARC and WHO allowed our close collaboration to be visible. Secondly, the study filled an important gap by at last providing European evidence on a topic close to the hearts and - might I say - lips of too many prominent leaders in Europe. Already the response we have received has been positive.

I would encourage such partnerships for action. A common vision and joint work in cancer control between WHO, governments, NGOs and the private sector is a major challenge for the 21^st century. We should work very hard to achieve this. Reducing the cancer toll can be achieved by strong alliances. We need to increase the awareness of the general public. We need to promote health education in relation to prevention and early detection. We need to develop and evaluate cancer control programmes and improve education and training of health professionals. We need to incorporate new findings and technologies into prevention, diagnosis and treatment of cancers, and to use available resources more efficiently.

Within WHO, partnership is equally important. Team work is a prerequisite to success. I am very pleased to see that the interaction and collaboration between the Agency and the Noncommunicable Disease Cluster is becoming stronger than in the past. I wish to congratulate Dr Paul Kleiheus, Director of IARC, and his staff on their scientific achievements and their excellent reputation in the cancer research community, and thank them for their genuine interest in our joint work and for their true spirit of collaboration.

I wish you a productive meeting.