The inherent complexity of the fight against cancer and the burden of the disease act together to make it one of the most serious threats to public health in the Islamic Republic of Iran. The country is currently struggling with a significant burden of non-communicable diseases (NCDs), which account for over 82% of all deaths in the country. Of these, cancer is the third leading cause of death and is on a rising trend.

In the Islamic Republic of Iran, annually 3500[1] children are diagnosed with cancer - one of every two of them succumbs to the disease - and access to quality and affordable pediatric cancer medicines has become a serious problem. Because of current sanctions, access to quality and affordable pediatric cancer medicines has become a serious problem.

Access to quality and affordable pediatric cancer medicines has become a serious problem in the country because of the sanctions, which have had an impact on the procurement of these life-saving drugs. The sanctions were imposed following the United States administration’s unilateral withdrawal from the Iranian nuclear deal in May 2018. This entailed a ban on transactions between Iranian bank accounts and the global banking system. Together with an over-compliance on the part of global suppliers that operate on the US market, this resulted in major disruptions hitting the import of end products, pharmaceutical raw materials, and medical devices, as well as an increase in the price of drugs and a shortage of some 70 essential medicines for high-burden diseases, including specialized cancer drugs. It should be noted that all cancer patients require uninterrupted, sustainable, and safe access to essential drugs. Studies indicate that a delay of around four weeks in starting treatment may result in a 10% mortality increase for most cancer patients. Furthermore, current COVID-19 epidemic has put a serious strain on the country’s overall health system.

WHO Country Office in the Islamic Republic of Iran (WCO) has been focusing on emergency interventions in order to provide access to quality and affordable medicines for children living with cancer. With a US$ 2 million funding from the European Commission, WCO procured 12 of the most needed cancer medicines for children and distributed them to the 32 pediatric cancer treatment centers and hospitals across the country. WCO worked closely on this project with the Iranian Food and Drug Administration (IFDA) on all issues related to identifying the most urgent need, agreeing on the list of selected medicines, and to ensure that the drugs reach the target hospitals and children in need.

As part of WCO’s planned activity in the joint 2020-2021 program, another priority is the establishment of a comprehensive multi-sectoral mechanism, at a national and provincial level, towards the prevention and control of NCDs. A major part of this was the support given by WCO to the Ministry of Health and Medical Education (MoHME) in the establishment of a National Cancer Control Secretariat (NCCS) to strengthen collaboration of involved departments within the organization.

Furthermore, WCO supported MoHME in the enhancement of the Cancer Information Management (CIMA) system[2], in the context of the COVID-19 pandemic. CIMA is one of the major global projects dealing with population-based cancer registry systems. Working with national and international partners, WCO supported national health authorities in identifying and analyzing the outcomes of more than 8300 individuals with a history of cancer in COVID-19 registry data, making it one of the largest samples of this kind to date. The established record-linkage systems are vital in gathering essential information and evidence necessary for effective policy and clinical decision-making.

In addition, together with MoHME and NCCS, WCO documented the specific situation of pediatric cancer in the Islamic Republic of Iran, producing documentaries with case stories of parents and their children, using photos, videos, and interviews as ‘voices from the front lines’. The documentaries are intended to raise awareness and serve as an advocacy tool by calling for further urgent support to provide life-saving medicines and other essential services to children living with cancer and their families. [3]

In parallel to the actions taken regarding children’s cancer, WCO has succeeded in raising around US$ 80 million to fight COVID-19, the most successful WHO country office globally in resource mobilization to combat the pandemic.

As a step further, WCO will upgrade CIMA this year, with the scope of enhancing cancer registration data according to International Agency for Research on Cancer (IARC) and WHO guidelines. This will allow the country to collect essential information and improve the quality of basic information through linking lab information systems, hospital information systems, health information systems, and death records. Furthermore, National Cancer Control Programme Midterm Review as a strategic intervention by WHO and NCCS in collaboration with UNICEF, IAEA and IARC is on the agenda. Besides, WHO is supporting MOHME to join the WHO Global Initiative for Childhood Cancer.[4]