Baroness Patricia Scotland, my dear sister,
Excellencies, honourable delegates and guests,
It’s a great honour to be here. Thank you, Baroness Scotland, for the invitation, and for your leadership and partnership over the last several years.
Thank you also for hosting today’s event, and especially for your leadership on this very important issue.
WHO welcomes the Roadmap for Cancer Control, and we congratulate The Lancet Oncology Commission on Cancer in the Commonwealth for its work. I thank the Chair, my friend Rifat, and the co-chairs and all commissioners for a job well done.
Although he is not with us today, I would also like to thank The Lancet’s Editor-in-Chief Richard Horton for his support for the Commission.
In 2019, Richard addressed the World Health Assembly, and spoke powerfully about his own journey with cancer.
Likewise, although Her Royal Highness Catherine, Princess of Wales could not be with us today, the way she and His Majesty the King have shared their own cancer stories with the world has been a source of inspiration, hope and courage to many.
It’s a reminder that cancer does not discriminate. It affects people in all countries and walks of life.
It is one of the greatest threats to human health and prosperity.
Cancer is the second-leading cause of death globally, accounting for an estimated 9.6 million deaths – more than the population of London – every single year.
Between now and 2050, cancer is estimated to cost the global economy more than US$ 25 trillion in treatment costs and lost productivity — which is equivalent to an annual tax of 0.55% on global GDP.
But cancer’s economic toll pales in comparison to its human toll – the impact it has on the people it strikes, their loved ones, families, friends and others.
Their suffering is the only reason we need for comprehensive action.
Every hour, 280 children lose a parent to cancer.
And nearly 50% of women diagnosed with cervical cancer are abandoned by their intimate partners.
For hundreds of millions of people around the world, and in the Commonwealth, a cancer diagnosis remains a death sentence, a trigger for poverty, or a cause of social distress and stigma.
Cancer is a great equalizer, but the global response to it is marked by searing inequalities.
In high-income countries, almost 90% of children with cancer survive. In low- and middle-income countries, survival rates are often below 30%.
Only 16% of Commonwealth countries include essential cancer management services in the package of core health services they provide for their populations. This is already identified in the roadmap as a challenge.
For many vulnerable families who must pay for treatment out of their own pockets, cancer leads to generational poverty.
A few years ago, a friend of mine was diagnosed with cancer.
He had two options. He could have been treated, but it would have cost him most or all of the money he had put aside for his family’s future.
Or he could forego treatment, allow the disease to run its course and die knowing his family would have a more comfortable life, even if he was not there to enjoy it with them.
He chose the latter. He chose death rather than disadvantage his family.
No one should ever have to make a choice like that. And yet so many do.
Many innovations celebrated in high-income countries remain inaccessible to the majority of people diagnosed with cancer globally.
For example, only an estimated 25% of women with breast cancer globally have access to life-saving medicines that have been standard of care in high-income countries for 25 years.
And newer treatments like immunotherapy offer huge advances, but often come with price tags to match.
For the moment, WHO includes immunotherapy for melanoma on our Essential Medicines List, but not for other cancers because of the trade-off between budget impact and clinical impact.
We are considering other indications, and we will be soon publishing a report in the Lancet family of journals on the budget impact in low- and middle-income countries of including immunotherapy for lung cancer, along with policy options to improve affordability and access.
We also call for researchers to include low- and middle-income countries in clinical trials for immunotherapy.
But while cancer care is perceived to be expensive, it does not have to be. WHO has developed tools to help governments define and finance priority cancer services, focusing on cost-effectiveness and equity.
As the Lancet Commission has found, improving cancer prevention and control is not just a health imperative – it is a social, political and economic opportunity, with substantial returns on investment: 12 dollars for every dollar invested.
The 10 challenges described in the Commission’s Roadmap articulate well the problems that so many countries face, and the 10 corresponding initiatives offer solutions.
Indeed, around the world, WHO is supporting countries – including in the Commonwealth – to address these challenges and to implement the solutions that the Commission has identified.
Since 2017, WHO has launched three cancer initiatives that are now being implemented in over one hundred countries, and mobilized almost US$ 1 billion to support them.
First, in 2020 we launched a global strategy to eliminate cervical cancer as a public health problem – the first time we have dared to dream of eliminating a cancer.
Cervical cancer is the fourth-most common cancer among women globally, with 660 000 new cases and 350 000 deaths every year.
More than 40% of those deaths are in Commonwealth countries.
But we have powerful tools that are now giving us the opportunity to eliminate cervical cancer: vaccines to prevent it, tests to detect it, and treatments to cure it if detected early.
The Global Strategy set ambitious yet achievable targets for 2030: to vaccinate 90% of girls; screen 70% of women; and treat 90% of those with cervical cancer.
Last year, six Commonwealth countries introduced HPV vaccines for the first time: Bangladesh, Eswatini, Kiribati, Nigeria, Togo and Vanuatu. Fifty out of 56 Commonwealth countries are now protecting girls against cervical cancer.
I thank the Commonwealth for prioritizing cervical cancer elimination, which is not just a health issue but an equity issue. Patricia, my sister, has a special passion for health, and I hope under new leadership that health will continue to be a priority in the Commonwealth.
Second, in 2018, WHO established the Global Initiative on Childhood Cancer, with St Jude Children’s Research Hospital in the United States, and more than 100 other partners.
Last year alone, the initiative trained 11 500 health professionals in 25 countries in childhood cancer care.
WHO and St Jude have also established a global platform to give children with cancer in low- and middle-income countries access to quality-assured lifesaving medicines, at no cost.
Last month, we began distributing medicines to clinics in five countries: Ecuador, Mongolia, Nepal, Uzbekistan and Zambia.
We estimate that this year we will reach about 6000 children with cancer across at least 40 hospitals in 12 countries, including four Commonwealth countries.
And third, in 2021 we established the WHO Global Breast Cancer Initiative, bringing together partners from around the world with a shared goal to reduce breast cancer cases by 2.5% every year, and save 2.5 million lives over 20 years.
Through this initiative, governments are setting up patient navigation networks, introducing updated treatment standards and training health professionals.
In addition to these specific initiatives, WHO supports countries to link cancer control to primary health care and universal health coverage;
We’re reshaping the market for cancer medicines and technologies, to increase value and access;
And we’re amplifying the voices of those affected by cancer.
In collaboration with the McCabe Law Centre in Australia, we are defining and promoting legal and social protections for people affected by cancer.
WHO is also leading preparations for the 4th High-Level Meeting on NCDs and mental health, to be held at the United Nations General Assembly this September.
Negotiations on the political declaration are now underway, and we seek the active engagement of all Commonwealth countries to secure bold but achievable commitments, and to translate those commitments into action.
The Commission’s report is very timely for that high-level meeting in September.
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Baroness Scotland, dear colleagues and friends,
As you know, we meet at a particularly challenging time for global health and development.
But I am greatly encouraged by the commitment of the Commonwealth and its member countries to promoting, providing and protecting health.
WHO and the Commonwealth have built a close alliance during the last few years, especially under the leadership of Patricia my sister, based on shared priorities agreed in the Memorandum of Understanding we signed in 2022.
We have collaborated on COVID-19, transparency of pricing for medicines, digital health, noncommunicable diseases, ageing, and most recently, on the Lancet Commission on Cancer in the Commonwealth.
I thank Baroness Scotland for her strong leadership, partnership and vision for strengthening the Commonwealth Secretariat’s contribution to global health.
My sister Patricia, thank you for your tireless efforts to improve health across the Commonwealth, during a momentous period in world history. It has been my great pleasure to work with you, and I know I speak for many of us when I say you will be greatly missed. But you will not escape from us, we will find you!
I look forward to continuing the collaboration between our two organizations under the leadership of the Honourable Shirley Ayorkor Botchwey.
Thank you all once again for your commitment to a healthier, safer and fairer future for the people of the Commonwealth, and the world.
I thank you.