On 24 July 2024, the World Health Organization (WHO) and key partners completed a 10-day in-country mission to support Indonesia to increase access to quality and comprehensive cancer control services. The in-country mission was the second of three phases of the 2024 Integrated Mission of the Programme of Action for Cancer Therapy (ImPACT Review) for Indonesia, supported also by the International Agency for Atomic Energy and the International Agency for Research on Cancer.
Globally, cancer is the second leading cause of death, accounting for an estimated 9.7 million deaths in 2022, alongside 20 million new cancer cases. About 1 in 5 people develop cancer in their lifetime. Approximately 1 in 9 men and 1 in 12 women die from the disease. Health systems in low- and middle-income countries are least prepared to manage this burden.
Indonesia reports more than 400 000 new cancer cases annually. Of these, more than half will result in cancer-related deaths. Cancer accounts for almost 1 in 5 premature deaths in Indonesia from noncommunicable diseases (NCDs). The top three leading cancers for both sexes in Indonesia in terms of mortality are lung cancer, liver cancer and breast cancer.
The imPACT Review is a systematic, multi-partner process commissioned by countries to assess national capacities and needs for cancer control and to identify priority interventions to address the cancer burden. Indonesia requested its first imPACT Review in 2010 and its second in 2018, which recommended the establishment of a national cancer control programme, the formation of cancer registries, the implementation of key preventive measures, and the expansion of services for screening and early detection.
Since then, with WHO support, Indonesia has introduced human papillomavirus and hepatitis B vaccination country-wide and launched the National Action Plan for Cervical Cancer Elimination 2024–2030. It has strengthened screening for and treatment of cervical pre-cancerous lesions.
The 2024 imPACT Review will inform Indonesia’s forthcoming comprehensive National Cancer Control Plan, the National Action Plan for Childhood Cancers, and the roadmap for integrating palliative care into primary care.
“The Ministry of Health (MoH) is committed to ensuring access for all Indonesians to quality and comprehensive services to prevent, detect and treat cancer, and provide palliative care to all who need it,” said Dr Yudhi Pramono, MARS, Ag. Director General of Disease Prevention and Control. “The imPACT Review is a critical tool for assessing progress and defining the path ahead, and we look very much forward to its completion.”
The 2024 in-country mission kicked off with a briefing to the Minister of Health, Mr Budi G. Sadikin. The team then conducted in-depth consultations with the MoH and national stakeholders, focusing on cancer control coordination, planning and financing, quality of care and health workforce development, cancer prevention and early detection, provision of and access to radiotherapy, and the health information system.
This was followed by visits to five provinces, where the national and international reviewers observed cancer service provision at primary, secondary and tertiary health facilities. They also consulted a range of key stakeholders from provincial and district governments, professional societies, academia and civil society organizations and individuals with lived experiences.
The in-country mission was preceded by a desk review in May 2024, as well as interviews with national experts and stakeholders on the country’s cancer registry, medical oncology services, cancer control planning and financing, and diagnostic pathology. The in-country mission will be followed by a comprehensive report containing a series of key recommendations.
“Together, WHO and its partners are pleased to support Indonesia’s cancer control activities, which are crucial to the country’s Health Transformation agenda,” said Dr N. Paranietharan, WHO Representative to Indonesia. “Across Indonesia, our collaboration with and support of MoH will help reduce the cancer burden, save lives and achieve a healthier tomorrow.”
Indonesia’s efforts are part of a broader push in the WHO South-East Asia Region and globally to better prevent, detect and treat cancer, and achieve Sustainable Development Goal 3.4: Reduce by one third premature mortality from NCDs. They reflect key global initiatives and targets on cervical cancer, breast cancer and childhood cancer specifically, and will contribute to the global implementation of World Health Assembly Resolution 70.12, on cancer prevention and control in the context of an integrated approach.
Written by Kafi Khaibar Lubis, National Professional Officer (Noncommunicable diseases), WHO Indonesia