Cancer is clearly a leading cause of death for women worldwide and the burden will only escalate without collective action and multi-sector leadership. In the face of scarce resources and competing health priorities, those of us in the voluntary health sector have a unique role to play in making women's cancer the global health and development priority it needs to be in order to save more lives. According to the International Agency for Research on Cancer, approximately 3.3 million women died from cancer in 2008 worldwide, corresponding to nearly 10,000 deaths per day. This number is projected to nearly double by 2030 simply due to the aging and growth of the population (women), with the potential to be even higher because of the adoption of high risk behaviors and lifestyle factors associated with economic development in most parts of the world.
In 2008, breast cancer was the leading cause of cancer death for women globally and claimed the lives of nearly 460,000 that year. Cervical cancer also wreaks devastation on nations worldwide. Despite the fact that the disease is extremely preventable and treatable with early detection–and is largely controlled in western countries–cervical cancer was the fourth leading cause of cancer death in women worldwide. In Sub-Saharan Africa and South Central Asia, cervical cancer is the top cancer killer among women.
Despite this daunting reality, we are making progress against these diseases–but it must accelerate.
On September 19-20, the General Assembly of the United Nations held an historic High-level Meeting to discuss non communicable diseases (NCDs), an often overlooked burden on the world's populations and economies. Only the second of its kind for a public health issue, the meeting was an unparalleled opportunity to put NCDs–including cancer, diabetes, cardiovascular disease, stroke, and chronic respiratory disease–at the top of the global health agenda. The successful meeting drew 34 heads of state and member states unanimously adopted a Political Declaration that included important language to accelerate effective programs and resources to address NCDs.
Through its global grassroots advocacy network, the American Cancer Society worked with the NCD Alliance and the Union for International Cancer Control, spearheading efforts to ensure strong language was included in the UN Political Declaration that supports critical cancer prevention and control priorities. The declaration calls for enforcing the Framework Convention on Tobacco Control (FCTC) and increasing access to cancer vaccines and screening. The declaration also commits governments to increase access to affordable, safe, effective, and quality-assured medicines and to improve access to palliative and rehabilitative services, particularly at the community level.
To leverage the UN High-level Meeting and the opportunity to complement efforts by heads of state, UN missions, and health ministers, the American Cancer Society joined with civil society partners to launch a Taskforce on Women's Health and NCDs. This taskforce mobilizes key organizations from cancer and other NCD communities such as the women's sexual/reproductive health and maternal, neonatal, and child health communities to collectively advocate for comprehensive women's health policies and resources, establish a common language, and share expertise. Founding taskforce members include the American Cancer Society, the World Heart Federation, the UICC, Women Deliver, Family Care International, the International Planned Parenthood Federation, PATH, Population Services International, and Jhpiego, with the Partnership for Maternal, Newborn and Child Health serving as a technical advisory partner. The taskforce goals are to increase global awareness and support for a gender-based approach to NCD prevention and control Specifically, this group aims to expand the technical capacity and resources available to meet emerging women's health needs in low- and middle-income countries, and to integrate NCDs with sexual and reproductive health, maternal and child health, and infectious disease efforts.
There is enormous potential in bringing civil society organizations together to advocate on global, regional, and national levels to address the leading cause of cancer death among women in the developing world—cervical cancer. Through Cervical Cancer Action (CCA), a global coalition of organizations with a shared goal of promoting a comprehensive approach to cervical cancer prevention that is co-chaired by the American Cancer Society and PATH, coordinated advocacy has resulted in nearly 400 letters of support from Presidents, First Ladies, Ministers of Health, Ministers of Women's Affairs, Parliamentarians, physicians and grassroots leaders calling for increased political and financial commitment to this critical women's health issue. Its Global Call to Stop Cervical Cancer petition has been signed by 1,200 people, including numerous governmental and civil society leaders throughout the developing world. In 2011, Cervical Cancer Action released a Progress in Cervical Cancer Prevention "report card" to assess global readiness to fight cervical cancer using new approaches and new technologies, especially in regions where the disease is most prevalent. The CCA report card underscores the urgent need for the global community to prioritize cervical cancer prevention and control.
For real change to occur, we must give those regions hit especially hard by women's health inequities priority attention. One such region is Africa, a continent that suffers from high rates of maternal mortality, infectious diseases, and a rising rate of cancer and other NCDs. Cervical and breast cancer in Africa outpace other forms of the disease, often striking when African women are in the prime of their lives. Women also face a stigma from cancer, and the poorly understood disease is often considered a death sentence and is feared more than HIV/AIDS.
To address the cancer burden in Africa and its unique impact on women, a ground swell of advocacy is emerging to raise awareness, influence policy, and build capacity and development for cancer control and prevention in the region. In its work with a coalition of regional leaders in Africa such as the African Organization for Research and Training in Cancer (AORTIC), Corporate Counsel on Africa, and the African First Ladies, the American Cancer Society has seen the progress and hope that is possible when leaders from the public and private sectors are engaged to address the region's emerging cancer threat. ACR has recently mobilized more than 150 civil society leaders from 15 countries and formed a powerful Africa Cancer Ambassador Network that focuses on promoting policies to prevent and control cancer in the region. A critical goal of this network is to help secure additional resources for the disease and place it as a priority on the global health and development agenda.
One of the most deadly global threats to women's health and in developing nations like those in Africa is the aggressive efforts of the tobacco industry to target women and girls in the region. Globally, tobacco use among girls is increasing and Africa is no exception. Mauritania and Namibia are among the African countries with a rising number of girls who smoke. In fact, sub-Saharan Africa is faced with the fastest growing rates of tobacco use in the developing world. Here, too, civil society is playing a key role. To fight this growing epidemic, the American Cancer Society has engaged with five other partners in the Africa Tobacco Control Consortium (ATCC) to implement an ambitious tobacco control program in sub-Saharan Africa. The overall goal will be to prevent and reduce tobacco use by implementing proven strategies at the national and local level.
In addition to the human cost, the economic impact of cancer and other NCDs is staggering and will continue to rise. A recent study by the World Economic Forum and the Harvard School of Public Health estimates that economic losses from NCDs total nearly $500 billion per year. This study estimates that the four primary NCDs plus mental health could result in a cumulative economic output loss of $47 trillion during the next two decades. The human and economic data combined show NCDs are a barrier to broader social, economic, and developmental progress.
Historic progress was made this year in driving attention to cancer and other NCDs as a global priority. As WHO Director General Dr. Margaret Chan noted, the UN meeting on NCDs was a "wake-up call" to the world to make NCDs an integral part of the global health agenda.
But future success is now in the hands of each sector of national and global stakeholders. Governments must be held accountable, and the private sector and civil society must work together in a whole-of-society approach to make the most of this unprecedented window of opportunity to turn the tide against chronic diseases, which cause more than 63% of deaths globally. If we act, collectively and urgently, we have the potential to reduce human suffering and save countless lives–both for women everywhere and for all those who suffer from non communicable diseases around the globe.
