Cancer preparedness of Asia-Pacific countries

With more patients in need of help to access treatments, advocates welcome the recent announcement of the Department of Health (DoH) that it would allocate at least a P700-million annual budget to the cancer assistance fund.

During the “Cancer Conversations: From Policy to Meaningful Action” webinar held in partnership with the BusinessWorld, Health Secretary Francisco T. Duque III reaffirmed the government’s commitment to implement the National Integrated Cancer Control Act (NICCA).

“Historically, the budget trend for the cancer control program has been fluctuating and frankly, insufficient. By having NICCA in place and indicated in the draft Administrative Order on Cancer Assistance Fund, the annual budget for the Cancer Supportive Care and Palliative Care Medicines Access Program will now be at least 700 million pesos. This will allow us to cover more priority cancer types and allow us to give larger numbers of patients in minimizing, if not outright eliminating their out-of-pocket medical expenses,” he said.

With this pronouncement, things are starting to fall in place as the Philippines and other countries face global metrics, with a focus on how they are supporting cancer patients throughout their journey.

One such measure is the Asia-Pacific Index for Cancer Preparedness (ICP) by the Economist Intelligence Unit (EIU). The ICP measures how ready healthcare systems are for the challenge of cancer. It seeks to answer the question of how well-prepared countries are to achieve major reductions in premature deaths from cancer, increase cancer survival rates, and improve the quality of life for cancer patients and survivors.

The index explores the issue of cancer preparedness through three broad domains: (1) Policy and planning: focusing on levers that are mostly in the hands of policymakers; (2) Care delivery: looking at capacity to deliver cancer-specific services within health systems themselves; and (3) Health systems and governance: acknowledging that cancer cannot be defeated by cancer-focused activities alone.

Charles Goddard, editorial director at the Economist Group, discussed the key findings of their report during the policy forum co-organized with the Cancer Coalition Philippines (CCPh). 

This regional index had drawn upon the findings of the global ICP (which evaluated 28 countries based on 45 separate indicators) to provide a comprehensive overview of how well the 10 included countries in the Asia Pacific are doing in the key areas of this challenge.

The data analysis and key findings presented in the report were derived before the coronavirus disease 2019 (COVID-19) pandemic happened. However, as the report itself pointed out, “the key findings and priorities for addressing cancer control provision have now been thrown into sharper focus, and should be interpreted in light of the unfolding health system and economic impacts that the pandemic has wrought.”

The 10 countries included in the report, as discussed by Mr. Goddard, were chosen based on various factors including size, income-level diversity, and progress made towards universal health coverage (UHC). These were Australia, China, India, Indonesia, Japan, Malaysia, the Philippines, Thailand, South Korea, and Vietnam.

In the overall ICP scores ranking, Vietnam and the Philippines were bottom-dwellers. The report acknowledged the reality that countries in the vast Asia-Pacific region show great diversity in their healthcare needs, and responses to cancer are highly influenced by their stage of economic development.

High-income countries with established healthcare infrastructures are primarily dealing with quality-of-care concerns. Upper-middle-income countries are refining their UHC systems to close access gaps and ensure financial sustainability. Lower-middle-income countries, on the other hand, are setting up the foundations for an increasingly important cancer challenge.

The report found a strong positive association between income levels and performance in overall cancer preparedness. An influential indicator for overall performance in the index is “screening and early detection,” highlighting the importance of improving the early management of the disease in the region. Other influential indicators are “cancer registries” and “infrastructure.”

A strong correlation was also seen between the overall index score and cancer control outcomes. This demonstrates that, in broad terms, better performance in the index is consistent with countries achieving better cancer management outcomes.

While healthcare spending (as a percentage of GDP) is positively associated with performance in the index, there is a stronger association with political will, an indicator that includes not only funding but also institutional aspects like the commitment to universal healthcare.

This was echoed by former Health Secretary Manuel M. Dayrit when he said: “The message of the forum is the need for visionary leaders that is sustained at the national level. It’s the leadership that will bring the whole country together for cancer control, and for Universal Health Care.”

Clearly, we celebrate the achievements in the implementation of the Cancer Control Act and commend the people and groups behind them. With the desire to measure up to the global standards in supporting patients and their families throughout their journey, the government and the whole cancer community must continue their collaborations and advocacy.

Teodoro B. Padilla is the executive director of the Pharmaceutical and Healthcare Association of the Philippines (PHAP). PHAP and its member companies represent the research-based pharmaceutical sector in the country.