The recently published City Cancer Challenge (C/Can) 2019 Annual Report serves as a powerful reminder that 2019 has been a landmark year for C/Can and its nine cities: Asuncion (Paraguay), Cali (Colombia), Greater Petaling (Malaysia), Kigali (Rwanda), Kumasi (Ghana), Leon (Mexico), Porto Alegre (Brazil), Tbilisi (Georgia), and Yangon (Myanmar). Starting with the transition to a standalone Foundation in January, and under the leadership of a new Board of Directors, C/Can has designed and implemented a new governance model, as well as policies and processes to underpin sustainable growth in the years ahead.
At the same time, in 2019 efforts focused on ensuring that local insights, knowledge and data were turned into tangible action for our cities’ leaders, healthcare professionals, patients and their families, through five core streams of work:
Improving the quality of cancer care infrastructure
C/Can has provided capacity building support to cities to help define quality standards and ensure harmonisation of practice in core areas including pathology, radiology, nuclear medicine, surgery, radiotherapy, medical oncology, and palliative care; as well as promoting ethics and patient-centred care; improving access to quality data and information management for informed decision making; and implementing evidence-based protocols.
“C/Can’s harmonised approach to cancer care will deliver a long-standing impact on the way radiotherapy is delivered in cities worldwide. We are pleased to count on Varian and Elekta’s support in our efforts to develop city-wide plans that improve access to quality radiotherapy.” Mary Gospodarowicz, Medical Director, Princess Margaret Hospital, C/Can Board Member
Enhancing the capacity of health professionals
In 2019, through a comprehensive technical assistance strategy and network of like-minded partners, 98 experts delivered technical assistance to 680 healthcare professionals working in a range of areas including pathology, radiotherapy, and palliative care.
“C/Can managed to bring together different institutions and specialists who understood and recognized the importance of applying guidelines and multidisciplinary work to manage breast cancer patients, despite the many weaknesses in our health system” Dr Valeria Sanabria Zuzulich, Breast Cancer Surgeon, Hospital de Clínicas, Paraguay
Developing sustainable financing mechanisms
C/Can is providing cities with the tools they need to access new kinds of capital. In Yangon, an in-depth analysis was conducted to quantify the demand for cancer services and assess the opportunity to expand treatment capacity and infrastructure in three of the city’s public hospitals. Building on this analysis, C/Can entered into a partnership with the International Finance Corporation (IFC), to strengthen health financing capacity among city stakeholders.
“IFC’s collaboration with C/Can will provide a roadmap to developing sustainable financing solutions for people with cancer in Yangon. This partnership will further help assess how cancer treatment can be applied to underprivileged communities, offering an opportunity to replicate the model in other emerging economies.” Ashani Chanuka Alles, Acting Country Manager for Myanmar, International Finance Corporation
Connecting and activating stakeholders
By engaging local, regional and global partners, and aligning their complementary skills and competencies, C/Can is supporting cities to address their priority cancer care gaps through integrated cancer solutions. In 2019, through its network of over 60 partners and 177 organisations, and partnerships such as that with ASCO, ASCP, ONS, IAEA, ISNCC, Hospital del Mar in Barcelona and the Catalan Oncology Institute (ICO), quality treatment guidelines for breast and cervical cancers have been established in 3 cities, and 19 cross-institutional and multidisciplinary cancer care groups have been set-up.
“C/Can has a critical role to play in coordinating and combining the strengths of local stakeholders and global experts to join forces to ensure that standard quality cancer care is available for all patients” Vanessa Eaton, Director of International Education, Department of International Affairs, ASCO
Informing data-driven solutions
C/Can is providing local decision-makers with a detailed snapshot of the cancer care situation and gaps in their city, so that solutions respond to local needs. Using C/Can’s innovative City Needs Assessment Questionnaire, we have produced 7 city assessments providing local decision-makers with current cancer care gaps. In Tbilisi, for example, 27 cancer care institutions, 174 healthcare professionals and 100+ patients contributed to the C/Can needs assessment process that informed the development of 12 priority projects in 2019.
“The bottlenecks and lack of data sharing among different health services where patients are treated wastes time, human and material resources. The scenario we are building together is the opposite of this.” Marcelo Capra Porto Alegre, Oncology Director, Grupo Hospitalar Conceição, Porto Alegre, Brazil
All of these efforts have required multidisciplinary and multi-sectoral collaboration. C/Can is openly committed to a multi-sectoral approach and belief that public-private partnerships are critical to delivering cancer treatment and care. Indeed, C/Can’s strength lies in its capacity to convene governments, cities, health and community organisations, health professionals, patients and the private sector to build resilient health systems to deliver quality cancer care.
“Reflecting on the progress made in 2019, we are reminded constantly of the power of the people most impacted to create the best solutions to the challenges they face. Helping to advance the implementation of locally-led solutions must be our focus in the year ahead.” Dr Susan Henshall, CEO, City Cancer Challenge