Cancer as a Social Challenge for Asia

In recent years countries around the world have been engaging in efforts towards the standardization of medical care. These efforts include domestic efforts to realize standardization within individual countries, and also wider efforts towards international standardization of medical care. These efforts have cumulated in the compilation of various standardized treatment manuals, or guidelines, for the treatment of many conditions, which are now in use around the world. However, even if such guidelines are in place, their existence does not necessarily guarantee that all cancer patients will receive the same, uniform treatment. Guidelines are compiled on a scientific (medical) basis and in the context of various constraints. No matter how medically effective the treatment method that is detailed in a guideline may be considered to be, if circumstances in a country (regional or demographic) prevent that treatment from being used, it is impossible to provide treatment in accordance with the stipulated guidelines. This constraint has an immense impact on standardization and the use of guidelines. In an era where the internet spans the globe, all people have access to information about medical treatment, regardless of national borders. However, when people?whether they be patients, family members or medical practitioners?realize that for various reasons they are unable to receive or implement such treatment, this causes personal dilemmas and considerable stress. It is easy to foresee that this individual and personal stress then develops into various types of societal stresses.

When researchers from Asian countries engage in discussions on clinical approaches to cancer, there are times when I get the feeling that there are gaps of perception in the discussions, or that we are talking on different planes. This is because that in each country virtually the same types of reports are being provided with regard to treatment methods and treatment results. The spread of international treatment guidelines is considered to be one of the factors affecting this uniformity in reporting. It is also the case that in many of the countries in Asia it is only patients with economic power, living in major urban centers, and patients at the upper end of the social scale who have access to the latest treatment methods. The reports that are provided from these countries are therefore based on the results of treatment to this limited range of patients. Given this situation, there are also times in discussions with researchers (clinicians), who you may know well, when you ask “What percentage of the population receives treatment in line with international guidelines?” and sometimes the atmosphere in the room changes and stiffens. There are still not all the countries in Asia where the great majority of the population has access to the same high standard of medical treatment. However, despite the fact that Asian researchers have worked hard to achieve results in cancer treatment that are on a par with their counterparts in Europe and North America, the various international cancer-related academic gatherings that take place in Asia have to date failed to address the key challenge of equity in treatment head on.

At the United Nations High-level Meeting on Non-communicable Disease Prevention and Control in 2011 the link between health and socioeconomic issues was raised, becoming a global political issue. 1. To date, the challenge of health equity is one challenge, as mentioned above, that has not been addressed directly, however, there is a growing shared recognition that cancer in Asia is an urgent social issue.
2. The realization that health issues are at the same time economic issues and that they present a global political challenge if they are to be resolved, and the fact that this recognition was given a voice at the UN high-level meeting, is one of the achievements of international efforts to tackle and control cancer.