Huge opportunity in global fight against cancer could be derailed

Next month's UN summit is hugely important

A decade ago, the fight against AIDS came into sharp focus when the first ever health-related United Nations (UN) summit was held about the disease. This led to an unprecedented international response, and eventually to the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Next month, it’s the turn of cancer and other non-communicable diseases (NCDs) such as diabetes and heart disease, when a special UN summit on NCDs is held in New York.

NCDs are a global problem, and are set to cause up to two-thirds of all worldwide deaths over the next 25 years.

This meeting presents a huge opportunity in the global fight against these diseases. But there’s also potential for the summit to pass by as a colossal missed opportunity.

What’s at stake

At Cancer Research UK, we’re backing recent calls for co-operation by governments to agree to concrete commitments and goals to tackle NCDs, and to agree on an overall objective to reduce preventable deaths from NCDs by 25 per cent by 2025.

Without such action, there’s a danger that a unique chance to save countless lives will be lost.

We’re also concerned by some of the points raised in a recent article in the BMJ about the role of certain industries in setting health-related policies. As the article points out:

“While non-governmental organisations and many public health professionals argue that legislation is needed for successful change, that is clearly not in the interests of industry.”

Whilst we acknowledge and welcome the role of some industries to help implement health policy, we’ve added our voice to over 100 other non-governmental organisations calling for [pdf] a clear distinction between this and their having any role in determining policy.

Decades of research tells us that up to half of all cancers could be prevented by changes to lifestyle, such as stopping smoking, reducing alcohol consumption, eating a healthy diet and staying in shape. And lifestyle changes also have a big impact on heart disease and diabetes.

So the food and drink industries, who are primarily answerable to their shareholders, have a major conflict of interest when it comes to thinking about policies aimed at cutting cancer and other diseases. We think that this conflict should disqualify them from being involved in setting policies around the consumption of their own products in the interests of public health.

Clearly, there needs to be more transparency and clarity around the role of industry in the prevention and control of NCDs – something that is lacking at the moment.

The devil is in the detail

In the run up to the UN summit, governments have been working on a draft declaration that will form the backbone of any future commitments to tackle NCDs. As you can imagine for such a hugely important document, involving so many different governments, several versions of the declaration are discussed, considered and debated before everyone is happy to commit to it.

The most recent draft of the document is being kept under wraps, but the BMJ has managed to sneak a peak. They’ve noted “subtle but clearly important” changes to language that could be undermining the overall goal of reducing deaths from NCDs such as cancer. They also say that “years of planning may be set to unravel” and that “member states are deeply divided on key issues”.

The BMJ agrees that the reasons for this are many and complicated, but one potential reason is that industry interests “might be trumping” evidence-based health interventions:

“There are numerous examples of the powerful sway that tobacco, alcohol, and food industries have over international governments and how this impedes effective health policy”

For example, some tobacco-producing countries are refusing to acknowledge the “fundamental and irreconcilable” conflicts of interest between the tobacco industry and public health.

Commitments and clarity

The opportunity presented by next month’s UN summit on NCDs cannot be overstated. As our director of tobacco control Jean King, said in a recent comment to the media:

“The United Nations meeting in September is an opportunity to ensure that diseases such as cancer, diabetes, heart and lung disease become central to long-term health planning across the world.

“The goal is to ensure that all countries focus on reducing the number of preventable deaths by 25 per cent by 2025. We need firm commitments to this goal otherwise this unique opportunity to help save lives will be lost. We urge all countries to commit to a coordinated global response to reducing deaths from preventable diseases.”

Coupled with these concrete government commitments, there needs to be much more clarity around the influence of industry in shaping policy. We think that the UN should develop a Code of Practice and ethical framework for industry, that clearly distinguishes between policy development, for which they should be kept at arm’s length, and implementation, where they obviously have a huge role to play.

As our colleagues at the American Society of Clinical Oncology point out, the UN summit on NCDs “has the potential to be a transformative event”.

But time is running out to make sure that the meeting lives up to this promise.

Oliver