University Health Economist Heads New Commission to Examine Global Cancer Care Inequities
Dr. Felicia Marie Knaul, a professor affiliated with Sylvester Comprehensive Cancer Center and director of the Institute for Advanced Study of the Americas, will lead a new Lancet commission focused on building a connection between cancer and health care systems.
Dr. Felicia Marie Knaul, a member of the Cancer Control Program at Sylvester Comprehensive Cancer Center, director of the University of Miami Institute for Advanced Study of the Americas, and professor at the Miller School of Medicine, will lead a new commission at The Lancet, a top global medical journal, to examine how to simultaneously strengthen cancer care and health systems worldwide, especially in the wake of COVID-19.
Along with Dr. Knaul, the Lancet Commission on Cancer and Health Systems will be led by two other renowned cancer experts, Dr. Mary Gospodarowicz, a radiation oncologist and former medical director of the Princess Margaret Cancer Centre as well as a professor at the University of Toronto, and Patricia J. García, former minister of Health of Peru and professor in the School of Public Health at the Universidad Peruana Cayetano Heredia in Lima.
Harnessing the accumulated knowledge of more than 30 health care experts from around the world — including several former ministers of health — the commission is tasked with improving access to cancer care and to novel treatments for the disease worldwide.
“Our commission will explore how to harness the synergistic and mutually symbiotic relationships between cancer and health systems to improve outcomes,” said Dr. Knaul, an international health economist who focuses on Latin America. “COVID-19 can catalyze innovation and radiate new energy for systemic change. We are confronted with both a challenge and an opportunity to improve cancer control for everyone, everywhere, and to shake health systems out of an equilibrium of apathy through which some have access to ever-improving treatment and prevention, while many—mostly the poor—lack access to even the most basic treatment for pain relief and palliative care.”
Cure Rates Need Innovation
Research indicates that access to cancer care across the world is profoundly inequitable, and access to the latest treatments and forms of palliative care are limited to patients in high-income nations, the commission contends.
Meanwhile, the number of cancer patients continues to rise. An expected 28.4 million people are projected to have cancer by 2040. And current statistics indicate that in wealthy countries, 90 percent of children with cancer have the likelihood of cure, whereas in low-income nations, only 10 percent survive.
“We cannot wait any longer. It is not acceptable that with all the innovation and advances in cancer control, treatment, management, and palliative care, there are still abysmal gaps between countries and even in the same country between different populations,” said García, an alumna of the Miller School’s William J. Harrington residency program in internal medicine. “We need to raise the bar and innovate in different aspects of health systems to reach everybody with the best standards.”
Knaul has put forward a new framework that will be pioneered with this commission. As the announcement published recently in The Lancet shares: “Hope-guided economic decision-making seeks to leverage successes in combating diseases and assumes that scientific breakthroughs can be equitably distributed to strengthen health systems and economies, benefiting entire populations.”
“Cancer epitomizes the injustices of health care access…now, affordable, implementable solutions exist, yet survival gaps persist,” the commission wrote. “This global health failure is perverse.”
Dr. Knaul’s work and motivation for founding the new commission is rooted in her own experience with cancer and as a global advocate for better access to early diagnosis and care. Diagnosed in 2008 with breast cancer, Dr. Knaul founded Tómatelo a Pecho, a Mexico-based non-governmental organization that promotes research, advocacy, awareness, and early detection of women’s health issues in Latin America.
Improving Treatment Access
The commissioners also include Dr. Gilberto De Lima Lopes Jr., associate director of global oncology at Sylvester and medical director of its international programs, who is working to develop new treatments for cancer and to improve access with a focus on Latin America.
“Cancer is one of the most complex of health problems,” Dr. Lopes said. “To provide equitable care to all suffering with the disease we need comprehensive action — spanning from prevention and early diagnosis to individualized treatment and palliative care.”
Joining them is University President Dr. Julio Frenk, a distinguished global health leader and professor of public health. As Mexico’s Minister of Health from 2000 to 2006, Dr. Frenk introduced health system innovations through the program, Seguro Popular, to provide better access to cancer care and control for close to 50 million Mexicans. Dr. Frenk also believes that the that faculty and staff at Sylvester will offer a wealth of knowledge to the commission.
“At the University of Miami, we are uniquely positioned to respond to the global cancer challenge because of our world class Sylvester Comprehensive Cancer Center and our interdisciplinary core of capable and caring researchers, who have extensive hemispheric and international reach,” Dr. Frenk said.
Leadership at Sylvester, which became South Florida’s only National Cancer Institute in 2019, is thrilled that three faculty members will serve on the commission.
“Access to cancer care should never be based on geography or income,” said Dr. Stephen Nimer, a leukemia and lymphoma specialist who serves as director of Sylvester. “I applaud The Lancet for establishing this commission. It drives home the far-reaching impact that cancer care plays in improving overall global health, and I am proud that Dr. Knaul, Dr. Frenk, and Dr. Lopes have all been identified for their expertise in developing collaborative opportunities to improve cancer care and health care for all.”