KALAYAAN MULA SA KANSER : PASS AN INTEGRATED PHILIPPINE CANCER ACT NOW!
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· Cancer is a growing and serious public health concern. It is inextricably linked with the achievement of the country’s poverty reduction and development goals.
· Cancer incidence is increasing and is ranked as one of the leading causes of death among adults and children. As of 2012, 189 out of 100,000 Filipinos are afflicted with cancer every year. At least 3,900 children are diagnosed with cancer every year.
o A recent report of the Philippine Statistical Authority (PSA) states that one in every ten registered deaths in the country is attributable to cancer. Since 2004, cancers have been the third leading cause of death following cardiovascular diseases; for child mortality and morbidity, cancer ranked 4th.
o Experts opine that the actual cancer burden and cancer mortality in the Philippine is in fact very much higher than what is currently being reported. Many more remain uncounted, unrecorded and unreported due to the absence of national cancer registries.
· Survival rates for the most common adult cancers (i.e. lung, breast, colon, cervical, prostate, liver) are relatively low compared to other countries in Asia and the world.
o For females, all cancer mortality rate, the Philippines ranks second highest among 15 countries in Asia, with 124 deaths per 100,000 population.
o Compared to Asian countries, the Philippines has the highest mortality rate for 2 types of cancer: breast (27 per 100,000 population) and prostate cancer (13 per 100,000 population. Lung cancer mortality rates are also high exceeding 40 per 100,000 population. For breast cancer, the Philippines also has the lowest survival (.58 mortality to incidence ratio.
o For childhood cancers, which now has an average survival rate of 84% in high income countries and a growing number of middle income countries, average survival rate in the Philippines is at a low 30%.
o Cancer is a catastrophic disease which pushes families deeper into poverty. It debilitates not only patients, but also their families and loved ones.
o The financial burden can be overwhelming, given that financial risk protection mechanisms are limited and patients often need to shell out money from their own pockets to pay for treatment and other costs, such as medical supplies, food, and transportation.
o Evidence shows that in a cohort of cancer patients, the mean out-of-pocket expenditure for cancer treatment, far exceeded the mean household income; 117 percent at baseline to 253 percent twelve months after, leading more than 56 percent of households into financial catastrophe. This does not yet factor in the staggering economic and social costs, with productivity losses for both patients and immediate caregivers.
o This huge out of pocket costs often deter health seeking behavior or leads to discontinuance and abandonment of treatment (i.e. voluntary stoppage of necessary treatment by patient /family) . In some areas and with certain types of cancer, abandonment or discontinuance of treatment can be as high as 75% while average treatment compliance is at a low 21%. These conditions are most observed among the poor. marginalized sectors but occurs even among the so called middle class.
· Incidence of cancer is projected to increase by as much as 80%, by 2030, in low resource countries like the Philippines (WHO). This will have a staggering effect on the ability and resiliency of the Philippine health system as well as its overall economy.
THUS, PURSUANT TO THE CONSTITUTIONAL PROVISIONS OF ARTICLE II, SECTION 15 , WE CALL ON GOVERNMENT TO PASS A LAW WHICH WILL EXPAND EFFORTS TO EFFECTIVELY MANAGE AND CONTROL CANCER, IN ALL ITS FORMS, BY INCREASING INVESTMENTS FOR ITS PREVENTION, EARLY AND ACCURATE DETECTION, OPTIMAL TREATMENT, AND BY ADOPTING AN INTEGRATED, MULTI-DISCIPLINARY, AND PATIENT/FAMILY CENTERED APPROACH.
We ask that this law include provisions that will have the following integral elements.
Strengthening of Cancer Care Infrastructure and Service Delivery Networks to cover the continuum of care. Public health facilities shall be strengthened to provide services spanning prevention, detection, diagnosis, treatment, palliative and hospice care, survivorship follow up and rehabilitation. This entails (a) providing investments in health facility renovation or upgrade, (b) providing reliable supply of medicines, biologics, and other supplies, (c) training and enhancing oncology related capacities in pathology, radiotherapy, surgery, nursing care, (d) establishing clear protocols for patient navigation and palliative care, (e) ensuring proper recording and monitoring of cancer cases , and (f) ensuring that recording and monitoring extends to primary health care units. Regional Cancer Centers shall likewise be designated in strategic areas to improve access to optimal care and reduce patient costs. Robust and cost effective refer all systems among various levels of service delivery shall be institutionalized.
Strengthening the capacity of the Human Resources for Health in Cancer Care. A competency-based curriculum for all health care workers providing cancer care treatment and support at all levels of the healthcare service delivery system shall be created. This shall include multi-disciplinary, interdisciplinary approaches to cancer care. This will also include adoption of cost-effective teaching platforms for enhanced knowledge, skills, and attitude and implementation of health worker accreditation and certification mechanisms.
Strengthening the FDA to ensure the safety, quality, and efficacy of medicines, biologics, and other health technologies. The Food and Drug Administration (FDA) shall strengthen its regulatory capacity to ensure availability of safe, efficacious, quality medicines, biologics, and other health technologies for cancer patients. The FDA shall also develop policies facilitating clinical trials, supporting early access to innovative therapies and health technologies to ensure highest possible fighting chance of survival among people with cancer.
Institutionalizing Funding and Social Protection Mechanisms for Cancer Patients, Survivors, Caregivers, and their Families. Given the catastrophic nature of cancer and in order to ensure equitable access to treatment and care, there is a need to provide financial support to cancer patients, survivors, caregivers, and their families in the following forms:
(1) Establishment of a Cancer Assistance Fund to reduce out-of-pocket expenditures for diagnosis, treatment, follow through survivorship care and rehabilitation services. This may be sourced from pooled and integrated funds from the Department of Health, Department of Social Welfare and Development, Philippine Charity Sweepstakes Office, Philippine Amusement and Gaming Corporation, among others.
(2) PhilHealth Benefit Packages for Cancer. The Philippine Health Insurance Corporation (Phil Health) shall develop and/or expand its benefit packages to include all forms of cancer including metastatic cancers and high risk cancers in children .
(3) Social Protection Mechanisms for cancer patients, survivors, caregivers, and their families. The State, in collaboration with DOH, SSS, GSIS, PCSO, PAGCOR, DOLE, DSWD, DOLE and LGUs shall develop social protection mechanisms to support the needs of the cancer patients, survivors, caregivers and their families to reduce, if not eliminate catastrophic cost and ensure well-being.
Establishment of a National Cancer Registry and Surveillance System and Evidence Generation. A National cancer registry and surveillance system covering all forms of cancer among adults and children shall be designed and implemented to support program decision-making. All public and private health centers, hospitals and facilities shall also observe notification protocols to alert the DOH of all cancer cases.
National and regional research and demonstration projects shall be conducted to generate evidence to improve policies and the implementation of the Integrated Philippine Cancer Control and Management Program (IPCCMP).
Strengthening Health Promotion, Information, and Education Programs. Health promotion and education activities shall be strengthened in schools and learning institutions, work places, communities, and among vulnerable, at-risk, and disadvantaged populations. A National Cancer Information Office shall also be developed to develop platforms (e.g. interactive websites) to provide comprehensive cancer information services to cancer patients, their families, the public, and health professionals.
The DOH, in coordination with the Philippine Information Agency (PIA), KBP (Kapisanan nang Broadcasters nang Pilipinas) and other related institutions , shall encourage media outlets to launch a media campaign on adoption of healthy lifestyles, early warning signs and symptoms of cancer, cancer prevention and control, treatment and management, using all forms of traditional multimedia and social media. The media campaign shall maximize participation of advertising agencies in developing behavior change communication materials that would promote cancer information and encourage adoption of health lifestyles among the public.
Establishing National Cancer Screening Programs. Identifying cancer at the earliest possible stage means that treatment is less costly, cure is most likely, survival rates will increase and health outcomes will become more positive.
We envision that creation and passage of this law will ensure that a diagnosis of cancer will no longer be akin to a a death sentence and that Filipinos will be able to fight and survive cancer just like citizens of other countries in Asia and the world.
Increased survivorship and improved health outcomes for Filipinos with cancer will contribute to our countrys achievement of Sustainable Development Goal 3 (Reduce mortality from cancer by at least 30%) as well as the realization of our countrys health and development priorities.
KALABANIN ANG KANSER TUNGO SA TUNAY NA KALAYAAN!
CANCER COALITION PHILIPPINES
- PHILIPPINE CANCER SOCIETY
- PHILIPPINE SOCIETY OF ONCOLOGISTS
- I CAN SERVE FOUNDATION
- CANCER WARRIORS FOUNDATION
- CAREWELL COMMUNITY FOUNDATION
- PROJECT: BRAVE KIDS
- PHARMACEUTICAL AND HEALTHCARE ASSOCIATION OF THE PHILIPPINES
 Ngelangel et al (2016). Philippine Costs in Oncology Study.
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