Improving access to cancer care with City Cancer Challenge
Overcoming barriers to access in cancer care
Currently, over half of the world’s population lives in cities, with 95% of urban expansion in the next decades anticipated to take place in developing countries. As people continue to move to urban environments the world over, this brings an additional challenge of sustainable healthcare infrastructure and planning to national and local governments.
Cancer is the second leading cause of death worldwide, with 70% of mortalities occurring in Low-and low-middle-income countries (LMIC). Health systems are struggling to respond to a rising cancer burden, with an urgent need for timely diagnosis, standardisation of care, improved data systems, health financing, and a specialised workforce.
Supporting partners in establishing equitable access to quality cancer care
Roche has taken a lead role in an exciting partnership with
Since its launch in 2017 by the Union for International Cancer Control (UICC), C/Can has developed a new model of addressing access to cancer care that, for the first time, leverages the city as a key enabler in a health system’s response to cancer. The approach is built on the core principle that cities can drive impact at national level by crafting data-driven solutions with the support of a network of global, regional, and local partners that reflect an understanding of the unique local context. C/Can is currently active in
Roche is working with C/Can, along with partners from the private sector including additional healthcare companies and others, to bring an end-to-end, multi-sector health system solution for cancer care at the city level. C/Can engages with cities with populations of over 1 million in LMICs and aims to address the complex array of issues that can hinder access to quality cancer diagnosis, treatment, and care. Its mission is to create a global community of cities and partners working together to design, plan, and implement cancer solutions to save lives.
Roche is supporting C/Can to work with Rwanda’s Biomedical Centre in Kigali in setting up a patient navigation programme to improve cancer care for women in Rwanda. The
The participating clinics will now be able to coordinate the best treatment plan across multidisciplinary teams including oncologists, surgeons, radiation oncologists and pharmacists. Each team will have a designated nurse navigator to follow-up on all the stages cancer patients go through, including screening, data entry, treatment, discussion of available health insurance and advocacy. The project is expected to optimise the use of existing healthcare resources, support teleoncology for remote service delivery and be replicated in other C/Can cities so that many more patients can access quality care.
Five treatment hospitals in Rwanda are involved in the programme, with patient navigation now a national priority for the country. In all, more than 1,354 cancer patients have benefited from the improved patient navigation program as of June 2023. The impact of the programme was an accelerated treatment initiation pace, with 92% of patients touched by the programme initiating treatment in less than 60 days, compared to the baseline of 66%. This solution has proven to be a cost-effective intervention and it is hoped it will improve patient outcomes, improve adherence and reduce cancer-related morbidity and mortality.
Roche has also collaborated with C/Can to support its network of local, regional and global partners and experts in Asuncion, Paraguay. Together with C/Can, the
Cali was the first city to join C/Can, in May 2017, and Roche has supported the City Engagement Process in the city since the beginning. Some of the achievements locally were:
the development and endorsement of care guidelines for leukemia and breast, cervical, prostate and pediatric cancers;
standardization of pathology lab procedures;
palliative care training for health workers;
strengthening planning and capacity development for health workers,
a radiotherapy development and quality assurance plan.
All projects have now transitioned to a local independent, non-profit organization, Pro Pacifico, that is coordinating the implementation, scale-up, monitoring and evaluation of these efforts. Roche continues to support the cancer control work in Cali, focusing on breast and cervical cancer control and supporting a scale-up of HPV diagnostics for cervical cancer prevention.
Since C/Can began working with the government, the private sector and other stakeholders in the Georgian capital in 2019, the number of patients treated for cancer has doubled. This has come about due to a range of interventions, including the expansion of Universal Health Coverage. The Roche team in Tbilisi was proud to support C/Can’s initial engagement process in the city with public and private sector stakeholders, and through the development and execution of programmes and solutions to address priority needs.
In October 2023 Roche was the first signatory to Georgia’s Universal Health Programme for Oncology, an agreement which will ensure all citizens - regardless of income or insurance status - receive the full suite of oncology interventions for their specific needs.
In addition, following the Ministry of Health’s decision to include cancer diagnostics in the Universal Health program, C/Can is currently working with all relevant stakeholders to enable this huge step forward to ensure patients can be properly diagnosed in a timely manner.
Roche & C/Can impactful collaboration framework
The partnership with C/Can extends beyond a traditional funding mechanism, providing technical guidance, and strategic counsel and leveraging Roche’s expertise and deep understanding of local health systems. It is anchored in the following shared objectives:
To empower city stakeholders to design and implement tailored cancer care solutions, driving improved access to quality care.
To scale local innovations to strengthen national healthcare ecosystems and influence health policy.
To share locally generated knowledge and evidence to accelerate health system strengthening and showcase our collaborative, cross-sector model.
To ensure continued success for the partnership, C/Can and Roche have jointly established an impactful collaboration framework and a governance
The new partnership framework provides clarity on process and efficacy, transparency and enhances communication between partners. It also serves as a platform for local engagement, fostering impactful initiatives and a network for shared learning. Insights and learnings from the partnership can be found in the following
Find out more at
References
95% of urban expansion in the next decades will take place in developing countries -