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A Vision for Global Cancer Medicine: Pursuing the Equity of Chance
Agnes Binagwaho1, Claire M Wagner2, Paul E Farmer2
1Agnes Binagwaho, Ministry of Health of Rwanda, Kigali, Rwanda, Harvard Medical School, Boston, MA, and Geisel School of Medicine at Dartmouth College, Hanover, NH; Claire M. Wagner, Center for Global Cancer Medicine, Dana-Farber Cancer Institute, Boston, MA, and Union for International Cancer Control, Geneva, Switzerland; and Paul E. Farmer, Harvard Medical School, Partners In Health, and Brigham and Women's Hospital, Boston, MA. agnes_binagwaho@hms.harvard.edu.
Abstract:
At the turn of the century, some claimed that HIV/AIDS was a disease that could not be managed in low-income settings. It was argued that "poor people would not comply with treatment," and that treatment was too expensive and too complicated to deliver. But over the past two decades, data on outcomes have thoroughly disproved this myth. Similar arguments have more recently been made about cancer treatment: chemotherapy was said to be too toxic and too costly and that it required administration expertise beyond that available in low-income settings. We argue that these claims are similarly rooted in ideology rather than evidence. Fortunately, such claims are starting to be refuted by a diverse set of global cancer partnerships around the world that are documenting progress and positive results. In this review article, we provide examples of programs that can give us reason to hope that the treatment playing field is being leveled such that birthplace does not determine survival prognosis. We believe that through strong collaborative efforts and solidarity, the equity of chance can be achieved for patients with cancer worldwide.
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