Meet our "Doers", on their way to become Cities of Tomorrow

Cali

Colombia

With a population of 2.4 million, Cali is Colombia’s third-largest city, and in 2017 became the first city globally to join C/Can.  Cali is home to one of the oldest cancer registries in the region. Since joining C/Can, a further two healthcare institutions have been supported in establishing cancer registration. Building on the work of the City Executive Committee (CEC) and its Technical Groups, a draft resolution to implement multidisciplinary teams (MDT) and guidelines in all centres treating cervical and breast cancer patients has been referred to the Ministry of Health for endorsement, with the aim of incorporating it into national guidelines. In addition, the Secretary of Health of the Valle del Cauca region has approved the creation of a Regional Cancer Control Programme and a multi-sectoral advisory committee.  A city-wide sustainability plan has been developed with local stakeholders, including ProPacifico, a non-governmental organisation with a track record of successful collaboration with the government and private sector. ProPacifico will be responsible for continuing the implementation of C/Can projects and integrating them within local government priorities while maintaining engagement with multi-sectoral stakeholders.

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Asunción

Paraguay

Paraguay’s capital city, Asunción, is the country’s most populous, with 2.1 million people. Since joining C/Can in 2017, it has developed policies and guidelines to improve the quality of core cancer care services such as pathology and the delivery of multidisciplinary cancer care. A draft resolution to implement MDT and guidelines was sent to the Ministry of Health for endorsement and final implementation to treat cervical and breast cancer patients. Most significantly, C/Can local stakeholders spearheaded the development of the first Law for Comprehensive Cancer Care, recognising access to prevention and care as a right. At the same time, the National Programme for Cancer Control was established, while the multi-sectoral National Cancer Advisory Board composed of former members of the CEC, ensured continuity and strategic alignment of actions initiated by C/Can. This was part of a comprehensive sustainability plan developed by the CEC to deliver a lasting positive impact on cancer care in Paraguay. Through strategic partnership agreements signed with key stakeholders such as the National University of Asuncion, the Minister of Health of Paraguay, and a local civil society organisation, C/Can is transitioning leadership and responsibilities to local champions to achieve those goals.

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Yangon

Myanmar

The largest city in Myanmar, Yangon has a population of 7.36 million.  Its cancer care services serve the southern part of the country, with an estimated reach of 16.6 million people. Since joining C/Can in 2017, Yangon has taken action to improve the public network of clinical laboratories by developing standard operating procedures, training personnel, and developing a telepathology platform in collaboration with the American Society for Clinical Pathology (ASCP).  C/Can secured a partnership with the International Finance Corporation (IFC), a member of the World Bank Group, to support the government in expanding cancer treatment in the city, with the aim of leveraging the private sector to provide quality, equitable, and financially sustainable cancer treatment to Yangon. Going forward, IFC will work with C/Can to identify and structure sustainable public-private partnerships for the existing radiotherapy and medical oncology facilities in Yangon’s public hospitals.

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Kumasi

Ghana

With a population of 4.7 million, Kumasi is Ghana’s second-largest city and the capital of the Ashanti Region. Since joining C/Can at the end of 2017, 250 professionals from over 30 healthcare institutions have contributed data to a comprehensive assessment of cancer care needs.  Among their findings are: limited staff to provide cancer care and treatment; scarce laboratory services in most health facilities; shortages of equipment for cancer diagnosis and treatment; poor maintenance of equipment and the need for SOPs (Policy and Protocols) for treatment planning and execution. Eight projects were prioritised and developed in 2019 to address key gaps, including in the areas of radiotherapy, pathology, palliative care and cancer registration. Early achievements include the allocation of a dedicated office and meeting space for the cancer registry, supported by City Hall.

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Kigali

Rwanda

Kigali is the capital of Rwanda, and has a population of more than 1.6 million. Since joining C/Can in 2018, the city has successfully mobilised a multisectoral group of stakeholders, made up of over 120 healthcare professionals and 80 patients from 11 public and private institutions, which have contributed data as part of a comprehensive assessment of cancer care needs. Among the findings are that cancer care services are fragmented due to a shortage of service and trained workforce (physicians and technologists). There is also a lack of adequate facilities to provide medical oncology services in referral hospitals. Kigali also needs infrastructure for basic histopathology and clinical laboratory services. Patients have limited access to the network of public cancer care services, and there is an absence of resource-adapted guidelines for the management of common and curable cancer sites and corresponding treatment protocols. Work is underway to finalise the development of plans to address these gaps, including in the areas of information systems, quality imaging procedures and human resource planning.

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Porto Alegre

Brazil

With a population of 1.4 million, Porto Alegre is the capital and largest city of the southern Brazilian state of Rio Grande do Sul.  Since joining C/Can in 2018, Porto Alegre has undertaken an extensive assessment of key cancer care capacities and gaps, with input from over 100 patients and 160 healthcare professionals from the main public and private cancer care facilities. Thirteen projects are underway to address cancer care gaps, including in the areas of patient access to information, along with further strengthening and financial coverage of priority diagnostic and treatment services.

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Tbilisi

Georgia

Tbilisi, Georgia’s capital, has a population of 1.17 million and joined C/Can in February 2019. Since then, a robust needs assessment involving 27 cancer care institutions, 174 healthcare professionals and 100+ patients has been conducted, with data collected on the capacity of cancer care infrastructure, equipment, healthcare workforce, management, quality of care and community access. Cancer gaps identified include the need to increase quality and standardisation of cancer care, lack of harmonisation of quality assurance in pathology diagnostics, imaging, medical oncology and safety of surgery in cancer care, strengthening current education and professional training programmes in cancer care; improving management decision-making based on cancer registry data, improving the efficiency of financial coverage for standard diagnosis and care, and finally, establishing comprehensive support for cancer patients and their families throughout different levels of care.

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León

Mexico

León, in the central Mexican state of Guanajuato, was the fourth city in Latin America to join C/Can. The third leading cause of death in the country, cancer was the attributed cause of more than 83,000 deaths in 2018, with some 191,000 new cases detected. 1,029 people died of cancer in León in 2018, with breast cancer the main cause. The state authorities have implemented measures to combat the burden of cancer, including efforts to improve the timely detection of breast cancer, as well as a study to assess the feasibility of developing a population-based cancer registry for the city. At an event held in September 2019, chaired by Héctor López Santillana, Mayor of León, key stakeholders from across the public and private sectors reaffirmed their support and commitment to improving access to quality cancer care through the C/Can process.

Greater Petaling

Malaysia

On 15 October, 2019, at the World Cancer Leaders’ Summit in Nur-Sultan (Astana), Kazakhstan, Union for International Cancer Control (UICC) Board Member and President of the National Cancer Society of Malaysia, Dr Saunthari Somasundaram, announced that Greater Petaling was joining C/Can. The second city in Asia to join the organisation, it is made up of Petaling Jaya and Subang Jaya, in Selangor, Malaysia’s most-developed state. The city provides cancer care services to a population of just over 1.4 million. WHO data shows that 43,837 new cancer cases and 26,395 cancer deaths were reported in 2018 in Malaysia. The three most frequent cancers in men and women (excluding non-melanoma skin cancer) in 2018 were breast, colorectum and lung. Malaysia is an upper-middle-income country, with the building blocks of a health system firmly in place, but gaps still exist in terms of access to timely diagnosis and care, with relatively low cancer survival rates compared to other upper-middle-income countries