Words cannot express how we all are beyond indebted to the health workers around the world. You are putting your lives at risk for the sake of saving all of us. You have given a new, profound meaning to the term “the ultimate sacrifice.”
Within the cancer community, health providers and patients alike have undoubtedly suffered the worst of the coronavirus’s double burden. We all know that cancer does not wait for Covid-19 to end. Its destructive work is genetically mapped out with precision. In fact, cancer thrives when the system is broken.
As a mother of a cancer survivor, I know only too well the worry of an infection for an immunosuppressed cancer patient. To add to that the anguish of having essential services for diagnosis or treatment canceled or delayed, when we all know that timing is crucial when it comes to cancer, is beyond imaginable. And to know that our precious health workers’ lives are at heightened risk because of the scarcity of inexpensive protective equipment is harrowing and shocking, to say the least.
Having said that, it has been extremely heartening to learn about how our cancer community has innovated and adapted to address the real challenges people face on the ground, day in and day out. The stories that have been shared are nothing short of heroic, with both personal and collective herculean endeavors being made to ensure that cancer diagnosis and treatment are not run over by the destructiveness of Covid-19.
Ironically, the fight against the coronavirus has required us all to don masks — and yet, it has taken the coronavirus, at a tragic and exorbitant human cost, to actually unmask and unmuzzle too many uncomfortable truths about a global health system that desperately needs investments and improvements to equitably care for all the patients who rely on it.
For one, many of the devastating effects of the coronavirus — including the shortage of equipment, staff, medication, lack of delivery systems, financial inaccessibility and lack of a decisive and unified political will and strategy — have been all too common issues when it comes to dealing with cancer for millions of people, mainly from low- and middle-income countries.
When we talk about 9.6 million people dying from cancer each year — I repeat, 9.6 million fellow human beings — a burden mainly carried by the poor and the disadvantaged within our global community, many governments and global leaders did not bat an eyelid. Why? Because the problem of treating cancer in lower-income countries was happening “elsewhere,” did not reach “our” shores and therefore did not affect “us” directly. Human nature at its basest.
It took Covid-19 to equalize the misery experienced by millions of the unfortunate amongst us, and to unmask this collective apathy to the very issues that are the daily lot of millions of disadvantaged cancer patients, particularly in poorer and middle-income countries but also at times within wealthier ones.
Many of these patients, still to this day, die needlessly from diseases that can be prevented, can be vaccinated against, can be screened for and for which, in many cases, there is a cure. Cervical cancer is the most striking example, where widespread screening, early diagnosis and HPV vaccination could actually lead to its eradication — and yet decisive action and adequate funding are not forthcoming.
So yes, in highlighting the need for health funding and the suffering of those who lack access to medical treatment, the Covid-19 crisis does have a few positives, if I dare say so.
Covid-19 has been the ultimate revealer of what we as a global health community have been saying and calling attention to for far too long: End the divisiveness between diseases.
We have always spoken out against the pitting of one disease over another; the either/or dichotomy of dealing with diseases rather than dealing with people, such as between communicable and non-communicable diseases. This approach has entailed serious consequences, in terms of both action and funding bias for one disease over another.
We have also been talking for a long time now about the shortage of about 18 million health care workers all over the world. And we are seeing the devastating effect of that now.
And we have pointed out the need for “implementation research,” which in plain words translate into looking at the role of non-medical infrastructure: delivery systems, financial systems, medical records and other issues that can affect the delivery of medical care. For too long now, a weak non-medical infrastructure has been the decisive factor in failing to secure an otherwise available treatment or cure that actually reaches the intended target: the patient who needs it. In low- and middle-income countries, for instance, there are considerable barriers to accessing pain relief medication for palliative care; while the North America is experiencing an opioid-related overdose crisis, low- and middle-income countries receive barely more than 0.03% of morphine-equivalent opioids distributed worldwide.
The issue of protective equipment sadly provides yet another example, as the lack of these non-sophisticated and inexpensive garments has been a major factor in accelerating the deadly spread of a highly infectious disease.
Furthermore, we have also spoken about the need to move towards universal health coverage — a model founded on equality in access to health care, on not leaving anyone behind, on a patient-centered approach, and on the strengthening of primary care.
I hope that once the Covid-19 nightmare is over, world leaders will take stock, rethink their priorities, and support the strengthening of health systems all over the world. Because humanity’s real war cannot be fought with guns, but only the power of a strong, sustainable and buttressed health system that is equitable for all.