1 hour ago
3
GENEVA, July 2 (IPS) - Anyone whose life has been touched by cancer knows that care is highly complex.From first symptoms through diagnosis and treatment, patients may need multiple diagnostic tests, combinations of surgery, systemic therapy and radiotherapy, and input from several specialists, alongside support services such as financial counselling, psychological support and palliative care.
Such a complex chain is inherently vulnerable, with one weak link meaning that a vital referral is missed, test results not delivered, or a patient is lost in the system while awaiting follow-up.As a chronic disease, cancer tests the full breadth of health systems like few other illnesses, exposing system-wide gaps that affect us all.
In low- and-middle income countries (LMICs), where more people are experiencing and dying from cancer, and resources are limited, the infrastructure that connects the elements of cancer care is often missing.
Health systems in cities offer a unique entry-point for building this connective tissue – for people with cancer and, ultimately, all others. Cities are close enough to patients to reveal the failures in care, and large enough to bring together the institutions, workforce, data and governance needed to fix it.
Cities are ground zero for closing the gap between cancer care policy and delivery in LMICs, which are projected to see cancer incidence rise 142 per cent by 2040 and represent more than half of new cancer cases and two-thirds of deaths by 2050.
Cities can offer the full range of health services that a patient needs: from primary care appointments to discuss initial symptoms to laboratory tests, imaging, surgery, chemotherapy and radiotherapy. These services are connected by a city governance architecture ensuring patients are referred from one institution to another, treatment is uninterrupted and services are financially accessible.
Cities also serve as referral and treatment hubs for surrounding areas, and even for neighbouring countries, meaning that developing stronger urban systems will undoubtedly create stronger national pathways of care, provided equity is designed in from the start.
This makes the city the most strategic starting point for closing the gap between cancer policy and delivery.
National cancer plans are essential, but they do not deliver care. Patient outcomes will only improve when these are actually implemented. And this requires policies being translated into time-bound, costed, funded programmes, and health authorities being given the governance structure, funding and authority to act earlier and more seamlessly to support better treatment and survival rates.
To transform this and turn policy into practice, governments and funders need to make at least two fundamental shifts.
First, they must move beyond externally designed interventions and invest in locally owned systems that can diagnose their own gaps, set priorities and sustain improvements over time.
Second, governments and funders need to stop treating national policy as proof of delivery and invest in the implementation mechanisms that make delivery possible and strengthen the systems at large.This means sustained investment in robust governance systems, defined referral pathways, sustainable financing and a trained and empowered health workforce.
At City Cancer Challenge (C/Can), we know this approach can work. We have seen how locally-led healthcare reform can ensure the fundamental processes and networks are in place to deliver long-lasting sustainable cancer care.
In Asunción, Paraguay, this approach showed what strengthening health systems means in practice. Improved diagnostic processes meant that women with suspected cancer were diagnosed earlier, started treatment sooner, and ultimately had better survival chances. It also meant that fewer women got lost along the pathway.
Asunción’s success came from coordinated action, not a single intervention. Laboratory quality improved, workforces were trained and empowered, protocols upgraded to international standards, and sample traceability strengthened across hospital services. Because these changes were locally owned and co-developed, they hold. This is what distinguishes real health system improvement from equipment that sits in a locked room, or protocols that disappear the moment external support does.
The value of this locally-owned model lies in its sustainability and scalability. Learnings from Asuncion can be used by other cities to identify bottlenecks in their own healthcare delivery, align institutions and build the local systems needed for better cancer care.
Cities have always been where health systems evolve, integrate and scale. And the impetus for strengthening LMIC health systems, starting in cities, is even greater to address the growing cancer crisis.
Where you live and who you are should not determine the quality of care you receive. Governments and funders should stop looking only at national cancer plans, protocols or new equipment. Instead, they should also ask whether local health systems can deliver timely, coordinated and equitable care, and invest accordingly.
Isabel Mestres, CEO, City Cancer Challenge (C/Can)
IPS UN Bureau
© Inter Press Service (20260702090728) — All Rights Reserved. Original source: Inter Press Service
