Keynote Message of Sec. Enrique T. Ona during the Dinner with the Philippine Cancer Society

September 9, 2010


Keynote Message of Sec. Enrique T. Ona during the Dinner with the Philippine Cancer Society


Manila Polo Club, Makati 
GREETINGS (VIPs)DR.  RACHAEL M. ROSARIO, Executive Director of the Philippine Cancer Society DR. ROBERTO M. PATERNO, Chairman of the PCS Board of TrusteesOur Honorees these evening–


Other members of the PCS Board of Trustees, our PCS Council of Advisers, my colleagues in the profession, other distinguished guests, ladies and gentlemen,

I am very honoured to be here this evening to join you as we give tribute to some of the great contributors to the work of the the Philippine Cancer Society --- a strong partner of the Department of Health in our cancer prevention and control programs, especially in maintaining our national cancer registry.

Perhaps some of you know that I have had my years of being part of the Philippine Cancer Society as a volunteer.  As a practitioner and a surgeon, I’ve always had a huge interest in improving the treatment and care of our cancer patients.  I know very well the affliction that patients have to face not only in terms of accessing costly treatments but also the personal suffering that comes with dealing with a tough and deadly disease that is cancer. I can think of no other condition that can cause such a painful, disabling, disfiguring and difficult experience to patients especially in our country where there is not much support to address the needs of those who are affected.

Ladies and gentlemen, I think that this is an opportune time to move cancer up in the national health agenda.  In fact, globally, there has been an emerging consensus in recent years to refocus efforts and resources of international funding agencies and governments to the intensifying challenge of cancers in developing countries like the Philippines along with other chronic disease challenges.

Last month’s issue of the Lancet talks about the so-called  “5/80 cancer disequilbrium” --- meaning that presently only 5% of global resources for cancer go to low- and middle- income countries where you have 80% of the total cancer burden.  In 2008, the Philippines was cited by the same Journal as one of the 23 countries that contribute to around 80% of the total deaths due to chronic diseases.  13% of these deaths is on account of fatal and disabling cancer.

The Lancet also raised the issue of the dismal survival rates in poor countries even for the most curable cancers --- breast, cervical and childhood leukemia.   The data can only reflect local reality because as it is right now, our health system is simply not able to provide expensive care and curative therapies (except for those who can pay) that are the mainstay of cancer management in richer countries such as the United States where we have seen cancer deaths drop in the last two decades.

However, the DOH agrees with the enlightened global perspective that doing nothing against cancer and other chronic diseases is not an option for the Philippines.   Cancer may be a difficult and complex health challenge but that is no excuse not to make it our priority and concern. Cancer is no longer a disease of the rich. In fact, we are being hard hit by the cancer epidemic.  Cancer will intensify in the next coming years as our nation grapples with the increase in major risk factors such as smoking, high-fat/cholesterol food intakes, alcohol use and poor physical activity.   If nothing is done to more effectively prevent and fight cancer, it will grow and spread with profound impacts that can impede our nation’s path to health and economic development.   

Ladies and gentlemen, I believe that together we can surmount barriers and improve current efforts to better address cancer in the Philippines.  We can do this especially for cancers that are highly preventable or curable by implementing a more comprehensive cancer control program that spans total cancer management including public awareness building, prevention and early screening, diagnosis, treatment and palliation.  Cancer care must be integrated in our health system.   Sources of sustainable financing must be identified.  And the delivery infrastructure must be built starting from primary care in our communities to specialized centers that can deliver affordable and high quality care given the increasing demand for services.

How can the Philippine Cancer Society help us toward this end?  The task is overwhelming but working together as we have done before, we can achieve anything!

First is through expanding and improving the quality of data provided by the National Cancer Registry.    This has been a crucial compass that has guided the DOH in setting policies, standards and interventions with regard to cancer prevention and control.  Beginning next year, I want us to widen the scope of the registry to other sites starting with Baguio, Cebu and Davao until we have attained nationwide coverage.   Help the Department of Health develop its capacity for cancer monitoring and surveillance.  Better information will lead to better cancer management.

Second is putting the National Integrated Program for the Prevention of NCDs into action.  The PCS must become a stronger voice in supporting our existing efforts on PREVENTION particularly those on tobacco control, physical activity, reducing environmental risks and implementing population-wide interventions that improve diet and nutrition.  Given that cancer care is expensive and even currently available vaccines are still beyond our reach, PREVENTION is still the smartest move against cancer.  A focus on prevention will make cancer control easier and a lot more affordable in the long term.

But while we target good primary prevention, we also have to make equal progress in delivering safe and effective cancer treatment especially where cure is possible.  And for late-stage cancer that is not amenable to currently available treatments, we should at least offer patients humane care through better access to end-of-life palliative treatment. 

I am aware of current efforts between the Department of Health and the Philippine Cancer Society on plans to pilot a Patient Navigator Program for women diagnosed with early stage breast cancer.  This builds on initial efforts of the DOH to provide a drug access program for children with leukemia that we started in 2009.   This effort is commendable as we look for innovative service delivery models that we can perhaps expand in the future as we try to address cancer more holistically using strategies that are appropriate to our settings.  In fact, globally, such models are being sought by international agencies such as the WHO, the World Bank and the Global Task Force on Cancer Control in Developing Countries which was formed last year by the Harvard Medical School and School of Public Health as well as the Dana Farber Cancer Institute.

Indeed, there is much to do and accomplish to improve cancer statistics in the country.  The long-term direction, I believe, is to make cancer a clear priority and its treatment and care an entitlement for patients, especially indigents. Cancer, after all, is a severely catastrophic disease that can drive patients into poverty.  Such insurance models are now already being done in other middle-income countries like Mexico and Colombia where there is some coverage afforded for cancer treatment especially for early stages when outcomes are most favourable. We shall be looking into providing financial protection for cancer through developing Philhealth benefits for catastrophic illnesses.  Here, I wish to enjoin the Philippine Cancer Society in developing clear national guidelines on cancer treatment and management that shall guide us in funding and delivering the most cost-effective treatments for the best outcomes.

To end, cancer requires a concerted effort of everyone.  While national leadership is needed on the part of DOH and government, there cannot be hope against cancer without your engagement.  Thank you and good evening!