Health Advocates Pushes for Implementation of Cancer Care Act and Universal Health Care Law Amidst COVID-19
The World Health Organization (WHO) tags cancer as the second leading cause of death around the world, with 9.6 million (or 1 in 6) succumbing to the disease in 2018. In the Philippines, there were over 141,000 new cancer cases and around 86,000 deaths recorded in the same year. Because of these alarming numbers, legislations like the Universal Health Care (UHC) Act and the National Integrated Cancer Control Act (NICCA) had their respective Implementing Rules & Regulations (IRR) signed in 2019.
But with the full implementation of the said legislations still pending funding, and with COVID-19 posing a great health risk to the immunocompromised such as those with cancer, patients and cancer caregivers may ask ‘what can be done about cancer care amid the pandemic?’
This is just one of the questions that The Economist Group’s webinar on October 7, entitled War on Cancer, aimed to answer. The discussion gathered experts in the medical field to talk about the impact of COVID-19 on cancer patients, to further emphasize the importance of having a comprehensive national healthcare plan in place, and to stress the necessary overlap that makes the UHC and the NICCA both beneficial in yielding significant economic and health-related returns.
The Cancer Care Act and the Universal Health Care Act
Dr. Clarito Cairo, Program Manager for Philippine Cancer Prevention and Control from the Department of Health (DOH), explained that though the full implementation of the NICCA was put on hold after focus was placed on the more wide-encompassing UHC, followed by the containment and control of COVID-19 in the country, the two laws are still on equal footing. “The UHC and the Cancer Care Act are equally important, and they complement one another. Even if COVID-19 is ongoing, we can implement the two laws because patients are waiting. They need assistance and services,” Dr. Cairo said.
Former Health Undersecretary Madeleine de Rosas-Valera stressed that while waiting for the implementation of the law, setting up a National Cancer Council would be key to ensuring the full implementation of the law. “We have to continue building on political champions to build a strong advocacy movement, both in government and local and even the private sector,” she said. “We have to continue coming up with strategies on how to address this, together with a group of people who have pure intentions of addressing cancer in the country.”
Valera also reminded that a consensus guideline on how to treat cancer should be implemented, followed by a cost analysis, and a needs-based assessment on whether new technology is needed to address gaps in cancer treatment in order to further support cancer control in the country.
Dr. Mae Dolendo, a pediatric oncologist from Southern Philippines Medical Center, also said that UHC and NICCA are not mutually exclusive. Investing in cancer care would actually be wise as it can pave the way to strengthen the current healthcare system. She pointed out, however, that the government alone cannot fund cancer care. “There has to be a civil society to fill in whatever gap the government has left. Stewardship is important – make the most out of our limited resources. Assess our existing resources. Apply the DOH strategy where we have regional centers that can deliver cancer care as well.”
Financing cancer control
The WHO reports that the economic impact of cancer is significantly increasing; in 2010, the total estimated amount was US$ 1.16 trillion in spending. A study by The Economist Intelligence Unit as well shows that the response of countries in the APAC Region to cancer are highly influenced by their stage of economic development – high-income countries, given their established health care system, are ahead in receiving quality cancer care versus lower-middle income countries.
Following this line of thought, bolstering funding for quality cancer care could possibly help improve cancer care in the country. Dr. Cairo said that they are pushing for a P541 million budget in 2021 to implement the cancer assistance fund pending approval from the legislative branch. Cancer Coalition Philippines Vice President Carmen Auste stated that the Department of Social Welfare and Development (DSWD) allotted a substantial amount under Bayanihan Act 2 for critical illnesses including cancer, and presented more action points that could help support cancer care further.
“The Department of Budget and Management approved a budget for all non-communicable diseases, but the budget that was approved was the amount being requested to fund cancer care,” Auste noted. “With the help of the DOH, I ask to directly go to the Department of Finance. In the context of budgeting, we need the Department of Finance and the Department of Budget and Management, and we ask in this forum to push for more advanced, comprehensive cancer centers. By 2030 there will be a 70% increase [in cancer incidence] and during COVID, cancer cases can actually double. For pharmaceutical companies, we ask if they can subsidize medicines given that PCSO has closed its cancer-subsidy window during this time.”
The Impact of COVID-19 on Cancer Care
Auste shared that around 75% of surveyed doctors who have attended to cancer patients said that their patients experienced a progression of the disease, and that new patients are unable to start treatment due to the discontinuance of care and service.
And on top of PCSO, a major source of funds for cancer patients, discontinuing its release of funds, more families are finding it harder to make ends meet with ongoing furloughs in various industries.
The panelists acknowledged these problems, but emphasized that being adaptable, proactive, camaraderie, and innovative can play a great role to help and still be able to provide care for cancer patients.
“Our doctors are very adaptive. They have shifted to oral medication instead of chemotherapy and have undertaken online consultations in order for patients to still get the care that they require,” Auste shared.
Dr. Cairo also added that the DOH has prepared guidelines on continuous provision of essential health services related to cancer diagnosis and treatment. “Our cancer patients should not be taken for granted.”
Valera emphasized that innovative strategies, innovative treatment, and innovative support can greatly contribute so that cancer patients can still have access amidst this challenging time.
“We should be in the process of reevaluating our capacity to deliver the needed health services that the Filipinos deserve. As we re-evaluate, we should try to look at the disease areas of equal importance. Non-communicable diseases are directly related to the infections of COVID-19,” Valera said. “We should also look at the diseases that will cause financial catastrophe to the health system. We just have to make sure that the responses are not just for COVID-19, but also for non-communicable diseases like cancer.”