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Megan Smith


Prompt 2:What are some of the lessons for the developing world from US cancer
research? Are there any lessons?

The biggest lesson the developing world could learn from US cancer research is
persistence to the process. Many advances America has made are result of maintaining
the issue as a national priority both in terms of research and treatment by relentlessly
searching for cures. Ironically, many of our early advances that lead to pivotal
developments in cancer research were by-products of other goals or endeavors. America
seemed to prescribe to a trial and error methodology concerned more with treatment
rather than a fundamental quest for roots and causes of cancer at times. Other countries
could benefit from this mentality that is not afraid of seeking treatments. As researchers,
doctors and scientists took risks and stepped forward, they were rewarded and able to
make progress. Eventually through this process America became more equipped to target
cancer more specifically, however, all of our treatment efforts began with boldness to
take initiative and risk even in uncertainty.
The most important component is persistence in priorities. If combating cancer is
not a prioritized issue in developing nations they cannot expect to see improvement. The
main tools of understanding fundamentals, diagnosing through observation and then
curing need to be out into practice. In order to cure cancer, it must be diagnosable, which
means we must understand its etiology. Understanding the world is what translates into
practical results that can change the world. Governments in developing countries need to
decide cancer is priority. They must be held accountable, and the private sector and civil
society must work together in a whole-of-society approach because if we act,
collectively and urgently, we have the potential to reduce human suffering and save
countless lives (Seffrin). There needs to be a focus on promoting policies to prevent

and control cancer, as well as working to secure additional resources for the disease
(Seffrin). The Center for Global Health and Diplomacy reported that the American
Cancer society joined with other civil society partners to work towards acquiring
commitment from the government to increase access to affordable, safe, effective, and
quality-assured medicines, and awareness to cancer vaccines and screenings (Seffrin).
In order for a developing nation to prioritize cancer and demonstrate this through
prevention and control, there first must be awareness.
Prevention can only occur after there is sufficient awareness and education, which
is fundamental in the battle against cancer. Not only does cancer have an acute stigma,
this disease is poorly understood and is often considered a death sentence and is feared
more than HIV/AIDS (Seffrin). People in developing countries lack knowledge of
disease, even though it is a barrier to broader social, economic, and developmental
progress (Seffrin). It seems that governments themselves may also be lacking education.
Not only are developing countries losing money to these diseases, but they are also not
able to fully utilize their people because disease is hindering their potential prosperity as
a nation.
For example, worldwide, cervical cancer is devastating many nations and is the
fourth leading cause of cancer death in women world wide. In Sub-Saharan Africa and
South Central Asia, cervical cancer is the top killer among women (Seffrin). In Africa
advocacy is emerging to raise awareness, influence policy, and build capacity and
development for cancer control and prevention (Seffrin). Yet, in western countries it is
largely controlled, as the disease is extremely preventable and treatable with early
detection (Seffrin). If something is so preventable in western countries but not in

developing nations, cultural barriers among others are important to examine.

For example, in a Eastern Asian country, a public health group developed and
distributed iron blocks for families to place in their cooking pots to help prevent anemia.
People ended up using the iron blocks as doorstops. Then the group remanufactured the
iron blocks into iron fish, a symbol of good luck in the culture, and nearly everyone
began using them. In addition, many misunderstandings result as information being lost
in translation. In a public health course I watched a video in which an older man refused
dialysis due to his religion. He would have accepted injections as a treatment, but it was
not communicated clearly that this was an option he had and as a result he died when his
life could have easily been prolonged by the treatment. Cultural barriers also present
major issues outside of individual hindrances in terms of creation, deliverability, and
American persistence in BME is another lesson developing countries can learn
from. The practice needs to continue within developing countries and in America on
behalf of developing countries, and most importantly in collaboration between America
and developing nations. Most of the advances needed in developing countries have
already been made, but we need to get creative and learn to cater what we know and what
we have and find ways to make it functional within other countries unique infrastructure.
We cannot bring something made in America, whether treatment, drug, or equipment and
expect it to be successful anywhere else in the world. There need to be fundamental
distinctions to increase access for developing nations. An article on the history of BME
mentions that perhaps the greatest benefit of biomedical engineers is the identification of
problems and needs of our current health care delivery system that can be solved using

existing engineering technology and systems methodology (BME history 20). Its not
about creating something new, but learning to adapt and reform what we have and
catering it to present needs. Our catering of our biomedical advancements must be done
with certain ingenuity in terms of transport and standards of cultural sensitivity.
In class we talked about the ASSURED criteria for any device in a developing
country; which involved affordability, sensitivity, specificity, user- friendly, rapid and
robustness, and equipment-free. These criteria are not easily met, so we must explore
reforming what we have in accordance to our understanding of the countries we are
trying to aid. Just as understanding is the fundamental tool to finding a cure in terms of
cancer or disease, understanding a nation, its culture, society, and infrastructure are
necessary to any successful reform or change, whether that be in the field of public health
or any other sector. For example, cell phones are everywhere. Delivery doesnt seem to
be a problem in getting them to remote areas perhaps the question of deliver is less
about possibility and more about nations priority issues and their persistence and
attempts to reform them. We need to think of practical, viable ways to share our success
with other nations. All tools are useless unless applied, shared, and used to make change,
so we must apply the tools we have and learn to integrate them within another country.
Overall, the biggest lesson America can pass onto developing countries is
persistence and prioritization. To bring this about it might mean that America itself has to
be persistent in trying to engage other countries in making it a priority. Some things we
can begin with in other countries is helping them see the scale of the issue and showing
them the possibility of success. We need to attack what we know how. In terms of cancer,
that means we can strive for progress in lung, throat and mouth cancer as well as

administering the HPV vaccine for cervical cancer, which is currently a huge issue in
Africa when it doesnt have to be. The thing is, we must treat what we know how, but
engineer new ways to do it. Treatments exist and we need to learn how to make them
available, which, as mentioned before, requires the commitment of a nation to stand
against this form of cancer.
I believe other nations should address not roots of illness, but roots of their
inability to treat them. This might appear as if current health issues are being overlooked,
although it would create a better system to deal with the overall burden of disease, which
would save more lives in the long run.
Perhaps at the very base, the lesson America has to teach developing nations is
that the road to cancer treatment is a process. A process demanding utmost persistence
and prioritization, however even to have these things there must be a certain level of a
functioning health system within developing nations or else no progress will ever be
sustainable. I think developing nations can learn from us that the road to success is long
and strenuous, but also that there are pleasant surprises along the way and that answers
may be found even when were not looking for them. It is something extremely
frustrating as Americans to look at other countries and know how to fix their problems,
but then not be able to because our methods are incompatible with their systems, culture,
governments, etc. Instead of trying to treat other countries as if they are able to accept our
advancements, we need to help developing countries through a process that can bring
them to a place where they have a system more similar to what we have in the US.

Assigned readings:
- Biomedical Engineering: A Historical Perspective
- Cited as (BME history)
- Womens Cancer Needs to be a Global Priority: Why a Multi-Sector Commitment is
Needed to Reduce the Burden of Womens Cancers
- Cited as (Seffrin)