WHO - Reducing Barriers To Accessing Cancer Care

Costeas-Geitonas School Model United Nations 2022
Committee: World Health Organization (WHO)
Issue: Reducing barriers to accessing cancer care
Student Officer: Lida Galati
Position: Deputy President
INTRODUCTION
Since the very early days, researchers and archaeologists have found cases of
cancer. Some of the earliest evidence of cancer is found in human mummies, and
manuscripts, in ancient Egypt. Growths suggestive of the bone cancer “osteosarcoma”
have been found among fossilized bone tumors. 1
Surgery, chemotherapy, radiation therapy, hormone therapy, targeted therapy,

including immunotherapy like monoclonal antibody therapy, and synthetic lethality are all
options for treating cancer. In most cases, these options are used in combination with one
another, such as preoperative chemotherapy. The location, size, and stage of the disease,
as well as the patient's general health, all influence the therapy option. Although cancer is
a universal disease there are some barriers that multiple patients have come across when
seeking cancer treatment. As cancer continues to grow rapidly and affects more people, we
must take some time to recognize, assess and fully understand the barriers one may face
when dealing with such a condition. Several factors might contribute to the delay in getting
cancer care.
For example, that includes the difficulty in accessing proper care when the patient
lives in rural areas and a medical institution that offers competent care may be difficult or
in some cases costly to access. Moreover in certain countries that do not have free health
care this may be a great challenge for low income families as the medication and
treatment, such as chemotherapy or radiation therapy can be quite high-priced.
Over and above that taking into consideration conditions globally some regions
that offer medical institutions may not be sufficient in general. For example it is not a rare
phenomenon that hospitals experience a lack of medical supplies and that can be vital
1
"Understanding What Cancer Is: Ancient Times to Present." American Cancer Society | Information and Resources About for
Cancer: Breast, Colon, Lung, Prostate, Skin, 4 Jan. 2018, www.cancer.org/treatment/understanding-your-diagnosis/history-of-
cancer/what-is-cancer.html.
1
when treating a delicate and exigent disease like cancer. to add to that more often than
not there may be communication problems between the medical staff and the patients.
This may be one of the main reasons that the patient has not yet completely understood
the depth of the treatment and may in some cases even drive the patient away from
completing the treatment or seeking it in the first place.
DEFINITION OF KEY TERMS
Cancer
“Cancer is a large group of diseases that can start in almost any organ or tissue of
the body when abnormal cells grow uncontrollably, go beyond their usual boundaries to
invade adjoining parts of the body and/or spread to other organs A neoplasm and
malignant tumors are other common names for cancer.”2
Cancer Care
“The sum of knowledge regarding tumors3 and cancer, or the study of these
conditions and the care and treatment of patients with cancer”
Chemotherapy
“Treatment that uses drugs to stop the growth of cancer cells, either by killing the
cells or by stopping them from dividing”4
Radiation therapy
“The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and
other sources to kill cancer cells and shrink tumors. Radiation may come from a machine
outside the body, or it may come from radioactive material placed in the body near cancer
cells. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled
monoclonal antibody, that travels in the blood to tissues throughout the body.”5
Hormone therapy
2
"Cancer." WHO | World Health Organization, 12 July 2019, www.who.int/health-topics/cancer#tab=tab_1.
3
"Tumor." TheFreeDictionary.com, medical-dictionary.thefreedictionary.com/tumor.
4
"NCI Search Results." National Cancer Institute, www.cancer.gov/search/results?swKeyword=chemotherapy.
5
"NCI Search Results." National Cancer Institute,
www.cancer.gov/search/results?swKeyword=radiation+therapy.
2
“Treatment that adds, blocks, or removes hormones. To slow or stop the growth of
cancer, synthetic hormones or other drugs may be given to block the body’s natural
hormones, or surgery is used to remove the gland that makes a certain hormone.”6
immunotherapy
“A type of therapy that uses substances to stimulate or suppress the immune

system to help the body fight cancer, infection, and other diseases. Some types of
immunotherapies only target certain cells of the immune system. Others affect the
immune system in a general way. Types of immunotherapies include cytokines, vaccines,
bacillus Calmette-Guerin (BCG), and some monoclonal antibodies.”7
Synthetic lethality
“Describes a situation in which mutations in two genes together result in cell

death, but a mutation in either genos alone does not. Cancer cells that only have one
mutated gene in a specific pair of genes can depend on the normal partner gene for
survival. Interfering with the function of the normal partner gene may cause cancer cells to
die.”8
Healthcare professionals
“Health professionals maintain health in humans through the application of the

principles and procedures of evidence-based medicine and caring. Health professionals'
study, diagnose, treat and prevent human illness, injury and other physical and mental
impairments in accordance with the needs of the populations they serve.”9
Oncology
“A branch of medicine that specializes in the diagnosis and treatment of cancer. It

includes medical oncology (the use of chemotherapy, hormone therapy, and other drugs to
6
"NCI Search Results." National Cancer
Institute,www.cancer.gov/search/results?swKeyword=hormone+therapy.
7
"NCI Dictionary of Cancer Terms." National Cancer Institute,
www.cancer.gov/publications/dictionaries/cancer-terms/def/immunotherapy.
8
www.cancer.gov/publications/dictionaries/cancer-terms/def/synthetic-lethality.
9
"Definition and List of Health Professionals - Transforming and Scaling Up Health Professionals' Education and
Training - NCBI Bookshelf." National Center for Biotechnology Information,
www.ncbi.nlm.nih.gov/books/NBK298950/.
3
treat cancer), radiation oncology (the use of radiation therapy to treat cancer), and surgical
oncology (the use of surgery and other procedures to treat cancer).”10
Chromosomal instability
“Chromosomal instability (CIN), the inability to correctly segregate sister

chromatids during mitosis, provides the evolutionary fuel to initiate and propagate the
transformed state of multiple forms of cancer.”11
Mitosis
“A process of cell duplication, or reproduction, during which one cell gives rise to
two genetically identical daughter cells. Strictly applied, the term mitosis is used to
describe the duplication and distribution of chromosomes, the structures that carry the
genetic information.”12
Noncommunicable diseases
“Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of

long duration and are the result of a combination of genetic, physiological, environmental
and behavioral factors.”13
BACKGROUND INFORMATION
Cancer
Cells are the foundation of our body. Cells are just like us, they grow and divide
when the body needs them too, and when they are too old or damaged, they die, and new
cells replace them and so on and so forth. “The origin of the word cancer is credited to the
Greek physician Hippocrates (460-370 BC), who is considered the “Father of Medicine.”
Hippocrates used the terms carcinos and carcinoma to describe non-ulcer forming and
ulcer-forming tumors.”14
10
www.cancer.gov/publications/dictionaries/cancer-terms/def/oncology.
11
“Mitotic chromosomal instability and cancer: mouse modeling of the human disease by Juan-Manuel
Schvartzman,” Rocio Sotillo,and Robert Benezra, february 10 2010 mitotic chromosomal instability
12
"Mitosis." Encyclopedia Britannica, www.britannica.com/science/mitosis.
13
"Non Communicable Diseases." WHO | World Health Organization, 13 Apr. 2021, www.who.int/news-
room/fact-sheets/detail/noncommunicable-diseases.
14
"Understanding What Cancer Is: Ancient Times to Present." American Cancer Society | Information and
ResourcesAboutCancer,www.cancer.org/treatment/understanding-your-diagnosis/history-of-cancer/what-is-
cancer.html.
4
Each cell has its one life cycle. That can differ when it comes to different types of
cells. As cells get damaged new cells take their place. Cancer disrupts this process and
because of mutations in the cells, DNA the cells infected grow abnormally. The genetic
information in each cell has all the instructions needed to inform the cell what to do, how
to grow and then later divide. Mutations in the DNA are not a weird phenomenon, they
happen quite often, although this may be true, cells usually “correct” these mistakes on
their own. When a mistake is not corrected, a cell can become cancerous. A tumor begins
to form when these genetic changes interfere with this rather peaceful and orderly
process.
Although some types of cancer do not form tumors. “These include leukemias,
most types of lymphoma, and myeloma”15. Fundamentally, cancer is a condition where
cells in an area of the body reproduce uncontrollably. The cancerous cells can invade and
potentially destroy healthy tissue and maybe even whole organs if it gets to such an extent.
Numerical CIN is a high rate of either gain or loss of whole chromosomes, also
called aneuploidy. Normal cells make errors in chromosome segregation in about 1% of cell
divisions, whereas cells with CIN increase the mistake rate to 20% of all cell divisions. As
opposed to that, structural CIN is the rearrangement of parts of chromosomes and
amplifications or deletions within a chromosome. Almost all tumors show CIN, and is
evident in about 90% of all human cancers where it exhibits chromosomal abnormalities
and aneuploidy.
The consequence of chromosomal instability can cause severe changes that impair
the expression of thousands of gene products, thus radically altering the phenotypes of
cancer cells, enabling progression or intrinsic multidrug resistance. That can be a challenge
to any countries that their current economic state does not allow them to further explore
CIN and find a treatment that combats, in time, what CIN can cause.
It is also worth mentioning that there are many types of cancer regarding where it
was first formed. There are over 200 types of cancer but the main four consist of:
Carcinomas. A carcinoma begins in the skin or the tissue that covers the surface of
internal organs and glands. They are the most common type of cancer. Examples of
carcinomas include prostate cancer, breast cancer, lung cancer, and colorectal cancer.
15
"What is Cancer?" Cancer.Net, 4 Oct. 2019, www.cancer.net/navigating-cancer-care/cancer-basics/what-
c%C3%A1ncer.
5
Sarcomas. A sarcoma begins in the tissues that support and connect the body. A sarcoma
can develop in fat, muscles, nerves, tendons, joints, blood vessels, lymph vessels, cartilage,
or bone. Leukemias. Leukemia is a cancer of the blood. Leukemia begins when healthy
blood cells change and grow uncontrollably. Lymphomas. Lymphoma is a cancer that
begins in the lymphatic system. The lymphatic system is a network of vessels and glands
that help fight infection. This type of cancer begins in the cells of the immune system
Figure 1: Cancer Metastasis16
As a matter of fact, cancer is the second biggest cause of all deaths globally. In the
UK alone one in every two people will form some type of cancer at least once in their
lifetime.17
A study conducted by the European Cancer Information System revealed that the
cancer burden is estimated to have risen to 2.7 million new cases and 1.3 million deaths in
2020. These estimates reveal that cancer affects men slightly more than women, with 54%
of new cases and 56% of deaths. As is well known, cancer mostly affects older adults. The
2020 estimates reveal that 62% of estimated new diagnoses and 76% of estimated deaths
occur in people over 65 years old.18
16
“metastatic cancer: what happens when cancer spreads”, by Kellie Bramlet Blackburn, May 25 2021:
metastatic cancer
17
“ Cancer research UK” cancer statistics UK
18
“2020 Cancer incidence and mortality in EU-27 countries”, 22 july 2020: cancer research
6
Figure 2: Statistics about the diagnosis of cancer19
Figure 3: Statistics about mortality rates in 202020
Cancer treatment
The complete elimination of cancer without damaging the rest of the body - treatment
with near-zero adverse effects- is the ideal goal of treatment, although rarely achieved, and is
often sought in practice. Sometimes this can be achieved by surgery, but the tendency of
cancer to infiltrate adjacent tissue or spread to remote areas with microscopic metastases
often limits its effectiveness, and chemotherapy and radiation therapy can have negative
effects on normal cells.
It is vital to treat cancer in its early stages as that is recommended by the medical
community in order to lower the chances of an untreatable stage of cancer. There are various
19
“cancer statistics” 2020, https://www.cancer.gov/about-cancer/understanding/statistics
20
“cancer mortality rates 2020”, cancer statistics https://www.cancer.gov/about-
cancer/understanding/statistics
7
ways than humanity, as we know it has found in order to tame and treat this deadly
condition. Depending on the situation, one might receive treatment or a combination of
them.
Surgery. The goal of surgery is to remove the cancer or as much of the tumor as
possible. Chemotherapy. Chemotherapy uses drugs to kill cancer cells. Radiation therapy.
Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer
cells. Radiation treatment can come from a machine outside the patient’s body, or it can be
placed inside one’s body. More than not, medical professionals recommend chemotherapy
and radiation therapy before surgery to lessen the chances of an unsuccessful procedure
Bone marrow transplant. bone marrow is the material inside the bones that makes
blood cells from blood stem cells. A bone marrow transplant can use the patient’s own bone
marrow stem cells or those from a donor. A bone marrow transplant allows the medical
provider to use higher doses of chemotherapy to treat cancer. It may also be used to replace
diseased bone marrow in some cases.
Immunotherapy. Immunotherapy, also known as biological therapy, uses the body's

immune system to kill the cancerous cells. Immunotherapy can help your immune system
recognize the cancer and attack it through the white cells, and potentially weaken it or
eliminate it completely.
Hormone therapy. Certain types of cancer are fueled by the body's hormones.
Examples include breast cancer and prostate cancer. Removing those hormones from the
body or blocking their effects is the first step to stopping the growth of the tumor. Targeted
drug therapy. Targeted drug treatment focuses on abnormalities within cancer cells that allow
them to survive.
Cryoablation. This treatment kills cancer cells with low temperatures. During
cryoablation, a thin needle (cryoprobe) is inserted through the skin and directly into the
cancerous tumor. A gas is pumped into the cryoprobe to freeze the tissue. Then the tissue is
allowed to thaw.
Radiofrequency ablation. This treatment uses electrical energy to heat cancer cells,
and therefore eliminates them. During radiofrequency ablation, a medical professional guides
a thin needle through the skin or an incision and into the cancer tissue. High-frequency
8
energy passes through the needle that causes the surrounding tissue to heat up, killing the
cancerous cells.
Figure 4: Infographic about cancer treatment options21
Evolution of cancer treatments
One of the most strenuous parts of having cancer is uncertainty. It is not

uncommon that health care professionals cannot give the patients an accurate picture of
how fast their disease is likely to progress, how it will react to certain treatment methods
or even what exact treatment would be best for them. As well as in some cases doctors
cannot even dictate exactly what type of cancer a patient has.
22
However, thanks to new technology that allows them to study the behavior of
cancer cells and potentially predict how that tumor will behave for the fullness of time! In
addition to that, these newly found insights are going to completely transform our view of
the disease. In the coming times, future doctors and researchers will not refer to diseases
as “breast cancer” or “lung cancer” but rather will assess and classify tumors according to
the pattern of abnormal activity. In conclusion, we will be finally acknowledging cancer for
what it really is- a disease of the genes.
Sequencing the cancer genome helps to determine exactly what cancer the patient
must have to determine the best treatment for the cancer. In addition, various
experimental cancer therapies are being developed.
21
houston methodist, treating cancer: https://www.houstonmethodist.org/cancer/treatment-options/
22
“the cancer revolution”, by Garry Hamilton, 23 August 2003:
https://www.newscientist.com/article/mg17924094-800-the-cancer-revolution/
9
If the circumstances allow this research to be successful how we currently treat

cancer will seem like a mere footnote in history. At such time oncologists will have a
system that allows them to precisely quantify what tumor is, evaluate how it is likely to
progress and be able to predict exactly which treatment is best for the case, in order to
have the best outcome for the patient.
One of the new methods used for conceding disease is liquid biopsy. Until now a
plethora of solid tumors have required invasive tissue biopsies to be diagnosed. But now it
is possible to identify early signs of the condition by analyzing blood samples. The
reasoning behind this is that every cancer releases into the blood both cancer cells and
fragments of DNA, even in the very early stages of the cancer’s development. Studying and
further analyzing them can reveal the true nature of the developing tumor.
An additional new screening method uses epigenetics. This calls attention to the
chemical modification of the DNA and proteins that do not alter the gene encodes but can
still determine whether the gene is turned on or off. Examining just one of these chemical
modifications – “the addition of methyl group to the DNA molecule”23- could imaginably
detect up to fifty non-identical types of cancer.
Not only that but precancer care can now diminish genetic risk factors and reduce
the chances of developing a tumor. “Women with mutations in the tumor suppressor
genes BRCA1 and BRCA2 genes, who are susceptible to breast and ovarian cancer, could
receive a prophylactic therapy called a biological modifier that can reduce the chronic
inflammation or metabolic syndrome that causes cancer to grow.”24
As mentioned above, CIN generates intratumoral heterogeneity, further fuels

cancer development, and promotes metastatic progression, and therefore, it is associated
with highly aggressive, poor patient prognosis and drug-resistant tumors.
As CINs are found in both primary and metastatic lesions, innovative strategies
exploiting CINs can offer therapeutic benefits and improve outcomes for cancer patients
generally. Unfortunately, the exploitation of CIN remains a significant problem, as the
23
“Liu, M., et al., Sensitive and specific multi-cancer detection and localization using methylation signatures in
cell-free DNA.” 2020. 31(6):
.https://www.scientificamerican.com/custom-media/the-coming-revolution-in-cancer-care/
24
“scientific american by Hackensack Meridian Health in partnership with Scientific American Custom
Media”:cancer revolution pre cancer treatment
10
abnormal mechanisms that cause CIN and their role in cancer development are not yet
fully elucidated.
Recent technological advances in the detection of CIN and new therapeutic

strategies developed to exploit the molecular origin of CIN began to emerge. As a matter of
fact, chemotherapeutics targeting CIN have been believed to be promising in the clinic,
both individually and in combination with other
therapies, and support CIN as a strong therapeutic
target.
Figure 5: Targeted cancer treatments have given oncologists powerful new tools to
stop the disease25.
Difficulty in accessing cancer care
To begin with, it is worth mentioning the inconveniences this condition may cause
to the patients. “The cancer burden continues to grow globally, exerting tremendous
physical, emotional and financial strain on individuals, families, communities and health
systems.”26 In impoverished and middle-income counties many health care systems are the
least prepared to manage the burden that comes with this condition, and excessive
numbers of cancer patients world-wide do not have access to neither quality diagnosis nor
treatment. On the other hand, in countries where their health care system is strong
enough, mortality rates due to cancer are reducing continuously thanks to accessible and
early detection, best fit treatment and survivorship care.
In 2018 in the US, the weekly median income for a full-time wage or salary worker
was $900, according to the U.S. Bureau of Labor Statistics. Even with a typical employer-
sponsored health insurance plan, a patient with 25% coinsurance would have monthly out-
of-pocket costs of $2,500 for a cancer drug that costs $10,000 each month.
25
Credit: Kateryna Kon/SPL/Getty Images: cancer related pictures
26
World Health Organization regarding cancer, WHO : topic 2 cancer
11
Figure 6: Cost of cancer treatments27
Over and above that when it comes to developing countries, they are not known to
have the most supportive health care systems and it is not rare that they have neither the
facilities nor the adequate equipment to handle the situation efficiently. The circumstances
of these countries strongly determine both decisions about which approaches might be
relevant and their success, but also may create an internal fear in the patient when it
comes to seeking help. When talking about serious cases it is very unlikely that they receive
competent care. A study showed that in low-income countries only 62% of the health staff
are skilled enough for challenging cases. 28
Additionally, in countries where the healthcare system is not free and most of the
expenses are not covered by insurance, it is out of the question for some people to even
think about completing the treatment. The lack of financial protection by the government
for the costs of healthcare and specifically cancer care, where the antibiotics and general
treatment tends to be exorbitant, means that approximately more than 100 million people
are pushed below the poverty line annually by the necessary payments and many more will
not seek care because they lack the imperative funds. For many people, mainly the working
class, it is most of the time out of the question to seek cancer care as they cannot afford it.
Participants identified travel to major regional centers and/or urban areas and
related arrangements as the main barrier to accessing diagnostic tests, operations, certain
27
U.S. Bureau of Labour Statistics, 2018, DrugPricingLab, 2019, LAMA Oncology, 2019
https://www.asbestos.com/featured-stories/high-cost-of-cancer-treatment/
28
“Health Care Systems in Low- and Middle-Income Countries”, by Anne Mills, D.H.S.A., Ph.D., february 6 2014,
journal of medicine: https://www.nejm.org/doi/full/10.1056/nejmra1110897
12
treatments, and post-care examinations. Financial burden and lack of awareness of

available services and support mechanisms have also been a major problem for most
patients and caregivers. Differences in the availability of specific screening devices, such as
PET-CT, complicate the experience of patients and caregivers in diagnosing and treating
cancer. While all surveyed cohorts considered a positive clinician-patient relationship to be
an essential feature of their experience of cancer treatment in rural and regional areas,
difficulties in retaining hospital and associated staff in some health services had a negative
impact on the experience of patients and caregivers.
Not only that but it is also worth mentioning that accessing proper cancer care
when living in rural areas can be excessively difficult. Patients living in rural areas tend to
face limited access to medical and oncology services, long journeys, and poor recruitment
in clinical trials. All the above are factors that affect the quality of care and health
outcomes. Cancer mortality and other adverse treatment outcomes are also high in such
areas. “Despite these consistent conclusions in the available research, there is little
information on the interrelated effects of multiple health problems on diagnosis and
management of cancer in rural settings specifically.”29
Finally, health professionals are at the center of information dissemination, but

there is research evidence to suggest that information complexity, communication barriers
and differences in the information patients receive about cancer treatment services can
explain patients' lack of knowledge or difficulty in accessing cancer treatment services,
facilities, and equipment.
MAJOR COUNTRIES AND ORGANIZATIONS INVOLVED
United States of America
In the United States, cancer outcome disparities by race and/or socioeconomic

status are well documented for breast cancer, colorectal cancer, prostate cancer, and lung
cancer. Non-white patients have been documented to have less survival rates that white
patients. Barriers differed between non-minority and minority patients, and minority
patients faced a greater number of barriers than non-minority patients in general.30 Several
29
“Barriers to Accessing, Commencing and Completing Cancer Treatment Among Geriatric Patients in Rural
Australia:” A Qualitative Perspective,15 February 2022, by George M, Smith A , Ranmuthugula G , Sabesan S.:
barriers when seeking cancer
30
‘Patients’ Barriers to Receipt of Cancer Care, and Factors Associated with Needing More Assistance from a
Patient Navigator:
13
studies have shown that african- american males have a significantly higher incidence rate
and are almost 1.5 times as likely to die from lung and bronchus cancer compared to white
males.31 Community-based patient navigation interventions are promising strategies and
are more likely to succeed in eliminating cancer disparities in early detection and screening
are culturally tailored programs. Nurses also need to be further involved in delivering and
developing fusible, culturally competent community-based cancer screening and treatment
navigation programs through education, practice, research, and policy improvement.
China
The development of palliative care in China is essential to the care of its aging
population and the subsequent increase in cancer incidence. There are physician-related
and population-related barriers which impede palliative care development. Different
economic regions and hospitals with varying levels of sophistication used different
treatment methods, drugs, and conditions. Regarding treatment challenges, 76.6% of the
medical personnel were dissatisfied with the way cancer is currently being treated. Early
diagnosis and patient revelation of the genuine conditions were significant elements that
affected their satisfaction with the cancer treatment.
Tianjin saw the establishment of the first hospice care facility. The Li Ka Shing
Foundation has developed neighborhood hospices. The World Health Organization has
worked with academic institutions, such as the one in Chengdu connected to Sichuan
University, to construct centers of excellence to both develop and teach palliative care to
physicians who are both practicing and in training.
Philippines
In the Philippines cancer is the second leading cause of the mortality rates among
its people. The most frequent tumor types are breast, colorectal, liver, lung, and prostate.
A study conducted in 2012 regarding the economic impact of cancer diagnosis in Filipino
families revealed that more than 40% experienced financial toxicity and about 25% are
falling into the lowest income bracket.32 To combat this issue the government The recently
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713073/#R1
31
Racial Differences and Disparities in Cancer Care and Outcomes, july 12, 2021
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180671/
32
“Overcoming Cancer Care Barriers in the Philippines”, June 27, 2019 · Ann Meredith Garcia Trinidad:
overcoming cancer barriers philippines
14
signed Universal Health Care Act automatically enrolls all Filipino citizens into the NHIP
(National Health Insurance Program). By expanding the capabilities of government
hospitals and rural health clinics statewide, this legislation seeks to enhance the
advantages now provided by PhilHealth (the Philippine Health Insurance Corporation).
Another important statute creates the Philippine Cancer Center and Regional Cancer
Centers with the goal of enhancing cancer care across the country. In addition, the law
requires the establishment of a cancer assistance fund to help with the cost of care, hire
additional oncology doctors and healthcare workers, and fund larger cancer awareness
programs.
India
When compared to other nations around the world, India has a large number of
cancer patients and a high ratio of them to available skilled medical personnel. This leads
to overcrowding in healthcare institutions and lengthy wait times in outpatient clinics.
Additionally, Indian cancer patients frequently use their savings to cover the cost of their
treatment, which could have devastating long-term effects. To address this issue, the
central government has launched a national health insurance program that provides free
medical care, including chemotherapy and supporting drugs, to all eligible residents. With
the help of this program, more people from extremely underprivileged socioeconomic
groups will now obtain cancer treatment. Over and above that, funds are also available for
people with cancer, especially those with limited income and low socioeconomic status.
Kenya
In Kenya, cancer is the third leading cause of mortality. Kenya has developed a new
national cancer control strategy that provides an opportunity to synergize information and
enhance understanding in order to improve cancer diagnosis and treatment nation-wide.
The plan includes the improvement of the two main tertiary cancer referral centers —
Kenyatta National Hospital, Nairobi, and Moi Teaching and Referral Hospital (MTRH),
Eldoret — through infrastructure and equipment upgrades. On top of that it aims for the
establishment of four comprehensive regional cancer care centers in Mombasa, Nakuru,
Nyeri and Kisii counties.
Prevent Cancer Foundation
15
The PCF has funded grants since 1986 for early career scientists working on cancer
research. Their main aim is to invest in more creative and innovative research regarding
overcoming barriers in cancer care and promote early diagnosis to prevent more advanced
staged cancer. The Prevent Cancer Foundation educates people on lifestyle changes one
can make to avoid cancer diagnosis, including healthy diets and vaccinations. Education
programs have been funded to spread awareness and screening programs across the
country.
Arc Cancer Support Centers
The Arc Cancer Support Centers has a dedicated helpline for patients and families
to provide emotional support to cancer patients when seeking and going through cancer
treatment. They also provide counseling classes for young adults and children. There are
additional events and classes for families. The arc Cancer Support Centers also aid
healthcare professionals. Often, cancer has a great effect on oncologist healthcare
professionals.
Komen Treatment Assistance Program
Susan G. Komen is the largest nonprofit source of funding and awareness for
breast cancer treatment world-wide. The organization has invested more than $2.9 billion
in research since 1982.33 Susan G. Komen Treatment Assistance Program assists breast
cancer patients by assisting and covering the expenses for transportation, food, childcare,
medication, oral pain medication, anti-nausea medication and oral chemotherapy.
Patient Access Network Foundation
The PAN Foundation is a nonprofit organization that gives patients flexibility to make
alterations to their medication, health care providers and pharmacies without altering their
grant eligibility. That has resulted in PAN being able to provide $3 billion in financial
assistance since 2004.
33
Financial Assistance & Insurance: https://www.komen.org/support-resources/financial-assistance/
16
TIMELINE OF EVENTS
Date Description of Event
3000 BC The oldest description of cancer was discovered in Egypt
460-370 BC Hippocrates used the terms carcinos and carcinoma to describe non-
ulcer forming and ulcer-forming tumors
1761 Giovanni Morgagni was the first to perform autopsies to relate the
patient’s illness to pathologic findings after death. This laid the
foundation for scientific oncology, the study of cancer.
1846 The development of anesthesia allowed surgery to flourish and
classic cancer operations such as the radical mastectomy were
developed.
1923 The first screening test, by George Papanikolaou, to be widely used
for cancer was the Pap test.
1976 Modern mammography methods were developed and first officially

recommended by the ACS
20 May 2000 WHO releases a resolution on NCD prevention and control
WHOs strategy in Health promotion and Reproductive health

22 May 2004
25 May 2005 WHO legal framework on cancer prevention and control
31 May 2017 WHO releases a resolution on cancer prevention and control in the
context of an integrated approach
22 July 2020 WHO releases statistics regarding cancer mortality in 2020
UN INVOLVEMENT: RELEVANT RESOLUTIONS, TREATIES AND EVENTS
WHO resolutions
17
Cancer prevention and control in the context of an integrated approach, WHA70.12, 31

May 2017: WHO resolution cancer
The 2017 cancer resolution ‘Cancer prevention and control in the context of an
integrated approach’ provides a framework for countries to act on cancer by recognizing
policy opportunities to scale-up access to diagnosis, prevention, care services, and
treatment. Furthermore, it highlights where cancer services support actions on other
health agendas including HIV, maternal and child health, adolescents, and the delivery of
Universal Health Coverage (UHC). The resolution identifies 22 priority actions, grouped into
four key areas for countries to systematically strengthen cancer services over time.
Cancer prevention and control, WHA58.22, 25 May 2005: WHO resolution cancer control
In the cancer prevention and control resolution in 2005 WHO recognizes the
factors that cause and some additional difficulties and promotes countries policies and
urges them to act with NGOs and more in order to prevent and control the rapid spread of
cancer in the last few decades.
Noncommunicable disease prevention and control WHA51.18, 25 May 2005 WHO

resolution NCD control page 36
In the noncommunicable disease prevention and control in 2005 WHO takes into
account what can cause NCDs and the problems that they may cause, and further
promotes legal framework in order to support a healthy lifestyle and further prevent the
excessive growth of these conditions
Prevention and control of noncommunicable diseases, WHA53.17, 20 May 2000 WHO

resolution control of NCDs page 37
In the prevention and control of NCDs WHO emphasized the need to increase
awareness of the growing epidemic of CRDs worldwide. A program was begun to design a
comprehensive approach to the prevention and control of CRDs.The resolution was
approved by the General Assembly of World Health Organization (WHO) in 2004.
18
Reproductive health: strategy to accelerate progress towards the attainment of

international development goals and targets, WHA57.12, 22 May 2004 WHO resolution
healthy lifestyle
In this resolution WHO states that reproductive and sexual health is fundamental
to individuals, couples and families, and the social and economic development of
communities and nations and is aslo vital for controlling cervical cancer. for that reason
this resolution urges the member states and WHO to develop a strategy for accelerating
progress towards attainment of international development goals and targets related to
reproductive health.
Health promotion and healthy lifestyles WHA57.16, 22 May 2004, WHO resolution health
promotion
In this resolution WHO urges governments to take action and educate everyone
regarding healthy lifestyles and generally requests the promotion of healthy diets and aims
for raising awareness among the public.
PREVIOUS ATTEMPTS TO SOLVE THE ISSUE
The US National Cancer Institute (NCI) has issued a call for proposals to test
innovative projects aimed at overcoming these barriers beyond descriptive research.
Barriers to optimal pain relief were identified during the development of the first national
clinical practice guidelines34 for the management of cancer pain, published in 1994 by the
Health Policy and Research Agency. These barriers were classified into three categories:
patient barriers, professional barriers, and system barriers.
More and more countries have been passing laws over the last years and have
been collaborating and even funding NGOs that have been trying to tackle the issue or at
the very least trying to ease the burden of the patients. To support this statement a very
vital example is the law that the Philippines passed a law that provides for the creation of a
cancer fund to pay for treatments, train more oncology professionals and health workers,
and support important cancer awareness campaigns.
34
“Management of cancer pain guideline overview.” Agency for Health Care Policy and Research Rockville,
Maryland.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607726/
19
PFCCAP (Partners for Cancer Care and Prevention) identified significant

impediments through community discussions with hospital leaders and government
authorities. This is made up of a severe shortage of skilled medical professionals, numerous
facilities with adequate screening tools, and a disjointed healthcare system with substantial
wait times and poor continuity of service. The PFCCAP offered a solution that includes
biannual on-site training, monthly teleconferences, quality control programs, and easier
access to screening equipment. Following the implementation of the PFCCAP plan of
action, the average time from the initial consultation to the biopsy, the diagnosis, and the
surgery dropped from 121 to 60 days, 33 to 4 days, and 65 to 20 days, respectively, from
2012 to 2018.
Although there are many things currently happening in order to tackle this issue it
is still evident that there are multiple difficulties in accessing adequate cancer care. First of
all there are many existing problems in numerous countries' health care systems, as
mentioned above, and governments should work on combating those firstly. Moreover
changes regarding health care systems can be quite lengthy and can take many years in
order to implement new laws or generally policies regarding both cancer and other
conditions. However, being encouraged by previous attempts that had promising results
and have been proven to have helped the situation there are auspicious chances of further
emboldened results in the future.
POSSIBLE SOLUTIONS
Collaborating with NGOs
To combat this issue efficiently there are certainly many things that can be done.
Being encouraged from previous rather successful attempts to eliminate the burdens it is
wise that governments world-wide cooperate and assist NGOs, like the Komen Treatment
Assistance Program, that are also working on tackling the issue, whether that is by funding
and generally helping the patients family economically and supporting current research
being conducted for new cancer treatments, by financing them and supporting and
promoting their work.
20
Eliminate existing problems
Over and above that they can work on eliminating already existing affairs in certain
countries' health care systems. For instance Morocco, according to the US government, has
a shortage of doctors (0.5 per 1,000 people), hospital beds (1.0 per 1,000 people), and
access to clean water (82 percent of the population) (75 percent of the population) In
addition, Niger's healthcare system consistently lacks funding and has few medical
professionals compared to the country's population. Some medications are unavailable or
in short supply: In 2004, there were 377 doctors in Niger, or 0.03 per 10,000 people. In
2003, the patient was responsible for 89.2% of all healthcare costs.35 Moreover, they can
invest in a more adequate education of health care professionals by organizing seminars,
biannual on-site training, monthly teleconferences, quality control programs as well as
providing existing health care centers with more advanced and methodical screening
supplies.
Raising awareness
On top of that, it would be wise to arrange campaigns to raise awareness about the
prevention of cancer. For instance, they could promote and educate the people on and
further inform them on how to detect and recognize cancer symptoms and urge them to
do an annual checkup, by the media, seminars, and presentations in schools. Furthermore,
they could make particular cancer tests, like the PAP test, low-cost or even free.
35
health care system in niger health care system around the world
21
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27

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Costeas-Geitonas School Model United Nations 2022

Committee: World Health Organization (WHO)

Issue: Reducing barriers to accessing cancer care

Student Officer: Lida Galati

Position: Deputy President

Surgery, chemotherapy, radiation therapy, hormone therapy, targeted therapy,

DEFINITION OF KEY TERMS

“A type of therapy that uses substances to stimulate or suppress the immune

“Describes a situation in which mutations in two genes together result in cell

“Health professionals maintain health in humans through the application of the

“A branch of medicine that specializes in the diagnosis and treatment of cancer. It

“Chromosomal instability (CIN), the inability to correctly segregate sister

“Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of

Figure 1: Cancer Metastasis16

Figure 2: Statistics about the diagnosis of cancer19

Figure 3: Statistics about mortality rates in 202020

Immunotherapy. Immunotherapy, also known as biological therapy, uses the body's

Figure 4: Infographic about cancer treatment options21

Evolution of cancer treatments

One of the most strenuous parts of having cancer is uncertainty. It is not

If the circumstances allow this research to be successful how we currently treat

As mentioned above, CIN generates intratumoral heterogeneity, further fuels

Recent technological advances in the detection of CIN and new therapeutic

Difficulty in accessing cancer care

Figure 6: Cost of cancer treatments27

treatments, and post-care examinations. Financial burden and lack of awareness of

Finally, health professionals are at the center of information dissemination, but

MAJOR COUNTRIES AND ORGANIZATIONS INVOLVED

United States of America

In the United States, cancer outcome disparities by race and/or socioeconomic

Prevent Cancer Foundation

Arc Cancer Support Centers

Komen Treatment Assistance Program

Patient Access Network Foundation

Date Description of Event

3000 BC The oldest description of cancer was discovered in Egypt

1976 Modern mammography methods were developed and first officially

WHOs strategy in Health promotion and Reproductive health

25 May 2005 WHO legal framework on cancer prevention and control

UN INVOLVEMENT: RELEVANT RESOLUTIONS, TREATIES AND EVENTS

Cancer prevention and control in the context of an integrated approach, WHA70.12, 31

Noncommunicable disease prevention and control WHA51.18, 25 May 2005 WHO

Prevention and control of noncommunicable diseases, WHA53.17, 20 May 2000 WHO

Reproductive health: strategy to accelerate progress towards the attainment of

PREVIOUS ATTEMPTS TO SOLVE THE ISSUE

PFCCAP (Partners for Cancer Care and Prevention) identified significant

Collaborating with NGOs

Eliminate existing problems

"The Cancer Revolution." New Scientist, 23 Aug. 2003, www.newscientist.com/article/mg17924094-800-

"17 Cancer Symptoms You Shouldn't Ignore." Ucsfhealth.org, www.ucsfhealth.org/covid/17-cancer-

Cancer Patients & Families, 9 Dec. 2019, www.asbestos.com/featured-stories/high-cost-

Presentation | JCO Global Oncology." ASCO Publications, 19 Oct. 2021,

Center, 25 May 2021, www.mdanderson.org/cancerwise/metastatic-cancer--what-

Cancer Care Network Foundation, www.cancercarenetworkfoundation.org/.

Cancer.net. "Types of Cancer." Cancer.Net, www.cancer.net/cancer-types.

"Cancer." New Scientist, www.newscientist.com/definition/cancer/.

Publications, 23 June 2020, ascopubs.org/doi/full/10.1200/OP.20.00174.

"Ensuring Quality Cancer Treatment." WHO | World Health Organization,

Cancer Patients & Families, 25 Sept. 2020, www.asbestos.com/cancer/finanical-aid-

5 Feb. 2014, www.nejm.org/doi/full/10.1056/nejmra1110897.

Colon, Lung, Prostate, Skin, www.cancer.org/treatment/understanding-your-

"what is chromosomal instability" www.sciencedirect.com/topics/medicine-and-

Language Selection | Public Health, health.ec.europa.eu/system/files/2022-02/eu_cancer-