By Nathan Grey, MPH
For many years, global health has been associated with diseases like HIV/AIDS and malaria. And rightly so. These diseases present significant threats to health around the world. But they aren't the only major killers. In fact, they're not even the leading killers anymore! Today, cancer claims more lives globally than HIV/AIDS, malaria, and tuberculosis combined, and the death toll from cancer is only going to grow.
How can this be? Well, there are two major factors that affect the growing impact of cancer around the world.
First, we've done a much better job of controlling diseases that used to kill people while they were still quite young. Vaccinations, new medications including antibiotics, and prevention programs (like providing bed nets to combat mosquitoes and malaria, and clean drinking water to curb a host of other water-borne illnesses) have led to people living longer. And as people live longer they are faced with the diseases more common to older age, such as cancer.
Second, when people live longer, there is a greater chance that they will be exposed to cancer-causing agents - like tobacco - at some point in their lives. Longer lives plus greater exposure to cancer-causing substances equals more cancer.
'Reduce suffering and death'
For nearly 100 years, the American Cancer Society has been working to save lives and reduce suffering from cancer in the United States. But did you know that for most of our history we've also supported the fight against cancer globally? That's right, the American Cancer Society is one of a handful of organizations striving to end cancer wherever it occurs.
So why is the global fight against cancer so important? No reason is more important than the commitment "to reduce suffering and death" that appears at the heart of our mission. Cancer doesn't recognize geographic boundaries; it doesn't stop at the border. We live in an interconnected world.
The Society is working throughout the world to make sure that people everywhere know about deadly risk factors that cause cancer, like tobacco and obesity, and we are helping other countries establish policies to make their communities safer. The success in reducing the number of Americans who smoke through education and life-saving polices has had a direct impact on tobacco use in other regions of the world. As Americans quit smoking, the tobacco industry has gone looking for new markets for their products. As a result, some of the highest smoking rates in the world today are in low- and middle-income countries where tobacco controls are weak.
We've also seen the market for fast and convenience foods expand dramatically. Many of the production techniques and marketing tactics that were perfected in the United States are now being used in the developing world. One result of easier access to this type of food, which tends to be less-nutritious, is that obesity rates are exploding everywhere. Worldwide obesity has more than doubled since 1980.
To combat these dangerous trends, we are helping other countries promote smoke-free environments and increases in the price of cigarettes in order to reduce the number of people who smoke and who may eventually get cancer. And we are helping to educate people about the importance of exercise and maintaining a healthy weight in helping to prevent and control cancer.
Once, not too long ago, cancer was a death sentence. Today, we have more opportunities than ever to save lives. We have vaccines for Hepatitis B, which is associated with liver cancer, and human papillomavirus (HPV), which is responsible for most cases of cervical cancer. We have effective screening tests for breast, colon, and cervical cancers. We have treatments for cancer that are getting better and better.
The tools at our disposal are powerful and effective. Some are ready to be used worldwide right now. For instance, we are teaching and funding patient groups in Brazil to advocate for better breast cancer screening and treatment; we're doing economic research on the impact of tobacco on South African communities and in their general society; in India, we've partnered with an organization to help people quit tobacco, assisting with training, offering culturally-relevant materials, and helping strengthen community involvement and advocacy efforts to change laws regarding tobacco; also in India, we're providing technical support and funding for patient navigation, particularly important because of their large underserved communities.
Certain issues like tobacco require a global solution. You can't fight a multinational industry in just one country and succeed. The stronger the tobacco industry is abroad, the more resources it has to advance its interests everywhere, including the United States. In addition, as the world becomes more interconnected, our work in other regions of the world becomes more important to us at home. For example, research and interventions conducted in other countries can give us insight into new ways to reach immigrant and underserved communities in the United States.
We have the knowledge to help prevent and effectively treat many cases of cancer around the world; we simply need the will to do so.
Grey is the national vice president of global health for the American Cancer Society.