Global Cancer\u00a0 & Research Projects<\/strong><\/p>\n It has been reported by the United Nations<\/a> that cancer causes more deaths than AIDS, Tuberculosis and malaria in poor countries. Indeed, more than 70% of all cancer deaths occur in low and middle income countries (LMICs).\u00a0 Global cancer epidemiology maps are available from the International Agency for research on Cancer (IARC)<\/a> and more recently (March 2015) cancer project maps are available from Global Oncology initiative<\/a>\u00a0 (Based at Stanford) which it is hoped will assist researchers across the globe to collaborate<\/a> (see Figure 1).<\/p>\n Figure 1:<\/strong> Global Oncology Initiative website facilities international collaboration<\/p>\n In May 2015, at the Ireland-Northern Ireland-NCI Cancer Consortium Conference<\/a> in Belfast, a lot of international respected speakers spoke about the global burden of cancer and the moral imperative that developed countries have in supporting the cancer research community in LMICs.<\/p>\n Subsequently, at the NCI Summer Curriculum in Cancer Prevention, Dr. Tom Gross gave a stimulating talk about the \u2018state of play\u2019 in LMICs and why it\u2019s important that the global community work together as best they can based on some fundamental facts:<\/p>\n Background Facts:<\/strong><\/p>\n Workforce capacity is another huge problem facing those working in cancer prevention, control and care in LMICs. Many global institutions, academic centres and non-profit agencies are working with partner organisations in LMICs to grow sustainable infrastructure but is a constant challenge to retain qualified medical staff. The emphasis of collaboration has benefits for those in the developed world too –\u00a0 Burkitt Lymphoma<\/a> is a historical example of how global collaboration can improve patient outcomes globally.<\/p>\n Health Economics\u00a0<\/strong><\/p>\n What has become apparent from NCI personnel and Summer Curriculum participants is the importance of health economics in decision-making in LMICs across the cancer continuum. For example, the NCI Non-Communicable Diseases regional infrastructure core planning grants<\/a> suggests health economics\/comparative effectiveness research as one of the seven potential core resources. Furthermore, the NCI supports the development of point-of-care technologies (see Figure 2 for examples) for detection, diagnosis and treatment in LMICs with the following characteristics:<\/p>\n Figure 2: <\/strong>Examples of NCI-supported grants for LMICs<\/p>\n The most basic construct of whether a technology is cost-effective or not is to use a cost-effectiveness threshold (CETs). Essentially, this is based on the cost per Quality Adjusted Life Year (QALY) metric. This is distinguished from the Disability Adjusted Life Year (DALY), a favoured metric in global health.<\/p>\n The Cost-Effectiveness Threshold in LMICs<\/strong><\/p>\n In 2014, Paul Revill and Beth Woods (University of York) <\/a>produced a research paper presenting CETs which are much lower than those previously applied in many countries using WHO recommended CETs<\/a> of 1-3 times GDP per capita. The York CETs are based on recent empirical estimates of foregone benefit (from the English NHS) and international income elasticities of the value of health. The choice of CET is, therefore, crucial in determining value from healthcare interventions when applying incremental Cost-Effectiveness Analysis.<\/p>\n Final Words<\/strong><\/p>\n The message from this blog is that the global cancer community are boosting\u00a0efforts to support cancer research in LMICs. What is encouraging to hear is that health economics\/economic evaluation is central to decision-making from supporting research projects to patient treatment and survivorship needs in LMICs.<\/p>\n","protected":false},"excerpt":{"rendered":" By Diarmuid Coughlan As of July 2015, I started a prestigious Cancer Prevention Fellowship at the National Cancer Institute (NCI) in Bethesda, Maryland USA. Perhaps, the most interesting opportunity afforded to me is to get involved in projects run by the NCI Center for Global Health. Global Cancer\u00a0 & Research Projects It has been reported … <\/p>\n![\"Figure](\"https:\/\/blogs.ncl.ac.uk\/healtheconomicsgroup\/files\/2015\/08\/global-oncology-initiative-1024x576.png\")
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