People-focused cancer care demands policy support

Access to high-quality cancer care remains deeply uneven worldwide. While advances in cancer treatment and diagnostics are improving survival rates in some cases, many people – particularly in low- and middle- income countries – still face significant barriers to timely and affordable care. 

Cost, infrastructure limitations, and policy inaction continue to shape who receives effective treatment. Even in well-resourced health systems, disparities persist, with marginalised communities often struggling to access the care they need. 

These issues are at the heart of Union for International Cancer Control (UICC’s) World Cancer Day 2025, being held on 4 February.

Speaking exclusively to Pharmaceutical Technology, Sonali Johnson, Head of Knowledge, Advocacy and Policy at the UICC, says that tackling these barriers requires not only policy action but also a shift in how cancer is talked about. Under a “person-centred” approach to cancer care, focus needs to shift from purely clinical outcomes to the lived experiences of patients and caregivers. Johnson talks about the expectations from an upcoming United Nations meeting on non-communicable diseases (NCDs), the impact of the US government withdrawing from the World Health Organization (WHO) on global health projects, and more.

Sonali Johnson: The main engine behind the UICC’s “United by Unique” theme is that cancer is not just a medical diagnosis. It’s about people. It’s about a person who has been diagnosed with cancer – their network, health status, preferences, and world view.  

A people-centred approach is about bringing the experiences, preferences and unique needs of people into the cancer care experience and into policy making with respect to cancer control. Understanding the social determinants of health (the non-medical economic and social conditions that shape health and wellbeing) can affect cancer outcomes. Other factors like nutritional status, mental health and pre-existing health conditions can also affect prognosis and are unique to each individual.

People-centred care means looking at the conditions in which people live and thrive, the kinds of foods they eat, the exercise they do, the clean air – whether they have clean air. We all have unique cancer journeys, and we think that needs to be brought into the policy dialogues to better meet people’s needs with regard to cancer prevention, diagnosis and care.

Sonali Johnson: ​​​​​​​I think it’s about defining people-centred care clearly and measuring what works. Different sectors can collaborate on the framework needed to implement a people-centred approach. For example, a cancer registry can measure outcomes over a long period to see whether a programme is working or not. There is also the behavioural aspect, which can be measured through surveys – how much people know about cancer, whether they think its stigmatised, their attitudes and perspectives, and how those change over time. Another factor is the environment – things like tobacco and alcohol taxes or food labelling, which enable people to make healthy choices.  

This [measuring outcomes] is a less developed area. But there is a great scope for support, and I think funders recognise that cancer is more than just a medical diagnosis.

Sonali Johnson: ​​​​​​​That is the big million-dollar question, and the question that countries are always asking.  

Health technology assessment is one approach used in countries to evaluate the efficacy, appropriateness, and cost effectiveness of a new technology and whether that technology would be integrated into treatment procedures and reimbursement schemes.  

I think action needs to happen at the global level to improve the affordability of new and exciting developments in cancer diagnostics, medicines and technologies such as by the development and quality assurance of generics and biosimilars, and access initiatives. But, additionally at the national and regional levels, mechanisms such as pooled procurement should be utilised. 

We need to look at what approaches work in the long term and how to create a win-win situation for industry and for governments.  This problem is very important to address as the cost of cancer treatment is rising every year in all countries and particularly in middle-income countries.  

This discussion is also an opportunity to emphasise the importance of cancer prevention, where reducing the risk of cancer through evidence-based actions is a very cost-efficient way of preventing cancer from occurring in the first place. For example, by reducing tobacco and alcohol consumption, addressing air pollution, promoting vaccination, and more. 

Sonali Johnson: ​​​​​​​The short answer to this is we don’t know yet. Of course, we are concerned about the impact on global health and the knock-on effects of a country like the US withdrawing from international work as it is a key partner in global health efforts – bringing not only money, but technical expertise to global health.  

In cancer, it remains to be seen what the position of President Trump’s administration will be. We hope for the best. We have UICC members in the US, who in any case, we will continue to work with. It’s not just the government, but also the other not-for-profit and the private sector companies in the US. We are positive that these important collaborations will continue. 

Sonali Johnson: ​​​​​​​We’re reaching a critical crisis, and we need to get strong commitments on NCDs at the United Nations High Level Meeting of the UN general assembly meeting on the prevention and control of NCDs.  At the national level, this means taking decisions on fiscal policy and taxation, putting in place cancer screening programmes, supporting health promotion activities, improving health literacy and ensuring that people have access to cancer diagnosis, treatment and care. 

We really need investment and political will to support cost-effective packages for NCDs and cancer. We need countries to spend more, but wisely as well. There is guidance available from UN agencies like WHO, the International Agency for Research on Cancer (IARC) and The International Atomic Energy Agency (IAEA). UICC is also working on a new set of global cancer commitments that we want civil society to rally around. That’s really our ask— that this high-level meeting is not just another talking shop where countries discuss their rising NCD burden without doing anything about it.  

Outside the health sphere, it is a human rights issue, and a productivity issue for a country that you have somebody with a chronic illness who is unable to work. There is an impact on the family, and this is only growing as we get a handle on infectious diseases. We want Member States to take bold actions and they will see a return. That’s really what we’re trying to get across.