Why Are We So Meek in Demanding Treatment for Non-Communicable Disease?

In the developing world, this inequity is something that we face every day -- the tragedy of cancer typified by a little girl with a disease with a 90 percent chance of a cure who looks at us with big brown eyes, full of unspeakable pain, to ask, "Will you treat me?"
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One day recently, I received a frantic call from a staff member. A mother and child had arrived unceremoniously on the doorstep of our medical facilities in Amman, Jordan. The mother was penniless; the child, a beautiful four-year-old girl, was suffering from leukemia. Her name was Zainab.

They had come from their homeland in Syria, where there is no access to cancer care, all the way to Jordan to place their hopes at our doors, having heard that the King Hussein Cancer Center is the best in the region.

Zainab's treatment would cost U.S. $100,000. However, our Goodwill Funds were depleted, and we were already overburdened with hundreds of other patients in need of financial support. The staff member on the other end of the line was asking "What should we say to Zainab's mother?"

As I held the phone, there were two things I knew for sure: One, with a cure, this lovely little girl had her whole life in front of her. And two, as the mother of a child who has survived leukemia, it was impossible for me to turn her away. We would have to find a way to cover her treatment costs.

In the developing world, this inequity is something that we face every day -- the tragedy of cancer typified by a little girl with a disease with a 90 percent chance of a cure who looks at us with big brown eyes, full of unspeakable pain, to ask, "Will you treat me?"

This story is multiplied over and over again, not only with cancer, but with other non-communicable diseases (NCDs). There are millions of patients around the world suffering from heart disease, diabetes, cancer and respiratory illnesses. Most are in developing countries, and most ask that same question: "Will you treat me?"

Out of the eleven targets suggested after the landmark 2011 United Nations High Level Meeting on NCDs, one is the overarching target to reduce mortality from NCDs by 25 percent by 2025. Only one - which had the most difficulty making the list of draft targets - deals with treatment, the target on "essential medicines and basic technologies for treatment."

The NCD community always talks about the importance of prevention; many consider it the Holy Grail in the fight against NCDs. Why was it so hard to also accept treatment as part of the solution?

Treatment and prevention are heavily interrelated. The success of one is directly related to the other. But prevention takes time to have an impact. What about the millions of people who need treatment NOW? I use a metaphor of someone who is drowning. It's no use to tell that person "You should have taken swimming classes." The logical thing is to save that person first and then talk about swimming lessons to prevent it from happening again.

A person in the developing world will not buy in to the importance of prevention if there is no treatment option available should that person get the disease.

This was our experience in Jordan. When we first started, the cancer taboo was so huge that no one believed that anyone could actually survive cancer. So naturally, our initial focus had to be treatment. Only after we had achieved quality treatment did people begin to listen to our messages about the value of early detection and prevention.

It is unfathomable and unacceptable that in 2012, with all the science and technology at our disposition, a child in Africa who has acute lymphoblastic leukemia -- with cure rates reaching beyond 90 percent -- is still looking death in the eye instead of having life-saving chemotherapy agents running through his or her veins.

That is not to say that the High Level Meeting on NCDs last year was a small feat; rather, it was an amazing achievement and a testament to all of us working together. And while I understand that there is a process to be followed and a political fight to be waged, we cannot ignore treatment if we are serious about fixing the NCD problem.

We know that we need essential medicines and basic technologies at affordable prices. So why have we been so meek in asking for resources for treatment? Why are we hesitant to ask for the global war chest we need to support this battle?

There are millions of people relying on us for their deliverance. It is time to demand access to quality treatment for NCDs on behalf of all the Zainabs of the world.

Princess Dina Mired is director general of the King Hussein Cancer Foundation in Amman, Jordan.

This is one in a series of articles published to mark the first anniversary of the 2011 United Nations High-Level Meeting on Non-Communicable Diseases on Sept. 19. The series is coordinated by the non-profit organization Arogya World in partnership with the Young Professionals Chronic Disease Network and will be housed at www.arogyaworld.org

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