ALL wars require will and weapons, including the one on cancer. Many of us are excited with the government’s new impetus to tackle cancer, with the launch of the “War on Cancer” initiative by Deputy Prime Minister Datuk Seri Dr Wan Azizah Wan Ismail.
This initiative, spearheaded by the College of Physicians of Malaysia, the Academy of Medicine of Malaysia, the Academy of Family Physicians of Malaysia and the Academy of Sciences Malaysia, is a platform for stakeholders from organisations to work towards “eliminating the scourge of cancer”.
The National Cancer Society of Malaysia welcomes all our new allies in the “war”, one we have been fighting on the frontline in Malaysia for more than 50 years. Now comes the difficult part. The enormous show of strength and commitment will need the integral part. A commitment of resources. Money to buy the “weapons”, if you will. Soldiers to fight in the frontline. And, most importantly, generals to lead the war in all its fronts, at the beaches or in the streets.
The war on cancer requires a general. We would be elated if that person would be the honourable deputy prime minister because that’s the level of leadership needed. Someone right at the top. Being mindful of the fact that our former “commander-in-chief” in the war against non-communicable diseases (NCDs), aka the chairman of the cabinet committee on NCDs, Tan Sri Muhyiddin Yassin, is now recuperating following an operation to remove a pancreatic tumour, is all the more reason for us to strengthen our resolve and commitment. Re-energising this cabinet-level committee to oversee the war is a crucial and critical step to ensure its success. This is the first step.
Like how no wars are won by the air force alone, fighting the war on cancer cannot be done by the Health Ministry alone. While the task force for the war on cancer should be led at the cabinet level, its members must comprise stakeholders from the government ministries, academia and civil society organisations.
Tobacco control measures, one of the largest risk factors for lung cancer, need the participation of the Finance, Primary Industries, Domestic Trade and Consumer Affairs Ministries, and branches of local government working together to ensure success, besides participation from the Health Ministry.
But, while the first step is bringing together all the “branches” onto the cancer battlefield, it is also important that they be given the power to “shoot”, that is, this highest-level task force needs to be given enough power to ensure that not only it draws up plans, but also ensure they are implemented, and monitored.
Strictly achievable short-, middle- and long-term key performance indicators need to be set, with measurements being spelt out clearly and responsibilities assigned across all levels of stakeholders. Or else, all the task force will do is draw up pretty plans, which will sit on dusty shelves, as in the past.
We have, for example, drawn up the National Strategic Action Plan for Cancer Control Programme. However, its implementation has been difficult due to a lack of empowerment.
While the war is fought on the traditional battlefront, History students in Malaysia will remember that even here, wars are waged on many fronts, as with the War for Hearts and Minds carried out during the Malayan Emergency of 1948 to 1960. Similarly, one of the greatest parts of the war on cancer needs to be fought to win the hearts and minds of Malaysians, and plans need to be conceived and carried out to achieve this. Cancer remains largely diagnosed in late stages in our country because Malaysians continue to have poor awareness of the disease, and in many cases, are apathetic to the needs of preventing it, such as reducing risk factors and screening regularly.
The war for prevention of the disease needs to be disseminated across all layers of society, with education provided even to schoolchildren, in order for it to be effective and long-lasting.
The War on Cancer initiative requires will, which we are happy to note that the government has, and clearly continues to demonstrate. However, this letter is not a call to merely commit to throwing more money at the problem. Besides the will to fight the war, we need the resources to fight it, including the planning, the cross-sectoral participation, the re-purposing of personnel, and above all, the commitment to keep these resources focused on achieving the goal, destroying the enemy that is cancer.
Many of us civil society organisations and other organisations are already doing our small part, fighting a guerilla war in the trenches with our limited resources and reach. We are more than happy to provide meaningful support to a concerted, sustained effort with the cavalry riding in to save the day.
Dr Murallitharan M.
Public health physician and director, National Cancer Society Malaysia