Dr. Judith Mackay, a long-time anti-smoking advocate, believes the recent LIVESTRONG Global Cancer Summit in Dublin, Ireland, was a landmark in the fight against cancer. Professor Mackay has been a key advocate of tobacco control in Asia from her base in Hong Kong and would like to see controls implemented in other parts of the world, such as Africa. Mackay is a senior advisor for the World Lung Foundation and a senior policy advisor for the World Health Organization. She spoke with allAfrica.com on the sidelines of the summit.
What do you think the summit has achieved?
In 1985 the American Cancer Society had a tobacco control meeting where it brought together all the tobacco control advocates from around the world for the first time. We developed a global strategy from then on in terms of tobacco control and I think this conference will actually do the same for cancer. There are people here from around the world and everybody is getting together, planning strategy, making contacts, learning from each other.
I actually think it's really a landmark conference in cancer control globally.
Information coming out of the summit says incidence of cancer is expected to increase in the developing world. Does this mean there will be more new cases or will there greater awareness and reporting?
I think the latter does come into it but I think there will be a very real increase in actual cancer numbers. That's for two reasons. One is that around the world we're having an aging population. Cancer, in fact, is remarkably rare in young people and it's principally a disease of the over 50s, over 60s. So simply because the world is aging there will be a lot more cancer reported.
Secondly, in the developing countries we still have an enormous bulge of young people just in terms of population structure. So even if the rates were to come down, if smoking rates were to come down, for example, we will still have more smokers in 2030 than we do today because of population expansion in the Third World. We're looking almost inevitably to an increase in cancer and its risk factors simply because of population and aging.
Where does Africa stand in terms of these higher rates of cancer and efforts to combat it?
I can speak best on tobacco rather than on cancer in general. But I think it's recognized that Asia and Africa are really the two priority areas. If we don't address both smoking and cancer in these two areas we're absolutely failing. One in every three cigarettes in the world is smoked in China, so we have to look to the low- and middle-income countries in order to beat this epidemic.
With the World Lung Foundation component of the Bloomberg Project, there is less emphasis on Africa just purely because of numbers. What [the Bloomberg Project] did was to look at the number of smokers in countries and then prioritize them. Africa does not really figure in that because the countries are smaller population countries [than those of Asia], relatively fewer people smoke, and those who do smoke fewer cigarettes than in Asia, which is more affluent.
What is happening, however, is a recognition that Africa has to be included in this. So many of the funding projects of Bloomberg are going to [nations in] Africa in spite of the fact they're not among the 15 priority countries. [The Gates Foundation] now, which has joined Bloomberg in looking at the global tobacco issue, is going to particularly focus on Africa.
So I think between them money will certainly cover Africa. And there is expertise in Africa. South Africa has got good research with the Medical Research Council and it's got good advocates. The inter-Africa tobacco control movement is basically based in South Africa.
Coming back to cancer I think the African voice has been well heard at this conference. People have talked about a need to have affordable treatment for cancer, to have better screening programs, better treatment and better facilities.
Do you think the toll of cancer in Africa has been overlooked due to other health challenges such as HIV, tuberculosis and malaria?
I think there always seems to be - it's not just in Africa - an incredible prioritization of diseases that hit the headlines. Cancer is very much a disease of the middle and older age, it's a quieter disease, it's not dramatic like road deaths, or dramatic like AIDS. I think the whole cancer epidemic globally suffers from the fact that it is not a high-drama, high-media impact story most of the time.
Funders have traditionally funded Aids, TB, malaria and even things like guinea worm. The reality is that at least 60 percent of the deaths in the world are caused by the non-communicable diseases. With tobacco alone we've got five million deaths a year. The big funders, like Bloomberg and Gates, have come on board for the first time recognizing that the non-communicable diseases have got to be funded properly and adequately.
Lance Armstrong's name alone is actually putting this into the headlines and I thank him for that. I think he's using his celebrity in absolutely the best possible way. And he's not trying to do it alone. He's drawing in very established partners: the International Union Against Cancer, the American Cancer Society and the European Cancer Leagues.
Do you think there's a need for more media coverage of cancer and if so how might this be accomplished?
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I think if you were to try to rate media coverage even against the number of deaths then cancer has to be much higher up the agenda. It has to be up the agenda in things like research and media advocacy and government action. It has to be higher up the agenda in every possible way. This conference is really good from the point of view of galvanizing media attention.
Given that Lance's commitment is long term he is very much there as a global celebrity and presence and I think will continue to make these stories newsworthy. He has on his bicycle two numbers. One is the number of days he said he would retire and then came back again, which is about a thousand days. A second number is the number of people who have died from cancer during those 1,000 days.
Is there anything else you would like to tell us?
I think the other question this conference has wrestled with is whether to prioritize prevention, early diagnosis or treatment - three crucial needs in the cancer epidemic. But we have decided it's impossible.
They've all got to be knit together in a comprehensive campaign. You can't say we'll only do prevention or we'll only do treatment. The epidemic is so big and so demanding I think we have to do all three simultaneously.
