Press Release
February 21, 2012

PRIVILEGE SPEECH
INTERNATIONAL CHILDHOOD CANCER DAY (ICCD)

SENATOR PIA S. CAYETANO

Mr. President, I rise on a personal and collective privilege in connection with International Childhood Cancer Day (ICCD). ICCD is an annual event observed every 15th of February to raise awareness on the importance of early detection and diagnosis in the treatment outcome of childhood cancer.

In September 2011, the United Nations General Assembly issued a Political Declaration which considered four major Non Communicable Diseases namely, 1. cancer, 2 .cardiovascular disease, 3. diabetes and 4. chronic respiratory disease, as the greatest killers of both adults and children.[1] Next to climate change, Non Communicable Diseases are seen as the second most severe global risk, even equal in cost to the global financial crisis.

Cancer now kills more people globally than malaria, TB and AIDS combined. Last year, the total economic burden for worldwide new cancer cases was US$ 300B; while in 2008, the total economic impact of cancer alone was US$ 895B, which represents 1.5% of the world's GDP.

Sadly, among children 5-14 years old, cancer is among the leading causes of death. Each year, more than 175,000 new incidences of childhood cancer occur in the world with about 3,500 NEW cases in our country alone, or around 10 children each day.

However, many experts are of the opinion that the number of childhood cancer cases in our country is in fact much, much higher than this number. Since childhood cancer is not yet a notifiable disease and since our current cancer registry is limited to three areas in NCR, many of these occurrences remain unreported and unrecorded. In addition, due to poverty, inadequate information or misconceptions (such as cancer is a death sentence, only adults can have cancer), lack of trained personnel on childhood cancer in primary health care facilities, inadequate childhood cancer specialty centers, many more children with cancer in our country remain undiagnosed and untreated.

Mr. President, my dear colleagues, by the time we finish this day, there could be another Filipino child who will die of cancer, another face of our future which would be irreplaceably lost, and another family who would mourn the early loss of their child and forever carry the burden of that loss.

But it need not be so, Mr. President. Childhood cancer is now curable. In developed countries like the United States, UK, and Japan, 8 to 9 out of 10 kids survive childhood cancer, and live productive and meaningful lives. Unfortunately, in developing countries like ours, 8 out of 10 kids will die. They die NOT because of cancer or the limitations of modern science. They die because of constraints posed by poverty and the families' inability to get early diagnosis, access life saving drugs and afford timely, appropriate treatment. If this situation is allowed to continue, many more children with cancer will suffer and die needlessly; many more families and communities will be impoverished due to catastrophic treatment costs. Continuing inaction will severely impact on our initiatives for poverty reduction, sustainable development, economic growth and security.

As our National Hero, Dr Jose Rizal, once said, these children are the future of our country; they are the heart of our nation. And so Mr. President, my esteemed colleagues, on International Childhood Cancer Day today, I invite all of you to join me in speaking out for kids with cancer. I also call on the administration of President Noy to make this fight a priority.

Mr. President, let us step up our country's response to the challenge of childhood cancer. Let us ensure that our health, development and legislative agenda as well as that of the whole government hierarchy, prioritizes childhood cancer and provides adequate resources to meet the basic rights of children with cancer, including:

1. the right to early and proper diagnosis;

2. the right to access affordable medicines;

3. the right to appropriate and quality medical treatment; and

4. the right to follow up care, services and sustainable livelihood opportunities for survivors.

Let us serve as champions and advocates for childhood cancer and mobilize local government units and other government agencies -- DSWD, DOH, DEPED, DILG, PCSO, and PAGCOR, among others -- to act and move as one to protect our children and save lives of kids fighting cancer

Mr. President, in our oversight capacity, may I recommend the following actions:

1. Expand the life-saving program: "Free Access to Drugs of Kids with Leukemia" to include other childhood cancers such as retinoblastoma and osteosarcoma, which can lead to blindness and loss of limbs. This very successful Public Private Partnership Program initiated in November 2009 by the DOH [2] has seen a remarkable increase in survivorship - from 20 per cent survival to as high as 50 % survival in covered project sites. This confirms that Public Private Partnership in health works. BASTA MAG TULUNGAN MABUBUHAY at MAILILIGTAS ANG BATANG MAY KANSER SA PILIPINAS!

In this connection, may we ask the Public Private Partnership office to prioritize the roll out of programs and initiatives for childhood cancer in the Public Private Partnership agenda for 2012-2013.

2. Ensure that the inclusion of leukemia drugs in the priority list of the Cheaper Medicines Law be continued, as well as ensure the inclusion of non leukemia childhood cancer medicines in the priority list of medicines. The Free Access Program would not have been successful without the enactment of the Cheaper Medicines Law, which I co-sponsored, wherein prices of some of the chemotherapy drugs for leukemia was lowered by at least 50% . As a case in point, the two most important drugs in a 3 year treatment of a child with leukemia is Mercaptupurine and Metotrexate tablets, which are taken daily. Before, Mercapt cost Php 80.00/tab. At the initial implementation of the law, the price was at Php 39.00. Now, DOH procures it at Php 6.00. Likewise, Metotrexate was previously priced at Php 19.00 then initially at Php 10.00 after the law. But now, DOH procures it at Php 3.50. Because of cheaper prices, the government was able to maximize its limited funds to help more kids with cancer have a second chance at life. Cheaper prices means improved access; improved access means more lives saved.

3. Strengthen our national health systems and services for childhood cancer. In this connection, we call on the DOH to:

a. Formulate a policy issuance to make childhood cancers a notifiable disease and establish population-based cancer registries in strategic regions of the country across all island groups;

b. Establish regional cancer centers all over the country. In the interim, provide separate, child-centered, childhood cancer units or wards in our regional and tertiary hospitals. Mixing children with cancer with other sick kids compromises their ability to survive cancer and unnecessarily exposes them to deadly infections and complications;

c. Allocate a substantial amount of the planned Catastrophic Fund for Cancer to all childhood cancers and not just limited to leukemia alone;

d. Develop an integrated, adequately resourced, national strategy and national action plan for children with cancer and ensure that civil society organizations and various sectors are involved in its formulation, monitoring and implementation;

e. Promote the inclusion of childhood cancer information, initiatives and interventions in maternal and child-health programs, especially at the primary health-care level;

f. Guarantee the availability, access and affordability of health services for the early detection and screening of children with cancer. Let us design and implement childhood cancer screening programs for our rural health units. Let us empower and mobilize the unheralded heroes of our health community -the Barangay Health Workers (BHWs). With proper knowledge and materials on the signs and symptoms of childhood cancer, BHWs can promptly refer the child to the nearest health facility or specialist;

g. Provide and promote increased access to basic vaccinations such as measles to prevent infections associated with cancers as well as promote vaccinations for Human Papilloma Virus (HPV) which can lead to cervical cancer and Hepatitis B which can lead to liver cancer; and

h. Ensure investment in cost-effective and updated training and education of health and medical professionals in sub-specialties dealing with childhood cancers, as well as health para-professionals and community health volunteers. To date, we only have less than 100 pediatric and hema-oncologists;

4. For PhilHealth to expand out-patient coverage to include coverage of diagnostic services, supportive care services and complete/full treatment of those affected by childhood cancers. In addition, ensure that it does not discriminate against survivors of childhood cancers and include provision for follow up care services of survivors.

5. For the LGUs, DILG, and DepEd as well as our civil society organizations to work together and

a. Promote community-based actions and initiatives for families of kids with cancer, including access to microfinance, sustainable livelihood and micro enterprise assistance, to enable families to support kids living with childhood cancer and ensure the highest possible quality of life and well-being for them;

b. Undertake high impact and multi-sectoral information campaigns to create an awareness of the signs and symptoms of childhood cancers as well as break the stigma and misconceptions associated with cancer, such as cancer is death; cancer is bad genes; cancer is a family curse; and

c. Develop educational and learning programs specific to kids with cancer, as the long treatment (up to 3 years for leukemia patients) often serves as deterrent to going to school or going back to school .

Mr. President, my dear colleagues, we believe that if we are able to do all these, we would have served the best interests of children in our country. Children with cancer, these children who are with us today and their families deserve our support. [WILL ACKNOWLEDGE KIDS WITH CANCER & THEIR PARENTS PRESENT IN THE GALLERY] We should not allow them to face and fight cancer alone. One avoidable death is one death too many.

Thank you.

________________________________________

[1] 36.1M; 2/3 of 57M deaths globally; 80% of which are in developing countries).
[1], #2 in wealthy countries, #3 in upper-middle income countries, #4 in lower middle-income countries, and #8 in low-income countries.
[2] in partnership with Cancer Warriors Foundation (member UICC and ICCCPO)

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