By The Nation
Thailand ranks sixth for cancer preparedness in the region with an overall score of 65.2, below the regional average of 66.5, while Australia (92.4), South Korea (83.4) and Malaysia (80.3) lead the region.
Thailand records strong performance for policy and planning but further progress can be made in the care delivery and health systems and governance domains to enhance overall cancer preparedness, especially given the country’s low level of physical activity, says the EIU report "Cancer preparedness in Asia-Pacific: Progress towards universal cancer control”.
Sponsored by Roche, the report examines the findings from the EIU’s Index of Cancer Preparedness and describes the complexities of the cancer challenge facing 10 Asia-Pacific countries: Australia, China, India, Indonesia, Japan, Malaysia, Philippines, South Korea, Thailand and Vietnam.
Overall, mechanisms to translate policy and planning to action are lacking in the region and gaps in service provision are of concern, the report said.
Middle-income countries in Asia-Pacific do not meet recommended spending for achieving universal health coverage, the report added.
The report called for prioritising prevention and early detection of cancer.
Asia-Pacific had an estimated 8.8 million new cases and 5.5 million cancer deaths in 2018. As of 2017, cancer was the leading cause of death in Thailand. Changing demographics associated with ageing population and changing lifestyles mean this burden is only set to grow, the report said.
Countries in the vast Asia-Pacific region show great diversity in their healthcare needs, and responses to cancer are highly influenced by their stage of economic development. High-income countries with established healthcare infrastructures are primarily dealing with quality-of-care concerns. Upper-middle-income countries are refining their universal health coverage systems to close access gaps and ensure financial sustainability. Lower-middle-income countries are setting up the foundations for an increasingly important cancer challenge.
The EIU research found a strong association between income level and overall cancer preparedness as measured by the Index of Cancer Preparedness: that is, high-income countries outperform upper- and lower-middle income countries. Furthermore, a strong correlation was seen between overall score in the Index of Cancer Preparedness and cancer control outcomes as measured by the ratio of mortality to cancer incidence in the countries. This demonstrates that, in broad terms, better preparedness to manage the cancer burden equates with achieving better cancer outcomes, the report said
Differences were observed between countries’ ability to address the cancer burden. Given that as many as 70 per cent of cancer cases in low- and middle-income countries in Asia are diagnosed at a late stage, an emphasis on preventive services and moving from opportunistic to population-based screening is needed. "While Indonesia and Malaysia have demonstrated strong growth in health spending, and China has the biggest reduction in out-of-pocket health expenditure in our analysis, it is still only high-income countries that meet World Health Organization-recommended spending for universal health coverage," the report said.
Jesse Quigley Jones, editor of the report, said: “While there is clear progress at the planning level, the translation of policy into health service delivery and improved cancer outcomes requires more emphasis. While upper-middle- and lower-middle income countries are pulling together more comprehensive cancer control plans, our index showed weaker performance in health system governance and service delivery domains suggesting progress in addressing health infrastructure and service capacity is more limited. A renewed political commitment is needed to address the cancer burden.
"Thailand was recognised for the significant progress made in universal health coverage [UHC] as well as its health technology assessment mechanisms. While the downstream benefits of UHC on improved cancer outcomes is yet to be seen, Thailand should continue focusing its efforts on closing persistent access gaps and ensuring quality of services across the cancer continuum through better infrastructure and service supply while prioritising effective policies on tobacco control and healthy lifestyle promotion.”