Which are the main goals of oncology development strategy in Armenia? Lord Ara Darzi comments

July 21, 2017  19:57

The citizens of Armenia deserve a healthcare system that strives to deliver excellence in all aspects of cancer services, says the former health minister of the UK, British House of Lords member, director of the Institute of Global Health Innovation, Imperial College London, and Executive Chair of the World Innovation Summit for Health (WISH), Ara Darzi.

In an interview with NEWS.am Medicine lord Darzi, who will lead the Armenian committee on drafting oncology development strategies, spoke about his views on the strategy and oncology development in Armenia.

Lord Darzi, we learned that you will lead the Armenian committee on drafting oncology development strategies. What are you planning to do on this position? Do you already have an idea about how and in what direction should oncology develop in Armenia?

As with every country when developing a healthcare strategy it is crucial to look at the needs of the population. The citizens of Armenia deserve a healthcare system which strives to deliver excellence in all aspects of cancer services. We are learning that there is a huge role for patients to play and that as healthcare leaders and clinicians we need to improve engagement with our patients to deliver a service that they want and need. By improving the understanding of the needs of our patients, we can deliver care that is high quality and has a meaningful and positive impact on people’s lives.

What is your opinion about today’s situation with oncology in Armenia? How well, in your opinion, are cancer prevention, diagnosis and treatment organized? What achievements and what problems does Armenia have in this field? Does Armenia have all the necessary equipment to diagnose and treat cancer?

Rightly so, cancer care has been prioritized by the government of Armenia. As with nearly all healthcare systems, Armenia needs to continue to prioritise work on cancer prevention, diagnosis and treatment and ensure that these are better aligned. I believe that there is more work to be done on prevention, developing better screening programmes to ensure that cancer is diagnosed earlier. This can be done through increased awareness of different cancer symtoms and encouragement of the population to seek care when these symtoms arise.

When looking at ensuring that patients receive a timely diagnosis, the new cancer strategy needs to invest in strengthening and equipping the service and the healthcare workers so that can undertake diagnostics. A key theme for the strategy is ensuring improved access to safe and effective treatment. A large focus of this is access to medications, this is especially important in patients receiving palliative care.

By better controlling patients pain and other end of life symtoms, we can minismise their use of tertiary care services and therefore reduce costs overall. There needs to be better understanding of the needs of palliative care patients through this strategy, incorporating palliative care services and increasing medical education on palliative care. To ensure that the strategy is continuously developing and improving the introduction of a cancer register is required, to better collect data and allow for outcome analysis.

Cancer treatment is rather expensive, and most people in Armenia cannot afford it. How, in your opinion, should cancer treatment be financed in countries like Armenia? Who should pay for the treatment of cancer patients -- the state, insurance companies, the patient himself or charitable funds? How is this organized in the UK?

The WHO advises that patients receiving cancer care should do so ‘without incurring prohibitive personal or financial hardship’. The government of Armenia needs to assess what is the most suitable funding model for Armenia, be this through continued state funding with or without contributions from insurance companies or charitable funds.

In the UK the NHS is funded mainly from general taxation and national insurance contributions. There is also a contribution from user chargers, this includes prescriptions, dental treatment and glasses- however this is only a small amount. Central government undertakes an annual Spending Review to ensure that the NHS receives the level of funding that is originally allocated. Patients can also chose to pay themselves through the private health care system, funded by private and corporate insurance.

For many years, the National Institute of Oncology of Armenia was owned by the state, and now this institute is put up for privatization. In your opinion, can the commercialization of a healthcare sphere like oncology be dangerous? Can’t this make cancer treatment even less affordable for most Armenians?

The design of the strategy will have to take this into account. Whether the system is state owned or privatized, access to cancer care and treatment should still be universal as directed by the WHO. The National Institute of Oncology should also be the lead for cancer research in Armenia and therefore some aspects of the Institute may need to be privatized, due to the expense of research in this area. The over riding focus needs to be that we ensure that funding for the cancer strategy is increased, and sustainable. 

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