Implement cancer control law

With the country in the throes of an unprecedented pandemic, many other major public health concerns have taken a backseat. But health experts are calling for urgent action on a two-year-old law that was passed to ensure that cancer patients are provided quality health services — a concern even more imperative now with the COVID-19 health crisis, which puts them at greater risk but also limits their access to hospitals and doctors.

Republic Act No. 11215, or the National Integrated Cancer Control Act (NICCA), was signed into law in February 2019, but it remains to be implemented two years on, particularly the creation of the NICCA Council, which is at the heart of the law and is critical to its implementation.

The government allocated more than P700 million under the 2021 budget to this program—P620 million pooled from the P500-million Cancer Control Program, P120 million from the Cancer Assistance Fund, and P136 million regular allocation for cancer under the noncommunicable diseases budget line item. “Historically, the budget trend for the cancer control program has been fluctuating and, frankly, insufficient,” Health Secretary Francisco Duque III admitted last month. But, he emphasized, with the NICCA in place, the annual budget for the government’s Cancer Supportive Care and Palliative Care Medicines Access Program “will now be at least P700 million,” an amount that could provide coverage for more priority cancer types. Health Undersecretary Myrna Cabotaje had earlier said the work and financial plan was ready, and that she hoped the NICCA Council would be formed by the first quarter of this year.

It’s now the second quarter but, aside from these budget pronouncements, there has been no update on convening the council, prompting advocates to express frustration over the law’s slow implementation. Paul Perez, president of the Cancer Coalition of the Philippines, said the NICCA Council is “very critical” to RA 11215. “If they were not convened, what is there to fund?” he asked. “Having the law signed is one thing. Having it implemented is another. And, in the era of the coronavirus, it is really, really challenging.”

Per data from the World Health Organization (WHO), there were 92,606 cancer deaths and 153,751 new cancer cases reported in the Philippines last year. Cancer patients face increased risk of severe illness from COVID-19 because their condition, or its treatment, leaves them more vulnerable to complications, according to the United States’ National Cancer Institute.

The fear of getting infected by the coronavirus has complicated the picture, preventing many cancer patients in the Philippines from seeking treatment. A report by Vera Files published in December 2020 cited data from a Philippine Society of Medical Oncology (PSMO) survey among 92 cancer specialists: 85 percent of these board-certified cancer doctors said they observed a decrease in the number of patients they saw daily, while more than 90 percent said their patients expressed hesitancy to visit the hospital during the pandemic. The PSMO survey further revealed that over 93 percent of its doctors had a patient whose cancer had progressed, or had died after failing to seek urgent care in the middle of the severe lockdowns.

Many people who have noncommunicable diseases like cancer have in fact not been receiving the health services and medicines they need since the COVID-19 pandemic began, a WHO survey of 155 countries conducted in May last year revealed. Among the reasons cited was the decrease in public transportation. In the early part of last year’s lockdown, there were reports of patients who had to walk to the hospital or government institutions to seek treatment or help. One of them, Henry dela Cruz Jr., walked almost five kilometers from his house in Antipolo to the Philippine Charity Sweepstakes Office (PCSO) in Quezon City, where he had to secure a document that would waive more than half the cost of his medicines.

Aside from medicines, tests and treatments for cancer could be especially costly for the poor, thus many cases are diagnosed late because patients are daunted by the expense. The PCSO has decreased its aid for each patient application, from P50,000 to P10,000. As Dela Cruz lamented to Vera Files, “Napakamahal magkaroon ng cancer sa Pilipinas, lalo na sa mga underprivileged at marginalized sector.”

The immediate implementation of NICCA, advocates say, is thus very crucial for cancer patients, because it envisions a more equitable and affordable cancer treatment, including the creation of the Cancer Assistance Fund that would provide much-needed financial assistance to patients in need.

The law has been signed, the funds allocated, and the pandemic demands that the government act quickly for cancer sufferers—so what’s stopping the Department of Health from creating the cancer council?