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The need to build on recent progressRising costs
Escalating the war on cancer will not be easy,
as Latin American economies face multiple
financing challenges. First, there are still unmet
basic social services and healthcare needs.
This has traditionally been compounded by
fragmentation of healthcare systems, combining
social security systems for those in the formal
sector with poorly financed public insurance for
the informal sector and the unemployed^21 as
well as private insurance schemes, which result
in disparities in care and outcomes.To address underprovision for the poor, Latin
America has responded with ambitious goals
for UHC—with astounding progress in many
cases. Countries like Argentina, Colombia,
Mexico and Peru have reported remarkable
progress in population coverage.^22 Measured
by the “UHC service coverage index”,
produced by the World Health Organisation
(WHO), the 12 countries studied averaged
about a 73% coverage in essential services
in 2015.^23 In spite of these signs of important
progress, PAHO estimated that, as of 2014,
about 30% of the population could not access
healthcare because of financial obstacles,
while 21% did not seek care because of
geographical barriers.^24A second challenge is that the specific
demands of cancer are large. There have
been some recent studies on the economicimpact of cancer in the region. For instance, an
estimation of overall direct and indirect costs
of cancer between 2010 and 2015 indicated
that the disease cost Brazil almost US$60bn
in 2015, with cancer expenditure representing
1.7% of GDP each year on average.^25
Moreover, for Brazil, the productivity lost as
a result of premature mortality due to cancer
was estimated at 0.21% of GDP in 2012.^26Meanwhile, the cost of cancer measured as
lost economic output has been estimated
in one study at US$30.78bn for Peru and
US$6.48bn for Costa Rica for 2015-30.^27 The
study took into account economic output
lost due to morbidity and mortality of the
labour supply, as well as the diversion of
funds in health expenditure. For Chile, direct
and indirect costs of cancer amount to over
US$2.1bn per year, or about 1% of GDP, based
on data from 2009.^28 More effort should go
into understanding the economic implications
of cancer in the region. Dr Gonzalo Vargas
Chacón, co-ordinator of the Consenso
Nacional de Especialistas en Cáncer in Costa
Rica, notes: “Cancer poses a serious risk for
the production cycle in terms of labour force
as it impacts people in their productive age.”(^21) K Strasser-Weippl et al., “Progress and remaining challenges for cancer control in Latin America and the Caribbean”, The Lancet Oncology, 2015.
(^22) K Strasser-Weippl et al., “Progress and remaining challenges for cancer control in Latin America and the Caribbean”, The Lancet Oncology, 2015.
(^23) WHO, Global Health Observatory data repository
(^24) PAHO and WHO, “Strategy for universal access to health and universal health coverage”, 53rd Directing Council, 2014.
(^25) Alessandra de Sá Earp Siqueira et al., “Economic Impact Analysis of Cancer in the Health System of Brazil: Model Based in Public Database”, Health
Science Journal, 2017.
(^26) Alison Pearce at al., “Productivity losses due to premature mortality from cancer in Brazil, Russia, India, China, and South Africa (BRICS): A population-
based comparison”, Cancer Epidemiology, 2018.
(^27) David E Bloom et al., “The economic burden of noncommunicable diseases and mental health conditions: results for Costa Rica, Jamaica, and Peru”,
Revista Panamericana de Salud Pública, 2018.
(^28) Camilo Cid et al., “Impacto económico del cáncer en Chile: una medición de costo directo e indirecto en base a registros 2009”, Medwave, 2016.