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The need to build on recent progressThe City Cancer Challenge supports
countries with limited resources to
enhance cancer care by strengthening
the response at the local level through an
approach involving needs assessments,
multi-stakeholder action, monitoring and
knowledge-sharing.Developed by the Union for International
Cancer Control (UICC), and now led by
the independent City Cancer Challenge
Foundation (C/Can), this initiative recognises
that the majority of the world’s population
is now living in urban settings, with cities
often at the front line of public health and
development challenges.^96The programme aims to improve cities’
cancer response through the following
approach:- Local conditions and stakeholders are
identified first, and a needs assessment is
carried out to identify priorities. - This is followed by a stage of planning.
Opportunities for partnerships and
technical support are identified. - Then there is an implementation
stage with monitoring and evaluation,
culminating in a process of knowledge-
sharing among cities.^97
Operations are initiated once a
Memorandum of Understanding is signed
among relevant health and administrative
authorities and C/Can, which provides
the framework for subsequent action. In
the case of Cali, Colombia, the municipal
authorities lead the initiative, but regional
and national authorities were also involved.
According to Silvina Frech, the Latin
America director at C/Can, there is a key
focus on “empowering city leaders, to
achieve sustainable solutions”. The model
is operating now in seven cities around the
world.Cali was the first city selected for
implementation in 2017, followed by
Asunción and Yangon. Candidate cities
were evaluated based on aspects of political
commitment, stakeholder engagement,
availability of cancer planning and data, and
availability of key cancer services, following
a checklist prepared by the UICC.^98A number of conditions led to the selection
of Cali. The city is home to a cancer registry,
which has been operating for more than
50 years and is a regional benchmark for
quality. This would provide a comprehensive
baseline for the programme. It had an
active cancer response, with a wide range
of services available, but the majority of
those are in the private sector. Overall
cancer survival was disappointing, with
starkly different outcomes for those in
private insurance against the uninsured.
With a population of 2.4m, the city’s cancer
challenges were growing given the influx of
rural people from surrounding areas.^99The City Cancer Challenge in Cali, a model of multi-stakeholder
collaboration
(^96) Luis Eduardo Bravo et al., “Cali, Colombia, Key learning City C/Can 2025: City Cancer Challenge”, Colombia Médica, 2017.
(^97) https://citycancerchallenge.org/
(^98) UICC, City Cancer Challenge Checklist, 2018.
(^99) Luis Eduardo Bravo et al., “Cali, Colombia, Key learning City C/Can 2025: City Cancer Challenge”, Colombia Médica, 2017.