WHO Meetings

ESMO consistently engages in high-level global health forums, focusing on crucial issues affecting patients with cancer and their doctors, and sharing knowledge and tools to help the World Health Organisation (WHO) Member States improve access to optimal cancer care for all.

As a recognised ‘Non-State Actor in official relations with the WHO’, ESMO was invited to deliver statements at the official proceedings of the 77^th WHO’s World Health Assembly (WHA77) in Geneva, Switzerland between 27^th May and 1^st June 2024. These individual statements addressed the following topics:

1. Pandemic Agreement – urging Member States to integrate disaster risk management into both secondary and tertiary healthcare where millions of patients with cancer are predominately treated; and to ensure continued access to life-saving services during and beyond emergencies.
2. Amendments to the International Health Regulations (2005) – stressing the importance of strengthening health systems’ preparedness for future pandemics so that the millions of patients with cancer are not left behind, and highlighting that pandemic related urgencies should not overshadow essential care for patients or compromise decent working conditions of healthcare professionals.
3. Immunization Agenda 2030 – by emphasising that prevention offers the most cost-effective long-term strategy for cancer control and urging the WHO Member States to:
   • Include gender-neutral, routine vaccination against human papillomaviruses (HPV) in their national programmes.
   • Maximise the uptake of the vaccines against the Hepatitis B virus (HBV) and raise awareness among high risk and disadvantaged groups on the benefits of the vaccines.
   • Improve vaccination coverage against both HPV and HBV viruses by making them mandatory and free of charge for all as part of national vaccination programmes.
4. Climate change, pollution and health – by urging the national governments to align their air quality standards with the WHO’s recommendations, in particular the annual limit value for fine particulate matter (PM2.5) in order to reduce the incidence of lung cancer (including non-smokers) and breast cancer. As a result, the WHA77 adopted a landmark resolution on climate change and health (including air pollution) by consensus with support from a coalition of 37 co-sponsor member states and the WHO is expected to work on developing the Global Plan of Action on Climate Change and Health (GPoA) to deliver on the agreed commitments alongside WHO’s strategy aimed at transitioning to climate neutrality by 2030.

In addition, ESMO joined a constituency statement by the NCD Alliance (NCDA) on the 14^th General Programme of Work: 2025-2028 (GPW14), which forms a high-level roadmap that will guide WHO’s work for the next 4 years and reinvigorate actions needed to get the health-related Sustainable Development Goals (SDGs) on track, including cancer, while future-proofing health and care systems for the post-SDG era. GPW14 will also serve as the technical strategy to underpin the first WHO Investment Round proposed for end 2024. The joint statement delivered by the NCDA emphasised the importance of a robust framework of national NCD-specific indicators to help inform policies and investments, which will complement the GPW 14 results framework. These frameworks should include data on the burden of NCDs, service coverage (including access to essential medicines, technologies, and diagnostics across all levels of the health system), catastrophic health spending, and overall investment in NCD services.

By delivering these statements at the WHA77, ESMO aims to secure a more robust and inclusive approach to cancer prevention and care on a global scale. By addressing critical areas such pandemic preparedness, vaccination coverage against preventable cancers, climate change, air pollution and the integration of health policies, ESMO underscores the need for resilient health systems that prioritise cancer care amidst global crises. These efforts are intended to ensure that essential cancer services remain accessible and effective, safeguarding the health of millions of patients with cancer worldwide.

ESMO’s advocacy is designed to further influence the WHO Member States to adopt and implement policies that reflect these priorities, leveraging international platforms like the WHA to catalyse action. Through collaboration with the WHO and other stakeholders, ESMO aims to drive forward a global agenda that not only mitigates the impacts of current and future health emergencies but also strengthens the overall infrastructure for cancer care, thus paving the way for sustainable health financing and the achievement of the health-related Sustainable Development Goals (SDGs).

About the WHO’s World Health Assembly

The World Health Assembly is the decision-making body of WHO. It is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board. The 77th World Health Assembly had as a theme: ‘All for Health, Health for All’.

ESMO urges WHO Member States to place cancer prevention and care at the core of decision-making on health systems.

ESMO delivered five official statements to the 154th World Health Organisation Executive Board meeting in Geneva, 22.-27. January 2024, on Universal Health Coverage, Non-Communicable Diseases, HPV vaccines, Health Emergencies, and Air Pollution.

ESMO regularly contributes to global health forums at the highest political level, highlighting issues that matter to patients with cancer and their carers, and sharing knowledge and tools that can support countries to enhance patients’ access to optimal cancer care.

Enabled by its ‘Non-State actors in official relations with World Health Organisation (WHO)’ status, ESMO was invited to make statements at the WHO 154^th Executive Body (EB) meeting in Geneva. The statements:

• Highlighted the urgency to advance the implementation of the 2023 UN Political Declaration on Universal Health Coverage (UHC) in Member Sates so that cancer care for the entire population is included in UHC benefit packages.
• Urged the improvement of cancer services and optimization of resources to achieve equity in cancer care by using ESMO-MCBS, and implementing the WHO National Cancer Control Plan (NCCP) tool, co-developed by ESMO.
• Stressed that HPV and HBV vaccines are an important and cost-effective long-term strategy for cancer control.
• Reiterated that health emergency preparedness and response planning must include strengthening of secondary and tertiary care levels, where patients with cancer are predominately treated.
• Urged the Member States to ensure alignment of air quality standards with the WHO’s recommendations, to reduce the incidence of lung and breast cancers[PFE5] .

During the 154^th WHO EB meeting, ESMO’s Official Relations status was renewed for the next three-year period (2024-2026). The status is a privilege, that is granted only to organizations that contribute significantly to the advancement of public health.

The WHO EB advises and facilitates the work of the World Health Assembly (WHA), which is the supreme decision-making body, composed of 194 Member States. ESMO will follow through the issues highlighted in the five statements to the EB at the next meeting of the WHA in May 2024 to continue to steer health policymaking at global and national levels.

During the 76th World Health Assembly, 21–30 May 2023, ESMO delivered an official statement and endorsed two joint statements with other societies.

The ESMO statement submitted welcomed the most recent draft amendments to the International Health Regulations, which if adopted by WHO Member States in 2024 will be legally binding under international law as of 2025, unless a state proactively files rejections or reservations within a 10-month period after their adoption in 2024. 

These amendments include the recommendations proposed by ESMO, that resilient health systems should include not only local community and primary health care services but also both secondary and tertiary level services.

Given that cancer patients are disproportionately treated at secondary and/or tertiary levels, and that one in five people will develop cancer at some point in their lives, ESMO urged Member States to ensure that this wording remains in the final version of the updated International Health Regulations in order not leave millions of cancer patients behind.

ESMO  also called on WHO and UN Member States to support the inclusion of equally specific language on secondary and tertiary healthcare, as opposed to the more generic term ‘continuum of care’, in the planned 2023 UN Political Declaration on Universal Health Coverage to be adopted by the UN on 21 September 2023. This Political Declaration represents the commitment of governments at the highest political levels to work towards achieving Universal Health Coverage by 2030, and to uphold the human right to health through the provision of affordable quality health services that leave no one behind. During the meeting, the World Health Assembly was asked to note the reports of the WHO Director General related to the topics above and to adopt Resolution (EB152/5) entitled: Preparation for the high-level meeting of the United Nations General Assembly on universal health coverage

Understanding that sustainable and resilient health systems need to be founded on Universal Health Coverage, and that to achieve Universal Health Coverage Noncommunicable Diseases must be addressed, ESMO endorsed a joint statement led by the Union for International Cancer Control (UICC) calling on governments to utilize the WHO ‘Best Buys’ (updated Appendix 3) to develop and scale-up national Universal Health Coverage benefit packages. Appendix 3 consists of a menu of policy options to support the implementation of WHO Global NCD Action Plan 2023-2030 objectives. It outlines a list of policy options and cost-effective interventions Member States should prioritise in order to prevent and control NCDs. For cancer treatment, it includes the 14 most cost-effective actions countries can take. The statement also calls for a coherent patient pathway between detection, diagnosis and treatment, the inclusion of palliative and rehabilitation services into existing NCD infrastructures and Universal Health Coverage, as well as monitoring the effectiveness of NCD interventions, and the planning for their continuation during health emergencies. The World Health Assembly endorsed the ‘best buys’, which provide countries of all income levels additional options to save lives from the diseases with the highest levels of mortality.

ESMO also joined a statement by the NCD Alliance on the WHO framework for 'Well-being and health promotion' which is one of WHO’s triple billion targets. The target is for 1 billion people to enjoy better health and well-being by 2025. The joint statement urges Member States to safeguard well-being policies from conflict of interests from the private sector, involve people living with NCDs in the planning and development of well-being policies, and promote multisectoral solutions that leverage existing policies in other areas and ensure that all health-related policies are complementary and reinforce each other. The World Health Assembly adopted the “Global framework for integrating well-being into public health utilizing a health promotion approach", which “strives to enable all people to flourish and achieve their full physical and mental health potential throughout their lives and across generations”. It’s six key strategic directions focus on: universal health coverage, equitable economies, protecting the planet, social protection systems, digital systems to enable health, and measuring and monitoring well-being.

ESMO congratulated WHO on its 75th Anniversary this year, which also represents the 20th Anniversary of the Framework Convention on Tobacco Control, the first international treaty negotiated under the auspices of WHO.

On 31 May, 2023, which is World No Tobacco Day, ESMO published an editorial in ESMO Open entitled: Tobacco cessation and the role of ESMO and medical oncologists: addressing the specific needs of cancer patients in times of the COVID-19 pandemic.

The editorial supports a focus of ESMO’s mission to reduce the burden of cancer, which includes promoting healthy lifestyles and preventing cancer. As far back as 2008, ESMO published the ‘ESMO position paper: The perspective and role of medical oncologists in cancer prevention’, noting that medical oncologists should inform their patients about lifestyle and environmental factors, which include smoking, explaining how they can adversely impact cancer treatment and survival.

It is estimated that 2.5 million cancer deaths were attributed to smoking in 2019. The American Lung Association notes that “More people die from lung cancer than any other type of cancer. Cigarette smoking is the number one risk factor for lung cancer; it's responsible for close to 80% of lung cancer cases”.  

This editorial, co-authored by WHO, ESMO and Charité Berlin seeks to raise awareness of actions that medical oncologists can take to contribute to tobacco cessation.

The  editorial highlights

• The need for oncology professionals to embrace the Health Professional Code of Practice on Tobacco Control, and serve as role models.
• The role of oncologists in supporting their patients and family members to quit smoking, as well as promoting smoke-free environments and the development of national tobacco control plans.
• That the topic of tobacco cessation is included in the ESMO-ASCO Recommendations for a Global Curriculum in Medical Oncology
• ESMO support for the development of the freely accessible ‘World Cancer Report Updates’ learning platform of the International Agency for Research on Cancer (IARC), which provides “a reliable resource for ESMO members for evidence-based data on the burden of cancer, its prevention, modifiable risk factors such as tobacco use, and public policy recommendations”.
• ESMO as a key partner in the Europe-wide ‘Cancer Prevention Across Europe’ campaign (PrEvCan), led by the European Oncology Nursing Society (EONS), in key partnership with ESMO, and around 60 other international and national organizations.
• The upcoming review of EU legislation on tobacco, envisaged in the EU’s Beating Cancer Plan, which ESMO is closely following and actively engaging in.
• The WHO Framework Convention on Tobacco Control (WHO FCTC), which celebrates its 20th anniversary in 2023. As  the first international public health treaty developed under the auspices of WHO, and it “provides a comprehensive approach to reduce the considerable health and economic burden caused by tobacco”.
• The WHO Tobacco Cessation Consortium launched in 2022 at the World Health Summit hosted by Charité Berlin and the WHO.

About World No Tobacco Day

The Member States of the World Health Organization created World No Tobacco Day in 1987 and in 1988 passed a Resolution for its celebration every year on 31 May.

The theme of World No Tobacco Day 2023 was to “Grow food, not tobacco”. It was accompanied by a WHO report calling on countries *to stop subsidizing tobacco farming and support more sustainable crops that could feed millions”, considering that more than 300 million people globally are faced with acute food insecurity.

In response to the Covid-19 pandemic, the 194 Member States of the World Health Organization are negotiating a convention, agreement, or other international instrument (generally referred to as the ‘pandemic accord’ or ‘CA+’ – Convention Agreement +) to strengthen pandemic prevention, preparedness and response and increase health security. 

Under the coordination of WHO, the Intergovernmental Negotiating Body (INB) composed of WHO Member States is leading this process. The content of the pandemic accord is crucial as it will regulate health globally and Member States will decide its terms, including whether any of its provisions will be legally binding under international law.

In addition, the WHO is coordinating the update of the 2005 International Health Regulations (IHR), which are legally binding, unless a state proactively files rejections or reservations within a 10-month period after their adoption.

Both documents are intended to regulate a coordinated global effort for national and international responses to health emergencies. Key components are strengthening the role of WHO, increasing the resilience of health systems, and uniting collective action around the principles of equity, inclusivity, and coherence for worldwide assistance and distribution of essential medical goods, including vaccines.

The proposed Amendments to the International Health Regulations (2005) include ESMO ask for ‘secondary and ‘tertiary’ care to be specified in the text to ensure that cancer patients, who are disproportionately treated at these levels, are not left behind during health emergencies.

During the first joint meeting between the INB and the WHO International Health Regulations Working Group, 21 and 24 July 2023, ESMO delivered a statement that called for the Pandemic Accord to be consistent with the IHR and to also to include specific wording on ‘robust referral services from primary to secondary and tertiary health care services’.

ESMO participates in the Intergovernmental Negotiating Body (INB) meetings that bring together the 194 WHO Member States to negotiate a Pandemic Accord. In the 12 June 2023 meeting, ESMO highlighted the importance of continued provision of health services at secondary and tertiary levels to cancer patients during health emergencies.

In light of the impact of the COVID-19 pandemic, the 194 Member States of the World Health Organization are negotiating a ‘Pandemic Accord’. The aim of the new international instrument is to strengthen pandemic prevention, preparedness and response, and to increase health security. It is noteworthy - and a cause for concern, that the Intergovernmental Negotiating Body’s (INB) proposed compilation text, which is the basis for Member States negotiations, does not explicitly mention secondary or tertiary care.

ESMO delivered a statement at the INB 5th meeting on Monday 12 June 2023 to urge the negotiating parties to strengthen the wording on the preparedness and resilience of health systems by specifying both secondary and tertiary care, and the need to ensure robust referral systems from primary care to these levels of care, where cancer patients are treated. Given that an estimated one in five people will develop cancer at some point in their lives, this precision is crucial to not leave millions of patients behind and without adequate and timely care during and beyond pandemics.

The new Pandemic Accord is anticipated to promote political commitment at the highest level to prevent and respond to pandemics, as well as ensure sustained financial investment within and among countries. The INB will submit its outcomes for consideration and adoption by the Seventy-seventh World Health Assembly in May 2024.

The ESMO ask for access to secondary and tertiary healthcare services is included in the latest amendments to the International Health Regulations (IHR), which will be legally binding once adopted, and the Zero draft of the 2023 UN Political Declaration on Universal Health Coverage to be adopted on 21 September 2023. Therefore, during the first joint meeting between the INB and the WHO International Health Regulations Working Group, 21 and 24 July 2023, ESMO delivered a statement that again called for robust referral services from primary to secondary and tertiary health care services to be specifically mentioned in the WHO Pandemic Accord where this wording is currently missing. 

The new Pandemic Accord is anticipated to promote political commitment at the highest level to prevent and respond to pandemics, as well as ensure sustained financial investment within and among countries. The INB will submit its outcomes for consideration and adoption by the Seventy-seventh World Health Assembly in May 2024.

ESMO was invited to participate in the Open Session of the 24th WHO Expert Committee on Selection and Use of Essential Medicines. During the session on 24 April 2023, ESMO’s Chief Medical Officer, George Pentheroudakis, provided an update on ESMO tools and resources, such as the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS), the ESMO Clinical Practice Guidelines, including the Pan-Asian Guidelines Adaptation (PAGA), that can be used to improve the evaluation of, and access to, cancer medicines globally.

Since 2019, the WHO Expert Committee on Selection and Use of Medicines acknowledges the role of the ESMO-MCBS as a screening tool to identify cancer treatments that have potential therapeutic value that warrants full evaluation for the Essential Medicines List (EML) listing. Potential new EML cancer medicines, in general, should have a score on the ESMO-MCBS of A or B in the curative setting and of 4 or 5 in the non-curative setting.

The WHO Model List of Essential Medicines is updated every 2 years, and, as appropriate, ESMO proposes new cancer medicines for the WHO Expert Committee to consider adding to the list, and provides WHO with the ESMO-MCBS scores for other cancer medicines for which applications for the EML list have been submitted to WHO by other stakeholders.

For the 152nd Session of the WHO Executive Board meeting, 30 January – 7 February 2023, ESMO submitted 4 official statements on the agenda topics of:

1. Universal Health Coverage
2. Strengthening WHO preparedness for and response to health emergencies - Strengthening the global architecture for health emergency preparedness, response and resilience
3. Political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases, and mental health
4. Strengthening clinical trials to provide high-quality evidence on health interventions and to improve research quality and coordination

Universal Health Coverage

ESMO’s official statement welcomed the WHO’s call to accelerate and intensify priority actions towards achieving Universal Health Coverage by 2030 as outlined in the Director-General’s Report.

The current situation is that many countries are not on track to achieve Universal Health Coverage by 2030 as called for in the 2015 United Nation’s Sustainable Development Goals and the 2019 United Nations High-Level Meeting on Universal Coverage.

Therefore, ESMO invited Member States to draw upon ESMO’s cancer resources in their efforts to deliver the 3 strands of Universal Health Coverage:

1. The ‘ESMO Global Curriculum in Medical Oncology’ can support training the necessary workforce to ‘increase population coverage’.
2. The evidence-based ‘ ESMO Clinical Practice Guidelines’ and ‘Pan-Asian Adapted Guidelines’ can support decisions to cost-effectively ‘expand essential health services’.
3. The ‘ESMO-Magnitude of Clinical Benefit Scale’ can support countries to prioritize the use of cancer medicines to both improve health outcomes and ‘reduce the financial burden of health services’.

ESMO has already assisted 5 WHO Member States deliver cost-effective cancer services in their Universal Health Coverage packages, and remains available to help others to do the same.

Health Emergencies

ESMO submitted its official statement on the agenda item “Strengthening WHO preparedness for and response to health emergencies - Strengthening the global architecture for health emergency preparedness, response and resilience”. 

ESMO welcomed the WHO’s work coordinating a global process to “draft and negotiate a convention, agreement or other international instrument (generally referred to as the ‘pandemic accord’) to strengthen pandemic prevention, preparedness and response” as outlined in the WHO Director-General’s Report. The process is led by Member States through the Intergovernmental Negotiating Body (INB).

The content of the pandemic accord is crucial as it will regulate health globally and Member States will decide its terms, including whether any of its provisions will be legally binding as a matter of international law.  

ESMO has provided input to the discussions on health emergencies on an ongoing basis at previous WHO meetings, and to the consultation of the third meeting of the INB3 on the pandemic accord, to ensure that the needs of the cancer workforce and cancer patients are addressed in the final documents. 

ESMO’s statement asked WHO Member States to give further consideration to expanding upon actions to address the following issues within the pandemic accord: 

1. Providing healthcare professionals with ethical and methodological guidelines on decision-making to help them deliver the best possible outcomes in situations where resources are scarce or require reallocation.
2. Developing an action plan to address the needs of vulnerable patients who are unable to access health services, due to travel restrictions or the fear of leaving their homes, on a timely basis during a global health emergency.
3. Leveraging civil society’s resources, like our own ‘COVID-19 and Cancer’ web portal, to inform efforts to minimize the risk to cancer patients during health emergencies. 

ESMO has also reaffirmed the commitment to assist WHO and its Member States in their invaluable efforts to prepare for, and respond to, health emergencies. 

Both documents are intended to regulate a coordinated global effort for national and international responses to health emergencies. Key components are strengthening the role of WHO, increasing the resilience of health systems, uniting collective action around the principles of equity, inclusivity, and coherence for worldwide assistance and distribution of essential medical goods, including vaccines.  

The INB submits its outcome document for consideration by the 77th World Health Assembly in 2024. 

Strengthening Clinical Trials

ESMO submitted an official statement  on the agenda item ‘Strengthening clinical trials to provide high-quality evidence on health interventions and to improve research quality and coordination’, that was accompanied by a report from the WHO Director General.

As the leading professional organisation for medical oncology, counting more than 28,000 professional medical oncologists who treat cancer patients and perform clinical trials, ESMO supported the WHO proposal to coordinate the development of normative guidance for all aspects of clinical trials, including expanding the ‘International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use’ guidelines, and most importantly to include health care professionals in their development.

ESMO also supported the WHO proposal of comprehensive mapping of national clinical trial infrastructures, which should include not-for-profit cooperative oncology groups. ESMO requested that indicators to track progress be included in the WHO self-assessment tools for use in the clinical trial ecosystem.

ESMO said it stands ready to support the design of robust WHO guidance on clinical trials because of their critical role in facilitating innovative research and delivering effective treatments.

In 2022, ESMO responded with written input to the WHO Consultation on Strengthening Clinical Trials that fed into this WHO agenda item. We recommended that any WHO international guidelines on clinical trials should:

1. Enable the regulatory environment by ensuring international guidance respect the principles and high standards  defined by the Declaration of Helsinki and the guidelines for Good Clinical Practice, as well as national and local regulations that guarantee patients' safety and rights, data protection, and the scientific integrity of data and its sharing.
2. Protect and foster independent academic clinical research by ensuring an efficient legal and funding framework that can optimize novel therapeutic multidisciplinary strategies and investigate important, but less commercially attractive, research areas and health issues, such as rare cancers.
3. Streamline the clinical trials process by simplifying, decentralizing, and reducing bureaucratic requirements which impede advances in scientific research, and are especially challenging for non-commercial trials.

The WHO Resolution on Strengthening Clinical Trials (WHA75.8) was adopted at the 2022 World Health Assembly.

The input from ESMO, as well as other stakeholders, to the 2022 WHO Consultation on Strengthening Clinical Trials can be found on the WHO website: Implementation of the resolution on clinical trials WHA 75.8.

In addition, WHO published a supplementary report with more extensive summaries of the inputs received to the Consultation, which is available here.

Non-communicable Diseases – Appendix 3, WHO Best Buys

ESMO submitted an official statement  on the agenda item Political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases, and mental health.

ESMO welcomed the WHO’s update of Appendix 3 of the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2030 as outlined in the WHO Director-General’s Report for this agenda item.

Appendix 3 represents the list of policy options and cost-effective interventions, commonly known as WHO ‘Best Buys’, health services that Member States should prioritize in order to prevent and control NCDs, which include cancer.

With cancer as a leading cause of death worldwide, ESMO urged governments to include the preventative interventions on the lifestyle risk factors of tobacco use, harmful use of alcohol, unhealthy diet, and physical inactivity, as well as the 14 cancer-specific interventions from Appendix 3, into national universal health coverage plans.

ESMO is proud that its clinical practice guidelines and expertise were able to support WHO in defining the cancer interventions of Appendix 3, which can in turn assist countries in defining their own national NCD interventions.

During the he 72nd Session of the WHO Regional Committee for Europe, 12-14 September 2022 in Tel Aviv, Israel, ESMO President Solange Peters submitted a video statement on ‘Working Together for the Elimination of Cervical Cancer,’ upon invitation by the WHO Regional Director for Europe, Hans Kluge, for the resolution of the ‘Roadmap to accelerate the elimination of cervical cancer as a public health problem in the WHO European Region 2022–2030’.

The ESMO Statement is posted on the WHO Europe YouTube Channel, noting that “In the push to eliminate cervical cancer, partnerships are critical. The European Society for Medical Oncology (ESMO) is a key partner in disseminating knowledge and best practices about what works to reduce disparities in clinical outcomes across the WHO European Region”.

This Roadmap on cervical cancer represents WHO Europe’s implementation of the WHO Resolution on the ‘Global strategy to accelerate the elimination of cervical cancer as a public health problem and its associated goals and targets for the period 2020–2030’, adopted by the World Health Assembly in 2020, and supported by ESMO.

The ESMO statement:

1. Welcomed the WHO Europe Roadmap and its clear value to foster partnerships, highlight implementation research, and to transfer evidence-based knowledge
2. Noted that ESMO contributed with its expertise to the WHO global strategy to accelerate the elimination of cervical cancer
3. Reaffirmed ESMO’s continued support for efforts to disseminate and share best practices, for example within ESMO training programmes and the publication of the evidence-based ‘ESMO Clinical Practice Guidelines’ on topics such as Cervical Cancer, Fertility Preservation, and Supportive and Palliative Care
4. Raised awareness that ESMO’s collaboration with WHO and health authorities has yielded results in several countries, supporting increased access to care for women with cervical cancer

Solange Peters concluded the ESMO statement saying that “As cancer professionals, we see the consequences of inaction and inequalities. Therefore, we encourage all stakeholders to share their knowledge and resources, and to implement what we all know works, by engaging our networks in a united ‘whole-of-government’ and ‘whole-of-society’ approach, as we stand together with women everywhere, and work towards the elimination of cervical cancer.”

In addition, ESMO endorsed 3 statements with other societies on the following agenda items:

1.  Regional digital health action plan for the WHO European Region’
2.  Implementation of the Action Plan for the Prevention and Control of Noncommunicable Diseases in the WHO European Region 2016–2025: Progress report
3. WHO European framework for action to achieve the highest attainable standard of health for persons with disabilities 2022–2030

Digital Health

ESMO endorsed joint statement with 28 other societies supporting the resolution on the ‘Regional digital health action plan for the WHO European Region’. Digital Health is a flagship project of WHO Europe’s ‘European Programme of Work’

The joint statement welcomes the action plan as well as its guiding principles and its vision to improve health outcomes for everyone, everywhere, equitably.

The joint statement calls for:

• Mindful and balanced implementation, so that the digital transition does not leave people behind and exacerbate health inequalities
• Addressing disruptions and a lack of capacity, training, and resources to ensure appropriate use of digital tools and technologies
• Reinforcing access to, and health literature for, the use of digital tools that can greatly support health systems, improve prevention and care, and increase equity, particularly in dealing with the burden of NCDs and mental health problems and supporting healthy behaviours
• Elaboration by WHO Europe of the following points:
  1. Focus on up- and reskilling the European health workforce to support implementation of digital transitions in health ecosystems at all levels, by ensuring availability of tools and resources, such as those developed by the new, EU-funded “BeWell” initiative.
  2. Clear digital health governance mechanisms to safeguard privacy and trust, and which also permit for meaningful and inclusive public and patient involvement in the digital health transformation and for consistent access to data for research across Member States.
  3. Providing guidance for engaging with industry and establishing labelling and certification schemes to help identify trustworthy digital health tools and applications, as done by the new “Label2Enable” project.
  4. Standardization of digital tools and technologies to foster greater accessibility, transferability, and integration, both across countries as well as sectors. Integration with digital social services and social service innovations is particularly critical.

The joint statement also stressed the need to align with the European Union’s strategies and actions on digital health, which include proposed legislation for a European Health Data Space.

All organisations endorsing the joint statement reaffirmed their commitment to support the plan’s implementation and called upon WHO Europe Member States and partners across Europe and the globe to take advantage of all opportunities to translate the digital health action plan into practice.

Palliative Care

ESMO, together with other organisations, endorsed a joint statement on the ‘Implementation of the Action Plan for the Prevention and Control of Noncommunicable Diseases in the WHO European Region 2016–2025: Progress report’.

The statement:

1. Welcomed the Action Plan’s inclusion of palliative care and its recognition of the need to continue to improve palliative care services, acknowledging they suffered major disruption because of the COVID-19 pandemic.
2. Appreciated WHO Europe’s support to Member States to improve palliative care services, as part of its ‘United Action Against Cancer’.
3. Urged Member States to take action to:
   • Improve palliative care for all people suffering from noncommunicable diseases (NCDs) through education of their health workforce in basic palliative care and the prescribing of internationally controlled medicines
   • Improve access to medicines, which are included in the WHO Model List of Essential Medicines, Section 2
   • Procure the Essential Package of palliative care services and medicines for the treatment and care of persons with NCDs.

In conclusion, the International Association of Hospice and Palliative Care and the endorsing organisations reaffirmed in the statement their commitment to partner with WHO Europe and its Member States to accelerate the uptake of basic health worker education, supply chain strengthening, regulatory strengthening to promote balanced policies, and access to affordable generics.

Rights of Persons with Disabilities

ESMO, together with other organisations, endorsed a joint statement on the resolution on the ‘WHO European framework for action to achieve the highest attainable standard of health for persons with disabilities 2022–2030’.

The statement:

1. Noted that the framework aligns with WHO Europe’s European Programme of Work, 2020–2025, which includes palliative care as part of the care continuum
2. Noted that the WHO Life Course approach includes all age groups, and reminded Member States that they approved Human Rights Council Resolution 48/3 in 2021 on Older Persons that explicitly includes a right to palliative care as a component of the right to the highest attainable standard of health for older persons
3. Stressed the importance of developing palliative care services for persons with physical and intellectual disabilities, including the dementias, emphasising that persons with disabilities are more likely to experience delayed access to healthcare, have unmet health care needs and poorer health outcomes, leading to unnecessarily high health care costs.
4. Requested that the list of services in the Framework be expanded to include palliative care
5. Shared concerns that “persons with disabilities may be less likely to receive needed life-saving treatment and that they may be disproportionately affected by the measures taken to control the pandemic” and suggested that persons with disabilities may also be less likely to receive palliative care
6. Referenced important reports on palliative care for persons with intellectual disabilities:
   • The Human Rights of Older People with Mental Health Conditions and Psychosocial Disability to a Good Death and Dying Well
   • Consensus Norms for Palliative Care of people with Intellectual Disabilities in Europe: EAPC White Paper
   • The challenges and triumphs of developing a survey on palliative care for people with intellectual disabilities around the world

In conclusion, the  statement reaffirmed the support of the International Association for Hospice and Palliative Care, as well as those organisations endorsing the statement, to offer their expertise to support the availability of palliative care services. It also called for the reporting on the implementation of palliative care services in the Region in midterm (2026) and final (2030) WHO Europe monitoring reports.

During the 75^th World Health Assembly, 22-28 May 2022, ESMO delivered 3 statements on the following agenda topics:

1. Human Resources for Health
2. Follow-up to the political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases
3. The Public Health Dimension of the World Drug Problem

Human Resources for Health

An ESMO statement was delivered by the ESMO President, Solange Peters, on the topic of Human Resources for Health, where she noted that the ever-growing cancer burden highlights the urgent need for more specialized cancer doctors to achieve universal health coverage.

The WHO publication in ESMO Open entitled Distribution of the workforce involved in cancer care: a systematic review of the literature, notes that “In order to tackle the disparities in cancer-related outcomes, a critical aspect is to strengthen the workforce for cancer care. Increasing health financing, recruitment, training, and retention of the workforce in LMs are key targets of the SDG agenda. The health workforce is a vital pillar of the health care system, and it is fundamental for delivering high-quality cancer care services”.

The COVID-19 pandemic and caring for displaced refugee patients from Ukraine have shown the reality of an inadequate number of health and care workers. They have served on the frontline, above and beyond their normal workload, and some have endured trauma, suffered burn out, and others have lost their lives.

For this reason, the ESMO statement emphasised that countries need a sufficient number of well-trained and well-equipped workforce of cancer professionals to ensure quality delivers of preventative strategies, timely diagnosis, and the safe and effective administration of cancer therapies and palliative care services. It also raised awareness that the ESMO Global Curriculum in Medical Oncology can support countries in the training of medical oncologists, noting the curriculum is freely available on the ESMO website.

The World Health Assembly noted the reports and adopted the resolution on Human Resources for Health, including the following, which call for investment in and protection of the health workforce worldwide:

1. Working for Health: draft 2022–2030 action plan, Report of the WHO Director-General
2. Global health and care worker compact
3. WHO Global Code of Practice on the International Recruitment of Health Personnel: fourth round of national reporting, Report by the WHO Director-General
4. Global strategy on human resources for health: workforce 2030, Report by the Director-General

Notes:

• In 2021, an ESMO statement at the 74th World Health Assembly, ESMO welcomed the Resolution on ‘Protecting, safeguarding and investing in the health and care workforce’. The Resolution reinforced WHO’s dedication of 2021 as the International Year of Health and Care Workers and requested governments to develop national workforce strategies, safeguard the rights of all health personnel, and to prioritise investments in health and care worker recruitment, retention, education, training, and protection, in order to build resilient and sustainable health system capacities that work towards Universal Health Coverage and leave no one behind.
• Following the ESMO Young Oncologists’ Burnout Survey, which highlighted the need to increase burnout awareness among oncology professionals, ESMO launched the Resilience Task Force to help understand risk factors, interventions and to develop solutions to help support the welfare of the oncology community.

Non-communicable Diseases

An ESMO statement was delivered by the ESMO Director of Public Policy, Rosa Giuliani, on the topic of ‘Follow-up to the political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases’ .

ESMO welcomed the many NCD strategies under this agenda item, and called on countries to implement them to support achieving universal health coverage and resilient health systems. ESMO urged the integration of these strategies into national NCD plans to avoid the delays and disruptions in cancer services reported by WHO during the current pandemic and health emergencies.

To support countries in planning and prioritizing their cancer services, ESMO highlighted its evidence-based ESMO Clinical Practice Guidelines, that set the standard of cancer care, and have also been adapted for cancer management during the global pandemic.

The 194 WHO Member States unanimously noted and decided to adopt the strategies and recommendations in the documents below:

1. Draft implementation road map 2023–2030 for the global action plan for the prevention and control of noncommunicable diseases 2013–2030 (document A75/10 Add.8)
2. Draft recommendations to strengthen and monitor diabetes responses within national noncommunicable disease programmes, including potential targets
3. Draft global strategy on oral health (document A75/10 Add.1)
4. Draft recommendations on how to strengthen the design and implementation of policies, including those for resilient health systems and health services and infrastructure, to treat people living with noncommunicable diseases and to prevent and control their risk factors in humanitarian emergencies (document A75/10 Add.2)
5. Progress in the implementation of the global strategy to accelerate the elimination of cervical cancer as a public health problem and its associated goals and targets for the period 2020–2030 (document A75/10 Add.3) and the Corrigendum
6. Progress achieved in the prevention and control of noncommunicable diseases and the promotion of mental health
7. Draft intersectoral global action plan on epilepsy and other neurological disorders in support of universal health coverage (document A75/10 Add.4)
8. Draft action plan (2022–2030) to effectively implement the global strategy to reduce the harmful use of alcohol as a public health priority
9. Draft recommendations for the prevention and management of obesity over the life course, including potential targets
10. Draft workplan for the global coordination mechanism on the prevention and control of noncommunicable diseases
11. Strengthening synergies between the World Health Assembly and the Conference of the Parties to the WHO Framework Convention on Tobacco Control

Notes:

In 2018, the ESMO statement for the UN High-Level Meeting on NCDs noted that 30 to 50% of cancer deaths can be avoided with investments in prevention, early detection, and cancer treatment, and that essential cancer medicines, vaccines, and opioids are inexpensive and should be readily accessible. For innovative expensive cancer medicines, the statement highlighted the ESMO Magnitude of Clinical Benefit Scale as a tool to assist governments to prioritize those that have the highest clinical benefit for patients. Before the 2018 UN High-Level Meeting on NCDs, ESMO and ASCO issued a joint public statement on cancer, which was instrumental in achieving the inclusion of a specific text on cancer in the 2018 UN Political Declaration on NCDs.

World Drug Problem

An ESMO statement was delivered by the ESMO Director of Public Policy, Rosa Giuliani, on the topic of ‘The Public Health Dimension of the World Drug Problem’, during the

ESMO welcomed the WHO Director General’s Report on the World Drug Problem and the need to improve access to controlled medicines used for legitimate medical purposes to relieve pain and suffering.

WHO statistics state only 14% of people in need of palliative care each year actually receive it due to unnecessarily restrictive regulatory barrier, and ESMO finds this unacceptable. The ESMO statement raised awareness that the ESMO Global Opioid Policy Initiative provided 10 recommendations to reduce those barriers. In addition, ESMO requested that countries at least provide patients the palliative care medicines on the WHO Model List of Essential Medicines, and that licensed physicians are properly trained to use opioid medications to relieve cancer pain.

The WHO report on this topic noted that WHO will publish Guidelines on the safe use and access to controlled medicines in 2022.

The WHA noted the WHO Director-General’s report and decided to request the Director-General to continue to report to the Health Assembly every two years until 2030 on WHO’s activities to address the public health dimensions of the world drug problem and progress made in the implementation of decision WHA70(18)(2017).

Notes:

• The ESMO Designated Centres Accreditation Programme recognises cancer centres that provide highly integrated oncology and palliative care services.
• The ESMO Fellowship Program offers palliative care fellowships designed to provide oncologists or oncology fellows additional experience in palliative care training.
• In 2022, the ESMO statement at the WHO Executive Board Meeting called for, among others for WHO Member States to ensure continued patient access to essential cancer and palliative care medicines and services that are affordable and do not compete with resources for health emergencies.
• In 2018, ESMO published an ESMO position paper on supportive and palliative care, noting that these services should start at the time of diagnosis and continue through to end-of-life or survivorship. The publication follows the 2003 ESMO stand on supportive and palliative care.
• In 2016, ESMO supported a successful international initiative to ensure that the Outcome Document of the United Nations General Assembly Special Session on the World Drug Problem contained recommendation to ensure access to controlled substances, such as opioids, for legitimate medical and scientific purposes, while preventing their diversion for improper use.
• In 2014, ESMO, the UICC, the NCD Alliance and other endorsing partners issued a joint palliative care statement at World Health Assembly supporting the successful adoption of the WHO Resolution ‘Strengthening of palliative care as a component of integrated treatment throughout the life course’, which calls for increased access to palliative care to relieve unnecessary suffering worldwide.

During the150th WHO Executive Board Meeting, 24-29 January 2022, ESMO delivered a statement on the ‘Political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases’. The ESMO statement welcomed the WHO strategies on the prevention and control of NCDs - which include cancer, focusing, among others, on addressing the reduction of the harmful use of tobacco and alcohol, as well as the issue of preventing and managing obesity, and promoting oral and mental health. Of particular importance, WHO noted that there has been progress in the implementation of the global strategy to accelerate the elimination of cervical cancer as a public health problem and in the achievement of its associated goals and targets for the period 2020–2030.

The ESMO statement called for WHO Member States to ensure continued patient access to essential cancer and palliative care medicines and services that are affordable and do not compete with resources for health emergencies.

Furthermore, ESMO called for countries to provide annual data on the health impact of their interventions to reduce the burden of cancer, to ensure progress towards achieving the 2030 Sustainable Development Goal 3.4: ‘By 2030, reduce by one third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being’ is properly measured. During the pandemic cancer services have been delayed and disrupted and for that reason it is important that countries accelerate actions and provide evidence that they are on track to achieve the 2030 goal.

ESMO appreciates the coordination role of the WHO Global Coordination Mechanism on the Prevention and Control of NCDs to mobilize and share knowledge to support countries in their efforts to reducing the cancer burden in the coming years.

ESMO continues to stand ready to contribute to global health efforts with recognised expertise in cancer management as we work tirelessly throughout the pandemic to save lives.

Dr. Tedros’s introductory remarks at the meeting can be read here, where he notes that “WHO estimates that at least half of the global disease burden could be prevented by supporting safer and healthier environments that allow people to make healthy choices and adopt healthy behaviours.”

On the occasion of the Special Session of the World Health Assembly, 29 November – 1 December 2021, where the WHO Member States agreed by consensus to begin a global process to draft and negotiate an international instrument (1) to strengthen pandemic prevention, preparedness and response, ESMO delivered an official statement calling for all responses to health emergencies to be legally binding and to:

• Reinforce health as a fundamental right,
• Promote health and reduce health risk factors,
• Build up and protecting the health workforce,
• Maintain the provision of healthcare services for people with pre-existing conditions such as cancer.

ESMO also requested that health authorities and administrators provide ethical and methodological guidelines on how hospitals and health workers should make decisions where financial and physical resources must be re-allocated or are in shortage.

ESMO has already raised awareness of this critical topic for healthcare professionals (Public Policy Webinar on Bedside Rationing), especially relevant during health emergencies.

ESMO looks forward to participating in the process to draft and negotiate an international instrument under the Constitution of the World Health Organization to strengthen pandemic prevention, preparedness and response, and to sharing its evidence-based resources to support WHO’s and its Member State’s efforts to ensure a healthier and safer world.

This was the second WHO Special Session since its founding in 1948, with one topic on the agenda: “The World Together: Establishment of an intergovernmental negotiating body to strengthen pandemic prevention, preparedness and response”. During their deliberations, the WHO Member States requested strengthening the existing and legally binding framework of the International Health Regulations of 2005, and avoiding duplication or overlap with a future international instrument for a framework for global collaboration. Several key issues were prioritised:

1. Ensuring equity addressing issues such as capacity-building, medical countermeasures such as vaccines, therapeutics and diagnostics, as well as barriers to their equitable and timely access and distribution. Equity is also relevant to issues such as research and development, intellectual property, technology transfer and empowering/scaling up local and regional manufacturing capacity during emergencies, while working towards achieving universal health coverage.
2. Adopting a One Health Approach necessary to address and encompass human, animal and planetary health, as well as a whole-of-government and whole-of-society approach to health and health emergencies.
3. Addressing prevention, rapid risk assessment, detection and response to strengthen the collective efforts to prepare and respond effectively to outbreaks of disease with pandemic potential.
4. Strengthening WHO and providing it with adequate and sustainable financing, enabling its leading and coordinating role in global health
5. Enhancing surge capacity, through striving to achieve universal health coverage and health system strengthening, including strengthening primary health care, the health workforce and social protection.
6. Addressing misinformation, disinformation and stigmatisation that undermine public health.

The International Negotiating Body will provide a progress report to the 2023 World Health Assembly for consideration by the 2024 World Health Assembly.

Note

To date the only other legally binding instrument established under Article 19 of the WHO Constitution is the WHO Framework Convention on Tobacco Control.

The 71st Session of the WHO Regional Committee for Europe was held virtually from 13-15 September 2021, and ESMO submitted statements on the following topics:

• An ESMO Statement submitted to the 71st Session of the WHO Regional Committee for Europe welcomed the Resolution on the European Immunization Agenda 2030, which urges Member States to enhance commitment to immunisation as a public health priority and commit to achieving the vision and goals outlined in the European Immunization Agenda 2030, especially against cancer-causing pathogens. ESMO’s statement also suggested that for the safety and administration of new vaccines the National Immunization Technical Advisory Groups should leverage the technical expertise of Non-State Actors like ESMO and other stakeholders as appropriate. For example, patients with cancer were largely excluded from the pivotal trials of the COVID-19 vaccines being tested. Thus, ESMO as a scientific society developed 10 statements clarifying the impact of COVID-19 vaccination on patients with cancer and reinforced the message by developing a strong ‘ESMO Call to Action’ which was endorsed by over 50 healthcare professional and patient organisations.
• An ESMO Statement submitted to the 71st Session of the WHO Regional Committee for Europe welcomed the Resolution that was adopted ‘Realizing the potential of primary health care: lessons learned from the COVID-19 pandemic and implications for future directions in the WHO European Region’. The ESMO statement urges Member States to strengthen primary health care, ensure robust referral services to secondary and tertiary levels where cancer is treated and to work towards including a comprehensive set of essential cancer services in national universal health coverage packages. The ESMO statement highlighted ESMO resources that can support governments to achieve these goals such as the ESMO-ASCO Global Curriculum in Medical Oncology, the ESMO Clinical Practice Guides, the ESMO-Magnitude of Clinical Benefit Scale.
• An ESMO Statement submitted to the 71st Session of the WHO Regional Committee for Europe welcomed the report ‘Response to the COVID-19 pandemic: lessons learned to date from the WHO European Region’. In the statement, ESMO agreed with the ambitious and comprehensive measures proposed, and asked Member States to include more detailed measures to protect cancer patients and health care professionals in national health emergency plans. ESMO’s statement also highlighted how its resources could be valuable in support of WHO’s global efforts.

The 74th World Health Assembly was held virtually between 24-31 May 2021, and ESMO delivered statements on the following topics:

• An ESMO statement supported the Assembly’s decision to extend to 2030 the mandate of the WHO Global Coordination Mechanism on the Prevention and Control of Noncommunicable Diseases (NCDs), which include cancer. The Global Coordination Mechanism is a unique WHO initiative led by Member States. It has the task of coordinating all stakeholders (including societies like ESMO) towards the implementation of the WHO Global Action Plan on the Prevention and Control of Noncommunicable Disease which has also been extended to 2030. For more information, please click here.
• ESMO delivered a statement that welcomed the Resolution on ‘Protecting, safeguarding and investing in the health and care workforce’. The Resolution honors and recognizes the selfless efforts of all health and care professionals across the globe, including those who risked their lives to assist both people with COVID-19 and patients with other illnesses during the pandemic. The Resolution reinforces WHO’s dedication of 2021 as the International Year of Health and Care Workers and its campaign to ‘Protect. Invest. Together.’ For more information, please click here.
• An ESMO statement welcomed the Resolution on Social Determinants of Health previously approved by the WHO Executive Board in January 2021. The Resolution supports achieving the 2030 UN Sustainable Development Goals, many of which address the social, economic, and environmental determinants of health that can positively influence good health and well-being. For more information, please click here.
• An ESMO statement welcomed the Resolution on ‘Strengthening WHO preparedness for and response to health emergencies’ which aims to improve the ability of WHO to address the current pandemic and future health emergencies. Recognizing that addressing a global pandemic requires multi-stakeholder collaboration and the pooling of knowledge and resources, the statement encouraged WHO to leverage resources developed by professional societies like ESMO. For more information, please click here.

The 148th WHO Executive Board Meeting was held virtually between 18-26 January 2021, during which ESMO’s ‘Official Relations with WHO’ status was renewed. ESMO also delivered statements on the following topics:

• ESMO delivered an official statement related to the WHO Director General’s Report on WHO’s COVID-19 Response. ESMO’s statement commended WHO’s efforts addressing the global pandemic. It raised awareness of ESMO’s COVID-19 and Cancer Portal that provides information for oncology professionals as well as patients and the public. It also highlighted the recently published ESMO statements addressing issues and concerns on immunising patients with cancer against COVID-19, reinforced by the strong  ESMO Call to Action on COVID-19 vaccinations and patients with cancer: Vaccinate. Monitor. Educate. For more information, please click here.
• ESMO delivered an official statement related to the WHO Director-General’s Report on the UN’s ‘Political Declaration of the third high-level meeting of the General Assembly on the prevention and control of noncommunicable diseases’. The WHO Report noted the mid-point evaluation of the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases, which has been extended from 2013-2020 to 2030. ESMO raised concern that the Report states that many WHO Member States are not on track to achieve the Sustainable Development and Political Declaration goals. For more information, please click here.
• ESMO delivered an official statement related to the WHO Director-General’s Report on ‘Expanding access to effective treatments for cancer and rare and orphan diseases, including medicines, vaccines, medical devices, diagnostics, assistive products, cell- and gene-based therapies and other health technologies; and improving the transparency of markets for medicines, vaccines, and other health products’. The statement highlighted key ESMO resources that can be of assistance to Member States in their strategies to appropriately select and prescribe cancer medicines, such as the ESMO Clinical Practice Guidelines, the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS), and the ESMO strategic recommendations to prevent and manage shortages of cancer medicines. For more information, please click here.

ESMO delivered an official statement in support of the WHO ‘COVID-19 Response’ Resolution unanimously adopted at the 2020 World Health Assembly, 18-19 May 2020.

ESMO welcomed the WHO strategy and supports WHO’s recommendations to address a wide range of challenges the pandemic poses to people with health issues, especially due to service disruption, lack of sufficient resources, and patient travel restrictions.

The ESMO statement calls on governments to especially protect people at high-risk of COVID-19 such as healthcare professionals and people with pre-existing conditions, including cancer. It requests that health authorities secure the availability of essential cancer and palliative services, and notes that the ESMO-Magnitude of Clinical Benefit Scale can help support value-based decisions for resource allocation. Where shortages exist, ESMO asks governments to provide institutes and clinicians with ethical and methodological decision-making guidance. For cancer patients who cannot, or are afraid to, travel to a hospital for treatment it is essential that countries have in place an action plan.

The ESMO statement makes WHO and its Member States aware that ESMO is fully supporting WHO’s global efforts through our ESMO COVID-19 and Cancer Portal, which includes information, educational materials, ESMO recommendations for cancer management in the era of COVID-19 for oncology professionals, an ESMO Guide for Cancer Patients on cancer care during the COVID-19 pandemic, and links to WHO norms and guidance. In addition, the ESMO Statement raises awareness of the ESMO-CoCARE Registry, which is an international collaborative initiative with a cross-tumour database, designed to gather clinical data on the virus’s impact on cancer patients in order to provide recommendations on how to minimise their risks during the COVID-19 pandemic and in the recovery phase.

In February 2020, ESMO endorsed the World Health Organization’s (WHO) Global strategy to accelerate the elimination of cervical cancer as a public health problem with an official statement at the WHO Executive Board Meeting in Geneva.

Several members of the ESMO Gynecological Cancer Faculty provided input to the WHO strategy and in particular on the topic of the management of invasive cervical cancer. ESMO’s participation in this WHO project raised awareness that the ESMO Clinical Practice Guidelines on Cervical Cancer, and Supportive and Palliative Care can help countries achieve the goal of 90% treatment and care for cervical cancer cases through use of evidence-based treatment protocols. The ESMO Patient Guide on Cervical Cancer can also be a useful resource to help patients understand their treatment options.

As a follow-up to the 2020 World Health Assembly, the WHO global strategy towards eliminating cervical cancer was adopted by the 194 WHO Member States, and aims to achieve the ’90-70-90’ interim targets below by 2030:

• 90% of girls are fully vaccinated with the HPV vaccine by 15 years of age
• 70% of women are covered by screening with a high-performance test
• 90% of women identified with cervical disease receive treatment.

Achieving these targets would see the median cervical cancer incidence rate would fall by 10%, setting the world on the path to avert 70 million cases in the century

WHO has provided a list of interventions necessary to address cervical cancer in the article  How to reduce the impact of cervical cancer worldwide: Gaps and priority areas identified through the essential cancer and primary care packages: An analysis of effective interventions. The data is based on the 2017 WHO Noncommunicable Disease Country Capacity Survey, and assesses the availability of health services for cervical cancer in the 194 WHO Member States, and the percentage of countries that offer or reimburse those services for their citizens. The authors propose 2 sets of intervention packages. The first is an Essential Cancer Package with 9 interventions: HPV vaccination, cervical screening, early diagnosis, pathology, radiation, surgery, chemotherapy, palliative care, and a cancer registry to monitor the process and measure progress. The second is a Primary Care Package with 5 interventions which includes HPV vaccination, cervical screening, early diagnosis, palliative care, and a non-communicable disease plan necessary to coordinate national cancer services. The data from the WHO survey shows that only 21% of countries offer their citizens the Essential Cancer Package of 9 interventions and 19.1% the Primary Care Package, underlining the need to implement the WHO global strategy towards eliminating cervical cancer.

ESMO attended the 146th WHO Executive Board Meeting, which was held between 3-8 February 2020. At this meeting, ESMO delivered an official statement on the agenda item regarding the WHO global strategy towards eliminating cervical cancer as a public health problem.

ESMO welcomed the WHO strategy and supported WHO’s recommendation that to achieve the goal of 90% treatment and care for cervical cancer cases, countries must implement evidence-based clinical treatment guidelines.

ESMO noted to all WHO Member States that ESMO has guidelines on Cervical Cancer, and Supportive and Palliative Care, which are freely available on the ESMO website, and accompanied by Patient Guides written in a language that patients can understand. In addition, ESMO called on all WHO Member States to fully integrate the WHO cervical cancer elimination strategy into national Universal Health Coverage programs, in order to fulfill their commitment to implement the 2017 WHO Cancer Resolution and to reduce premature deaths from cancer by 25% by 2025 and 33% by 2030.

For more information, please click here.

During the 2019 WHA, an ESMO statement requested that the 2019 UN Political Declaration on Universal Health Coverage (UHC) specifically state: ‘Country governments must guarantee their entire population ‘UHC benefit packages’ that ensure financial protection, and include a core set of comprehensive, safe, affordable, effective and high-quality health services for the prevention, diagnosis, treatment and palliative care of noncommunicable diseases, including cancer, delivered by an adequate, and well-trained workforce’. The final version of the 2019 UN Political Declaration on Universal Health Coverage includes all of the points mentioned in the ESMO statement.

A second ESMO statement focussed on the WHO ‘Draft roadmap for access to medicines, vaccines and other health products, 2019-2023’. The roadmap aligns with the WHO 2019-2023 triple billion target to ensure that one billion more people benefit from UHC; one billion more people have better protection from health emergencies; and one billion more people enjoy better health and well-being. The ESMO statement called for the need to ensure that access to medicines is improved not only at the primary healthcare level but also at the secondary and tertiary levels where cancer care is provided. Subsequent WHO documents include mention of the need to strengthen of primary care and referral services to secondary and tertiary care.

ESMO attended the 144th WHO Executive Board Meeting, which was held between 25 January and 1 February 2019. At this meeting, ESMO delivered three official statements with the following messages:

• ESMO requested that the 2019 UN Political Declaration on Universal Health Coverage include the provision of a set of cost-effective essential cancer and palliative care services delivered at the primary and secondary healthcare level.
• ESMO resources such as the ESMO Clinical Practice Guidelines and the ESMO-MCBS can support countries achieve the goals of the WHO Roadmap on Access to Medicines.
• ESMO endorsed the UICC-led statement for a WHO strategy to eliminate cervical cancer.

During the 2018 World Health Assembly, ESMO emphasized the importance of cancer as a priority on the WHO global agenda. An ESMO statement advocated for the strengthening of health systems to achieve Universal Health Coverage and to provide essential healthcare services to the millions of cancer patients who die prematurely due to lack of access to appropriate treatment. In particular, ESMO called on the WHO to ensure that governments would be required to take specific actions in the interest of cancer control. A second ESMO statement on the issue of shortages of medicines ESMO provided WHO with recommendations by ESMO and the Economist Intelligence Unit on how to prevent shortages and supported the WHO Global Reporting System which will monitor the supply of essential cancer medicines.

ESMO attended the 142^nd WHO Executive Board Meeting, which was held between 22-27 January 2018. At this meeting, ESMO delivered an official statement on the topic of ‘Addressing the global shortage of, and access to, medicines and vaccines’.  In its statement ESMO welcomed a WHO global medicine shortage notification system not only for medicines on the WHO Model List of Essential Medicines (EML), but in a second step for all medicines that provide a proven significant magnitude of clinical benefit. ESMO encouraged WHO to consider the 2017 policy recommendations published by ESMO and The Economist Intelligence Unit on how to prevent and manage shortages of cancer medicines. These ESMO recommendations include the need to provide a clear definition of a medicine shortage, introduce legislation for early notification, establish strategic plans for shortages at national and institutional levels, develop a harmonized web-based platform, assess risks of shortages for medicines on the WHO EML, introduce incentives for production, and establish procurement models.

An ESMO statement was delivered during the 2017 World Health Assembly supporting the adoption of the 2017 WHO Cancer Resolution whose aim is to reduce cancer deaths and achieve universal health coverage. The actions recommended in the Resolution are designed to improve access and affordability of quality cancer care and its integration into national healthcare systems. As an organisation representing medical oncologists, ESMO supports WHO policies that ensure patients have timely access to safe, affordable, effective, high-quality medicines, treatment and care.

ESMO attended the 140th WHO Executive Board Meeting, which was held between 23-31 January 2017. ESMO’s official statement during the meeting advocated for the urgent need for a robust and comprehensive Cancer Resolution that can help drive national progress, particularly in low- and middle-income countries that face the biggest challenges of a rapidly growing cancer burden.

ESMO advocated for the ‘Cancer Resolution’ because it believes the Resolution could:

• Establish the core disciplines and services for a holistic, impactful and scalable cancer response, adapted to the local burden and aligned with national healthcare capacities for cancer care.
• Bring together in one document existing commitments from a series of World Health Assembly resolutions that are highly relevant for cancer, including those on palliative care, access to surgery and anaesthesia, essential medicines, patient-centred primary care, as well as the life course and aging agenda.
• Reinforce the mandate for the non-communicable disease (NCD) team at WHO to respond to Member States’ requests for technical assistance and guidance on cancer.
• Emphasise the opportunities for integration and efficiencies of building on existing health services such as HIV-AIDs, child adolescent health or reproductive health and maternal services.
• Provide a framework for effective international engagement, because there are a number of key allied agencies and organisations who stand ready with the expertise and tools required to assist.

ESMO’s advocacy efforts were supported by the ESMO National Representatives who contacted the Ministry of Health of those countries represented on the WHO Executive Board.

For more information, please click here.

During the 2016 World Health Assembly, ESMO co-hosted a side-event on the topic of ‘Are we making the right investments for optimal cancer control? A global dialogue’. The outcome of this event was that several governments called on the WHO to present a ‘Cancer Resolution’ for adoption during the 2017 World Health Assembly.

ESMO, the UICC, the NCD Alliance and other endorsing partners delivered a joint statement at the 2014 World Health Assembly in Geneva supporting the WHO Resolution ‘Strengthening of palliative care as a component of integrated treatment throughout the life course’. The WHO 'Palliative Care Resolution' was subsequently adopted by the WHO Member States and calls for increased access to palliative care to relieve unnecessary suffering worldwide.

Subsequently in 2016, ESMO supported a successful international initiative to ensure that the Outcome Document of the United Nations General Assembly Special Session on the World Drug Problem contained recommendation to ensure access to controlled substances, such as opioids, for legitimate medical and scientific purposes, while preventing their diversion.