A MODEL FOR DEVELOPING A NATIONAL HEALTH POLICY INITIATIVE
THE CASE OF NATIONAL CANCER FORUM CHILE www.foronacionaldecancer.cl
Introduction
Chile is a mid to high income country with a population of 17,5 million inhabitants, an income percapita of 20.000 USD, recent member of the OECD, with a long tradition in public health developments. Its main indicators show an advanced demographic and epidemiological transition with 80 years of Life Expectancy, and a epidemiologic transition in which 29% of deaths are due to cardiovascular causes and 25% to cancer
Chile utilizes 1% of its gross domestic product on cancer care and treatment. We estimate that the economic impact as measured in Disability Adjusted Life Years to be US$ 3.5 billion. Persistent inequalities still occur in cancer distribution and treatment. A high quality cancer research community is expanding, however, insufficient funding is directed towards disproportionally prevalent stomach, lung and gallbladder cancers. Chile has a rapidly ageing population wherein
40% smoke, 67% are overweight and 18% abuse alcohol, and thus the corresponding burden of cancer will have a negative impact on an affordable health care system. We conclude that the
Chilean government must develop a national cancer strategy, which the authors outline herein and believe is essential to permit equitable cancer care for the country.
Several programmes are in place to face cáncer, particularly succesful is the childen cáncer drug program (PINDA), the cérvix cáncer screening program with a 60% pap smear in the females over
40 years of age and a group of 20 specific guaranteed Access to diagnosis and treatment dealing with different cancers.
Nevertheless there is no comprehensive cáncer policy in Chile and a group of academics and policy experts started a policy building exercise with the name of National Cancer Forum in
2013, with the rationale of open policy construction
First the Forum commended a mapping of cáncer research and key actors in the field (Cancer
Research Map Chile 2010-2012), the main findings of this research were

Research is 14% of all projects on biomedical research, receives only 10% of resources for a problem that provoques 25% of mortality

Basic biology and breast cáncer are the main issues and no research is being done on gallbladder cáncer a leading tumor in women.

Two universities make 89% of research projects

Although there is a bunch of NGOs and patients associations they have very Little power and presence in the public opinión context.

There is no policy statement nor legislation regarding to cáncer control although there is a reasonable antitobacco law (2012)
National Cancer Forum
The National Cancer Forum Chile (NCFCh) started with the following structure

An executive Comitte made of six coordinators, five aditional volunteer members, coming from academia, cáncer researchers and clinicians, social scientists, patients associations,
A Supervisory Board under the Honorary Presidency of the Minister of Health and representatives of academia, private sector, churches and religious organizations, key social communicators, members of Parliament and health providers including private sector, pharma and health insurance.
Six work groups or Nodes in the network with autonomy:
1.
Policy
2.
Integral care
3.
Prevention
4.
Research
5.
Civil Society and PP alliances
6.
Social Communications
The Methodology of work has been

Original Research on neglected issues in cáncer such as Cancer economics, Social and personal perceptions of patients, Social Responsibility, Spirituality and cáncer, National
Comparative policies

Open seminars to presen tour studies with academia, public health and goverment members, patients associations, church officials, etcétera.

Workshops to discuss and write reports from different nodes

Website and social networks presence

Media presence with weekly releases in TV, papers, websites.

Writting and presentation of a National Strategy for cáncer to Presidential candidates in
2013

Drafting and presentation of General Cancer Law Project with a group of multiparties in
January 2014 and December 2015. Project in search of oficial goverment sponsorship.
Main achievements and problems to solve:
Forum established as a legitimate actor in society, percieved as a reference for cáncer issues
Influence guaranteed in open and technical debates, presence in most meetings relating to subject
Appreciated Pre-Legislation work with members of Congress and Civil society
Scarce esources though not an expensive effort
Dificult relation with MoH they perceive the NCF as a competitor and invader in their territory
Future Goals
An active General cáncer law for Chile
Transform the group into a Foundation National Cancer Forum to maintain the committments.