NCD Global Monitoring Framework & WHO Indicators in Cancer Control

André Ilbawi, M.D.

Medical Officer, Cancer Control Department of Management of NCDs, Disability,

Violence and Injury Prevention (NVI) World Health Organization

• Assess service delivery – Type, quantity and quality of services – Performance or outcomes

• Planning & implementing – Set agendas and targets – Accountability identify areas for improvement – Determine best practices

Why measure?

What gets measured gets done.

Outline MDGs to SDGs via GAP

MDGs

• No NCDs

2011 UN HLM

• Recognizing the problem

GAP

• NCD targets established for 2025 (9)

• Tracer targets

• Reporting 2015, 2020, 2025

SDGs

• Defining the agenda to 2030

• Variables – Types of indicator – Site, frequency & method of collection

• Consider – Not value neutral – Huge resource requirement – financial and human – Assessing overall health system function

Measurement consideration

• NCD GMF: – Variable status by country and indicator

• NCD Progress Monitor: – Reporting before 2018 UN High-level meeting

• Other cancer indicators – Registry data (GLOBOCAN) – Data gaps globally

Where are we now?

Indicator #1: Premature Mortality

Definition Likelihood of death for person aged 30yo to die from NCDs by age 70

Target 25% reduction by 2025

Rationale Outcome of policies / programmes / clinical services

Data source National vital registration records

Limitations - Complex statistical calculation - Ageism?

Indicator #1: Premature Mortality

Indicator #1: Premature Mortality

Indicator #2: Cancer Incidence Definition Age-standardized rates of cancer types

Target None specified

Rationale Outcome of policies / programmes

Data source Population-based cancer registries (GLOBOCAN)

Limitations Registry coverage

Global Cancer Atlas. Online. http://canceratlas.cancer.org/taking-action/cancer-registries/

Indicator #2: Cancer Incidence

GLOBOCAN. IARC.

Indicator #3: Cervical Cancer Screening

Definition % women aged 30−49yo screened for cervical cancer

Target None specified

Rationale National systems response

Data source Household survey (representative sample) / WHO STEPS

Limitations - <30% countries have accurate data - Substitute with national response data (NCD country capacity survey)

Indicator #3: Cervical Cancer Screening

Assessing national capacity for the prevention and control of NCDs WHO. 2016.

Indicator #4: Availability of Essential Medicines & Technologies

Definition Available & affordable medicines and technologies to treat NCDs (at least ASA, statin, ACEI, diuretic, CCB, metformin, insulin, inhalent)

Target >80% of specified medicines & technologies

Rationale National systems response

Data source Facility survey

Limitations Inadequate cancer-specific medicines and technologies

• Bridge gaps in data – >100 countries do not accurately count births

and cause of deaths – Only 1 in 5 LMIC have adequate data to drive

decision-making • Issues in cancer control

– Access, cost, quality • Link to larger data initiatives

– GICR – Health data collaborative

• Quality of care working group

Where do we want to be?

Assessing national capacity for the prevention and control of NCDs WHO. 2016.

• NCD GMF & Progress Monitor are the current focus of global cancer/NCD data monitoring

• Resource mobilization needed to – Strengthen infrastructure for data collection – Expand data collection to include access, cost,

quality including link to larger data initiatives

Conclusions

Assessing national capacity for the prevention and control of NCDs WHO. 2016.

THANK YOU

André M. Ilbawi ilbawia@who.int