Thursday , April 22 2021

Legal framework for cancer control

With regard to the control of high frequency diseases, it is common to propose a legal framework that allows its prevention and cure through sanitary measures that have implications for people and the community. Also for the government that must design and implement public health strategies that have permanence and continuity, for the health insurance that must afford to fund the actions. When the disease is prevalent and causes high mortality, such legal initiatives must be well founded and enjoy social and political consensus.

This year we are celebrating the promulgation of transcendental laws, such as preventive medicine, which proposed the formula for controlling tuberculosis and that of mother and child, which laid the foundations for reducing malnutrition and infant mortality through complementary feeding. Both successful initiatives were the product of the social medical genius of Eduardo Cruz Coke during the government of Arturo Alessandri Palma in 1938, shortly before finishing his term.

Laws in the health field can affect people's freedom and autonomy, as they eventually require notification and compromise of confidentiality, limit their mobility by some form of isolation to avoid infection or the required immunization. Communities also suffer from limitations for similar reasons, as well as the impact on inequality and higher expenditures.

In the case of cancer, a complex and difficult to control disease, 53,320 new cases are being planned for Chile by the World Health Organization (GLOBOCAN) by 2018, along with 28,443 deaths and a five-year prevalence of 135,618 survivors. with the condition. As the cause of death, it is already the first in five regions of the country.

This disease has led to policy advancements with interesting results in prevention, progressive restrictions on tobacco consumption, early diagnosis in cancer of women, and allocation of resources to specify guarantees (AUGE, Ricarte Soto Law for high-cost drugs). All of this, however, leaves spaces of great inequality and confusion between diagnoses and means of intervention, opening up opportunities to increase gaps through the unregulated use of resources. In the second, it is even more dramatic when families and communities incur huge expenses to cover procedures that are not always effective.

In the absence of a culture of rationality that balances the effectiveness and cost of used media, we fall into a more complex situation. This is the case of the so-called judicialization of medicine, a global trend that aggravates an inherently difficult issue when intervening in the courts in an attempt to strike the fundamental rights related to health. This conflict of competence, along with several other aspects, makes it indispensable to have a legal framework to face cancer with rationality and breadth. There are research questions, population and hospital records, civil society participation and public-private partnerships, cost-effectiveness analysis, human resources training and more, which will be best done with a General Cancer Law.

There is already a parliamentary motion for several years that has transversal support in the congress, the Ministry of Health is working on a new National Plan for Cancer Control that soon will come with the collaboration of many and President Piñera publicly pledged his support for the motion parliamentary body mentioned above.

It is time for action to take this bill for better control of cancer in Chile.

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