33 Recommended elements for an NCA in South Africa To provide overarching coordination of existing legal, policy, budgetary and regulatory frameworks and/or accountability mechanisms, any legislative response to expand health care access for cancer should include: • Tasking of a national cancer prevention and control coordinating body To steer cancer priorities through policies, programmes and reforms and align stakeholders to ensure implementation of national cancer plans across all nine provinces as well as establish mechanisms for monitoring, evaluation and revision. • Cancer programme/plan To establish clear and measurable objectives as well as monitoring and evaluation to inform investment in and budgeting for cancer. • Cancer nancing To guarantee funding for cancer treatment and care as well as cancer research and innovation. • Strengthen the availability, quality and equitable distribution of cancer care To use evidence-based research for setting common cancer standards of care for both public and private sectors as well as ensuring patient-centredness. • Social protections To provide cancer patients and their families nancial assistance that might include coverage for cancer related absences from work, support for caregivers, etc. • Cancer surveillance To enhance data collection and populationbased reporting on cancer. • Accountability mechanisms To ensure oversight, compliance, monitoring and evaluation in relation to implementation of the NCA. Conclusion and way forward We call upon legal experts to come together with public health practitioners in the cancer eld, cancer treatment specialists, cancer survivors and advocates from across the spectrum of prevention and control, to address the urgent gaps in the South African legislative approach to achieving equitable cancer care. References for further reading and additional information 1. Meyer, S and Nqabeni, G. Cost of Cancer: Challenges for the next 10 years. Cancer Alliance; Report CA 05/2021. Available from: https://canceralliance.co.za/wp- content/uploads/2023/06/Cost-of-CancerAdvocacy-ReportPRINT-version-2.pdf 2. National Health Insurance Bill. South Africa. Available from: https://www.gov.za/sites/default/les/gcis_document /201908/national-health-insurance- bill-b-11-2019.pdf 3. Labour Relations Act 66 of 1995, South Africa. Available from: https://www.gov.za/documents/labour-relations-act 4. Maphumulo, WT & Bhengu BR. Challenges of quality improvement in the healthcare of South Africa postapartheid: A critical review. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556 866/#:~:text=Presently%2C%20of%20the%20estimated %20population,(Naidoo%202012%3A149) 5. Finestone, E, Wishnia, J & Ranchod, S. Estimating and projecting the burden of cancer in South Africa. Available from: https://canceralliance.co.za/wp- content/uploads/2023/06/Percept-report-on-theCost-of-Cancer-in-South-Africa-version- 2.pdf 6. WHO Model List for Essential Medicines: The selection and use of essential medicines 2023. Available from: https://iris.who.int/bitstream/handle/10665/371090/W HO-MHP- HPS-EML-2023.02-eng.pdf?sequence=1 7. Tomlinson IPM & Ilyas M. Molecular pathology of solid tumours: some practical suggestions for translating research into clinical practice. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1187 067/pdf/mp54000203.pdf 8. Heins, MJ, De Jong, JD, Spronk I, Ho, VKY, Brink M, Korevaar, JC. Adherence to cancer treatment guidelines: inuence of general and cancer specic guideline characteristics. Available from: https://pubmed.ncbi.nlm.nih.gov/28013246/ 9. Marron JM, Charlot M, Gaddy J, Rosenburg, AR. The ethical imperative of equity in Oncology: Lessons learned from 202 and a path forward. Available from: https://ascopubs.org/doi/10.1200/EDBK_100029?url_v er=Z39.88- 2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%20 0pubmed 10. Lambert SD, Levesque JV, Girgis, A. The impact of cancer and chronic conditions on caregivers and family members. Available from: https://research.monash.edu/en/publications/theimpact-of-cancer-and-chronic- conditions-oncaregivers-and-fam 11. Ward ZJ, Scott AM, Hricak H, Atun R. Global costs, health benets, and economic benets of scaling up treatment and imaging modalities for survival of 11 cancers: a simulation-based analysis. Available from: https://www.thelancet.com/journals/lanonc/article/P UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE
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