Cancer is a growing problem in all MENA countries, currently ranking as the fourth leading cause of death in the region. The incidence of cancer in this region is expected to experience the highest increase among all WHO regions in the next 20 years, posing a major burden to health and development in MENA. In the period just prior to the spread of conflict, regional healthcare systems had begun to take preliminary steps in prioritizing cancer care within national systems. However, much of this progress has been stymied or even reversed as recent conflicts have presented unprecedented challenges.
The Syrian and Iraqi conflicts, and the massive forced migration of populations across borders, have led to the fragmentation of cancer care in affected countries in the region. It has also presented the healthcare systems of neighbouring host countries, such as Turkey, Jordan, and Lebanon, with an unforeseen additional cancer burden. This burden comprises the large number of refugees seeking cancer care who are not covered by insurance or by
humanitarian packages, as well as therapeutic migrants seeking cancer care across therapeutic geographies in the region. In the context of demographic upheaval, political instability and the fragmentation and regionalization of care, there is a need for vital, multidisciplinary research in order to better understand the complex dynamics that influence health-seeking behavior among this patient population. This includes research into the patients’ different therapeutic geographies of cancer care, including their communities, the health system of their host countries, post-conflict reconstruction of highly fragmented health systems, and assessing the effectiveness of existing humanitarian and development aid on cancer prevention, treatment and outcomes.
As war changes the biospheres in which these cancer patients live, the political and economic context of this biosphere reshapes oncology and its diagnosis and treatment through surgery and palliative care. Cancer care
represents a complex, highly expensive, multi-modal challenge to MENA health systems and there is an urgent need to develop research to understand the new onco-landscape of delivering affordable and equitable care in health systems in areas of conflict.
Palliative care has been identified by WHO and partner countries as one of the major gaps in research. Through R4HC, research capacity will be built around health systems research methods to inform policy, cancer surgery and palliative care. Specific research will also be undertaken on implementation of outcome measures, as a means to scale up quality, access, influence individual assessment and treatment plans for palliative care.