السياسة الموحدة لخفض الوفيات بأمراض السرطان في دولة الإمارات العربية المتحدة

Objectives

The policy framework seeks to reduce cancer mortality in the United Arab Emirates as a national performance outcome, aligned with the UAE Vision 2021 agenda and the national strategy for non-communicable diseases.[1][2][3]It aims to provide equitable, comprehensive, innovative and sustainable cancer services that meet international standards, respond to patients’ needs and strengthen health-system readiness.[1][4][5]

• Reduce cancer deaths through a coordinated continuum of prevention, early detection, diagnosis, treatment, palliative care, rehabilitation and continuing support.[6][7][8]
• Prevent cancer and related non-communicable diseases by reducing tobacco use, unhealthy diet, physical inactivity, obesity and exposure to environmental and occupational carcinogens, while supporting vaccination against human papillomavirus and hepatitis B.[9][10][11]
• Improve public awareness of cancer risks, symptoms, prevention and screening, with particular attention to breast, colorectal, cervical and lung cancers.[12][13][14]
• Expand early detection through periodic examinations, population screening, primary healthcare services, mobile clinics and faster referral to treatment.[6][11][15]
• Provide evidence-based diagnosis, surgery, medical and radiation oncology, pathology, advanced diagnostics, palliative care, supportive care and rehabilitation.[6][16][17]
• Reduce disparities in the geographical distribution of cancer services, specialist facilities and workforce capacity across the United Arab Emirates.[18][3]
• Strengthen cancer research, innovation, personalised treatment, clinical practice, workforce development and partnerships as cross-cutting enablers of cancer control.[19][17][20]
• Standardise policy, clinical practices, measurement indicators and stakeholder coordination within the applicable legal and regulatory framework.[5][21]

Implementation

Implementation is based on nationally coordinated action led by the Ministry of Health and Prevention, linking federal and local health authorities, healthcare providers, government bodies, private-sector partners, academic institutions, civil society, data providers and international reference bodies.[22][23][24]The model combines national governance, local delivery, integrated information systems, common standards, workforce development and continuous performance improvement.[4][25][26]

• Oversee national agenda indicators, mandates and policy approval through the Cabinet, while the Prime Minister’s Office coordinates implementation, reviews indicators and submits periodic reports to the Prime Minister.[23]
• Coordinate national roles, action plans, progress monitoring and reporting through the Ministry of Health and Prevention, with local governments and executive councils aligning local strategies and reviewing participating entities’ performance.[23][27]
• Establish a national committee for non-communicable diseases and multiple risk factors, an executive team and sub-teams for the cancer-mortality indicator.[24]
• Engage the Department of Health Abu Dhabi, Dubai Health Authority, Sharjah Health Authority, government and private hospitals, relevant ministries, universities, public-benefit organisations, patient-support associations and other contributing institutions.[28][29][30]
• Develop policy roadmaps through current-situation assessments, analysis of challenges and gaps, and adaptation of relevant international best practice.[5][31]
• Implement health-promotion programmes in communities, schools and workplaces, including healthy-food labelling, school nutrition standards, physical-activity initiatives and workplace wellness.[9][32][33]
• Expand tobacco-control measures through cessation clinics, clinical guidance, health-worker training and enforcement of federal tobacco-control legislation and regulations.[32][12][14]
• Deliver screening through unified standards, electronic reminders, mobile units and disease-specific campaigns, and establish clinical pathways, referral arrangements and common waiting-time standards from screening and diagnosis to treatment.[34][17][15]
• Develop specialist facilities, community and home-based palliative care, patient and family support, and access to diagnostic and treatment services across population groups.[8][3][17]
• Build workforce capability through training, accredited guidance, professional education, conferences, workshops and collaboration with universities and local and international partners.[19][17][20]
• Establish a unified electronic national cancer registry and electronic mortality-reporting system, consolidating data from health authorities, hospitals and other relevant sources.[19][2][26]
• Monitor cancer mortality, risk factors, morbidity, service quality, screening coverage and initiative implementation through national indicators, registries and quality measures for diagnosis and treatment.[19][3][35]
• Require participating entities to provide relevant statistics, measure performance, report results, challenges and recommendations, and support improvements in data quality, availability and sustainability.[27][29]
• Coordinate resource availability, budgets, financial transfers and financial-performance monitoring through the Ministry of Finance; monetary budget amounts and financing allocations are not specified.[27]

Monitoring & Evaluation

Cancer mortality is the principal national outcome indicator, aligned with the United Arab Emirates Vision 2021 agenda and measured as cancer deaths per 100,000 population.[22][32][36]The policy framework also calls for monitoring incidence, risk factors, morbidity, service quality, early detection, treatment outcomes and initiative implementation.[37][19][38]

• Calculate age-standardised cancer mortality rates using five-year age-group mortality rates and standard-population weights, with a declining rate indicating improved performance.[39]
• Track cancer incidence by nationality, sex and cancer site, and analyse mortality by cancer type and emirate to inform national and local action.[37][40]
• Maintain a unified national cancer registry, electronic mortality reporting and early-screening registration systems to consolidate accurate, timely and comprehensive data.[41][42][26]
• Establish national registries to monitor risk factors, morbidity, mortality, service performance and the results of cancer-control initiatives.[19]
• Issue annual cancer-status and registry reports, supported by scientific data-collection standards, standard forms and defined mortality-data fields for health facilities.[41][26]

The supplied material presents a baseline cancer mortality rate of 25.6 deaths per 100,000 population and a displayed target of a 25% reduction by 2030, while noting that cancer and cardiovascular-disease targets were recalculated following World Health Organization feedback.[43][39]It does not provide a complete, consistent target framework for all indicators or interventions.[43][15]

• Develop quality indicators for early detection, diagnosis, treatment and palliative care, and link relevant clinical quality measures to accreditation.[38][44][3]
• Evaluate screening programmes against defined and regularly updated standards, including coverage, mobile-unit use, reminder-system completion and dissemination of screening statistics.[34][15]
• Monitor delivery of the cancer registry, awareness campaigns, workshops, distributed materials, target-group reach, referral policies, waiting-time standards and palliative-care plans.[35][45][15][46]
• Improve data availability, quality, accuracy, sustainability and regular updating of population statistics, surveys and publishable data.[27][7]

Accountability is structured across national and local institutions. The Cabinet oversees national-agenda indicators, issues mandates and approves policies, while the Prime Minister’s Office coordinates implementation, reviews indicators and submits periodic reports to the Prime Minister.[23]The Ministry of Health and Prevention coordinates roles, develops action plans, monitors progress and reports indicator and initiative results to the Prime Minister’s Office and Cabinet.[23]

• Require participating entities to measure relevant indicators and submit results, challenges and recommendations to executive councils.[27]
• Require data-source institutions to supply national-indicator statistics and undertake actions that improve data availability, quality and sustainability.[27]
• Coordinate with international reference bodies, including the World Health Organization, on technical explanations and publication of final national results in international reports.[27]
• Use a national committee for non-communicable diseases and multiple risk factors, an executive team and cancer-indicator sub-teams to support central monitoring and coordination.[24]

Important monitoring constraints include absent or weak electronic links to source systems, limited database and data-collection capacity, poor data quality, inadequate periodic information on initiative delivery, weak coordination, limited measurement of early-detection indicators, insufficient workforce analysis and limited specialised cancer research.[25][47]Several extracts do not specify detailed evaluation methodologies, reporting timetables, complete indicator definitions or formal sanctions for non-performance.[16][29][48]

Costing & Financing

Financing responsibilities are assigned principally to the Ministry of Finance, which coordinates resource availability for national-agenda implementation, approves budgets and financial transfers, and monitors financial performance indicators.[27]Cancer-control resource needs encompass prevention, screening, smoking cessation, diagnosis, treatment, specialist services, palliative care, rehabilitation, cancer registration, workforce development and research.[8][11][3][20]

• Allocate resources towards preventive vaccination, priority-cancer early detection, smoking-cessation counselling, specialised diagnostic and treatment services, and community palliative care.[8]
• Support health-insurance coverage for cancer prevention, early detection and treatment, with a stated ambition to improve coverage for all individuals.[44][10][11]
• Mobilise investment and support from public, private, donor, academic, research and international partners for cancer services and research.[20]
• Use tobacco taxation as a fiscal policy measure, although the material does not specify how related revenue is allocated to cancer control.[9]

The material identifies high cancer-treatment costs and an imbalanced resource distribution, with relatively large treatment budgets and limited allocations for prevention and early detection.[49]This indicates a policy concern about shifting or strengthening investment upstream, but no quantified reallocation, funding gap or financing target is supplied.[49]

No total programme budget, expenditure estimate, unit cost, monetary allocation, financing ratio, cost-effectiveness assumption, economic forecast or quantified resource-mobilisation target is specified in the supplied extracts.[27][50][11][35]Human-resource and infrastructure requirements are recognised, including qualified staff, capacity-building, specialist centres, mobile screening units and electronic information systems, but are not monetised.[25][34][44]