 Good afternoon and welcome to this press conference here from the 47th annual meeting of the World Economic Forum in Davos Thank you for joining us here in the room And thank you for joining us on the live stream and through Facebook and of course a special welcome to everybody here On the panel, maybe just one word of housekeeping. You see an extra name here We're hoping for the Health Minister of Malaysia to make it in time for the press conference He's currently stuck In traffic because he forgot his badge, so we hope he can make it so please bear with us while we're We're still starting and going ahead with the press conference now health has always been a Very important issue in the work of the World Economic Forum, but usually we're looking at global health issues We're looking on the national level and as you see from the title of this press conference This is about a bit of a different angle. We're talking about cities And we're here to launch the see can 2025 sit a city cancer challenge and and looking really at the city level of cancer as one of the most damaging Non-communicable diseases that are out there to talk about the issue We have assembled an expert panel here today, which I'm happy to introduce to you now to my immediate left I'm joined by Kerry Adams who is the chief executive officer of the Union for international cancer control or UICC as Most of you might know it Next to him. We're joined and thank you for being here Michael Berkovitz Who's the president of the hundred resilient cities of the Rockefeller Foundation? Right at the center of our panel here. We're joined by Christoph Franz who's the chairman of Rosh from here from Switzerland and For the moment last but definitely not least on our panel Edwin Makaria who's a partner of the Dalberg global development advisors based in Kenya if I Correctly informed so welcome everybody and without further ado Kerry What is this new initiative about that we're launching? What is the see can 2025 city cancer challenge? Tell us about it. Well, thank you very much and also. Thank you to the world For giving us a chance to launch the city cancer challenge 2025 here today Over the last few years as in the last seven or eight years There's been a lot of work done and that at the global level I'm raising the profile of cancer and the non-communical diseases Some of you will be aware of the challenge that was set down in 2011 2012 to reduce no premature deaths from cancer and other ncds by 25 percent by 2025 Following that we have the sustainable development goals which have embedded within that those goals under health goal number three That we should have an ambition to increase that number to more than 30 percent by 2030 so a lot of global commitment to address ncds and cancer globally now we need to turn that into action Embedded it within those those commitments was a call to action for multi-sector responses So the private sector civil society and governments working together to address as extremely difficult and challenging set of diseases Cancer being one of those some response to that the UICC talked to its partners and identified a number of organizations Where we felt we could work together to address cancer in low and middle income countries But around the world where we anticipate massive growth over the next 20 30 years Those discussions led to the city cancer challenge could we identify that cities with the growth anticipated in population in the future and the inherent growth of ncds and cancer in those cities were perfect opportunities for us to galvanize support around reducing the number of unacceptable and avoid all deaths in the future Hence the city cancer challenge 2025 which reaches out to all cities over one million population To say that there is now an international Collaboration of organizations that want to help them to understand the problem They are facing today in the future and what they can do about it working with that international Collaboration and this press conference features organizations which are willing to be party to that commitment around the world So what are we going to do in the next few years? There are over 500 cities with a population of over one million our ambition is to sign up as many of them We can in the next two to three years that say that they want to take on this challenge for their citizens to put in place Better cancer treatment and care than exists today But we need to learn along that pathway it will take time for our international consortium to know how it should work And how it would operate so we're launching today We're announcing three cities that will become the learning cities in the first phase of that action They will be young gone for me and ma their parents also for Paraguay and Cali from Columbia And we're delighted that those countries and those cities have said that we think this is such an important initiative for the future That we're prepared to work with UICC and its partners over the next five years to improve the availability of cancer treatment and care in those cities So that's the basis of why we're doing it and how we will go about it And I must say it's absolutely delightful to see so many partners supporting us around the world to help cities achieve that ambition Thank You Kerry Michael Maybe your your organization title gives it away your your folks on resilient cities, right? So maybe you can elaborate why the city level? Why is that important to tackle there? Yeah so thank you and You know, I think when we talk about building urban resilience We think about building urban resilience in a very broad way We think about it not just in relation to acute events things like earthquake hurricane terrorism But also in terms of long-term slow burn events things we call chronic stresses long-term food water and energy shortage high levels of crime and violence Shifting macroeconomic trends and in that context, you know premature deaths from non-communicable diseases is one of the important chronic stresses that impact Cities and and cities as Kerry mentioned are so important for the first time several years ago more than 50% of the world's population lives in cities and by 2050 that's projected to be at or around 70% So you can see the world is is is urbanizing. It's urbanizing rapidly And and what's so interesting and exciting really about working with cities is that cities are innovators or mayors or innovators They're they're happy to Implement and try out solutions. They're closer to the ground. They're not constrained by the gridlock of national politics even though nations are also important and They're they're willing to learn from each other And implement solutions that work on the ground and so that's why I like this challenge so much It's focused on cities and it's focused on building a network that shares lessons learned So that cities can leapfrog each other and really implement the best in class and not go through the whole innovation Cycle that comes out of cost Finally what I really like about this is looking at and what we encourage cities to do is to look at the multi-sectoral approach to understand the the relationship between Infrastructure between social between the different sectors and silos that often bind us And try to address those challenges more holistically and I see in this approach That that same Type of approach that I hope We'll really address this issue Thank You Michael Over to you Christoph we heard from from Joe Biden earlier this week From basically the government government perspective on on cancer Let's hear it from you as a representative of the private sector who plays a major role on that issue What can be your role and how are you cooperating with your partners here in the panel? Yeah, thank you very much It was a year ago when John Biden Joe Biden actually here in Davos launched the cancer immune to a moonshot initiative and I Highly appreciate this effort because we are living in a time when scientific progress is delivering new solutions to devastating Disease and every four seconds somewhere in the world someone dies from from cancer So it is obvious that this kind of non-communicable diseases will be tremendous Social but also financial burden which we have to address and Being involved in the private healthcare sector in the pharmaceutical industries we Strive to invent new innovative medicines and there is a perspective that in the next years Maybe next decade to come we may be able to Transform and turn some types of cancer into a chronic disease and the dream obviously would be to cure some types of cancer But our industry has also learned and that's the reason why I'm sitting here on the podium that Even the most groundbreaking Innovation in our business doesn't make sense if in the end of the day It doesn't reach the patients and we are aware that the patients get access to our medicines in the developed countries But in many parts of the world, this is not the case and in order to make a change We have to get involved with other partners I personally had the opportunity to visit some Sub-Saharan African countries in in October and visited a multitude of public hospitals got involved in discussions with Ministers of Health Prime Ministers I went to see stakeholders non-governmental organizations Foundations in these countries and one of my major learnings was the fact that There is no one-size-fits-all solution to this issue So we basically have to find individual solutions on the ground and the second learning We the pharmaceutical industry the private health care sector will not be able to master this challenge on our own We need to get involved into partnerships and that's why I'm so enthusiastic about being involved in the secant 2025 challenge because here Non-governmental organizations the private health care sectors and also Public institutions are joining forces in order to make a change happen and when we start making a change It's useful to do it where you have a lot of people who are Affected with this devastating disease and we feel that the city cancer challenge is a great opportunity To start make change happen and it's not important sitting here around talking about great plans What's really important is tomorrow when we start implementing implementing first of all in the three learning cities Kali Rangoon and But then spreading the learnings we have in these cities in different environments different solutions spread best Practices to other cities and thus make in the end of the day in the next 15 years to come very Substantial change happening throughout the world and we as the private health care sectors are committed to contribute to it but We feel that there is also a lot of Willingness to make change happen from the state organizations and in those countries where for example health insurance does not exist on on a National level I Feel that the mayors of the cities can make a lot of difference by creating this kind of political pressure from the bottom up It's not a top-down approach. It's a bottom-up approach to create the right framework in order to make Better health care available for everybody Thank you. Thank you and you mentioned the financial burden which brings us to admin because you're you're looking at the financing of things Cities are notoriously short of money. I think that is fair to say and all mayors in the world will forgive me So share with us. What's the financing angle here? What do we need? So of course for those who are looking at this challenge and asking if we agree that this is what we want to do Where where do the resources come from to be able to finance this and so we spend some time Looking at exactly this question and trying to find are there pockets of resources across public private social sectors You can actually crowd in together to bring the financing you require But the first thing you have to do is of course understand what's the quantum of resources that you're talking about, right? If you know the typical approach would be you're building a facility on top of or you know in addition to what is already on the ground So it's additive rather than completely new and the estimates that that would cost between five to twenty five million dollars Now that's a big number if you're the mayor or your governor of a city And you have to wonder well is this a pipe dream or is it actually possible to do that? And so we've looked at different pockets of resources that do exist Recognizing that they are private companies That actually do this on a commercial basis and the ideas of how those private companies could Access additional resources through their traditional securities derivatives kind of markets We've also looked at public-private partnerships that can be built particularly things like guarantees That help de-risk the opportunity or even things like resource-based mechanisms creating social impact bonds You know that that actually can make a difference and of course there is a question of how does the city itself increase its own tax base? or access to taxes that are collected and Utilizes for this really critical challenge that every single country and every single society faces And so if you're anchoring at the city level, are you are you able to find those resources to be able to do this? Now one of the critical Numbers that we all you know that we also ran, you know back of the envelopes. I come from Kenya On done roughly every single day in Kenya There are about 15 people who get on a flight and travel to India for cancer treatment every single day And when they get on that flight and get to India and get the treatment the total cost of that including flights Accommodation the treatments itself and so on and so forth is roughly about $10,000 Now if you multiply out those numbers 15 people 365 days a year $10,000 it comes to 50 to fifty four point seven five million dollars every single year That's getting spent that's money that is not being spent in the country That's that value is not being captured in the city in the country itself But we also know from a clinical outcomes perspective That actually you know patients do much better when they're treated much closer to home If you're happy and more comfortable you do much better That is something that you're currently losing in a very complex issue. That is cancer treatment We also know that you get better follow-up because now the facility is much closer to where you are Rather than getting on another flight to get to India to get to be checked by your doctor again But there's also that positive additive value of creating a facility creating jobs at the local You know within the city itself as well as creating a platform for innovation and to me That's that's what becomes really exciting about this challenges Finding where their pockets of resources currently being spent by individuals insurance companies extended family and so on and so forth Harnessing that to bring care that is going to be critical in each of the emerging markets as they you know as the disease burden profile changes And and and using that as a hub for for actually helping drive transformative change And so it reminds me of that old you know and famous African Proverb you know if you want to go fast go by yourself if you want to go far go together That's part of what makes this collaboration Exciting is these are people coming from public sector private sector Social sector and asking these hard questions and a commitment to doing something about it which gives over they'll be there'll actually be an answer That long term you know We'll be able to look back and say that was a seminal moment in launching this and this has made a difference in the lives of people Thank you, Edwin. Thank you. Thank you very much Before we open the floor for questions We asked our social media followers for a couple of questions before and I want to just take one The role of technology so the forum has been talking a lot about the fourth industrial revolution obviously technology Is playing a role in innovation and research but beyond that how can cities use technology? Sorry for putting you on the spot here, but that's that Ghana did a lot of interest I'm happy to start with that. I mean as mentioned earlier by Christophe I mean cancer is a complicated disease and there are very few cancers which don't involve the use of chemotherapy radiotherapy and also The use of surgery and in order to understand what the cancer is on what stage it is you need imaging and you Diagnostics so if I just limit the technology challenge there for low-midland countries For example, we need to develop and deliver Technology new advances in radiotherapy imaging and diagnostics in order to improve the efficiency and effectiveness of diagnostic and then treatment So that is one area where absolutely we need support beyond that of course now given primary health care workers The ability to diagnose earlier and present earlier as we know if you present earlier in cancer Your chances of being cured are infinitely higher than if it's presented later So the use of technology to inform and educate primary health care system I think is fundamental, but I'll stop there But I think just in the treatment side we really we are very fortunate. We work with the radiotherapy industry We're working with the imaging and diagnostics industry. They are supportive. They want to find a way to help this initiative I'm hoping that there will be an announce that they're part of this very soon And they will make a big difference because they will start thinking differently I believe on how they can deliver the solutions that required in low-resource settings And maybe just added in the in the prevention space That as cities Better understand the dynamics of their city. So what the impact is of building a road through High residential area and what you know the disease Outcomes will be on either side of that road. I think as cities begin to better understand Which of their interventions has what impact on public health? They will be able to take smarter decisions that both, you know address something like mobility as well as reducing Both communicable and non-communicable diseases. Thank you. Edwin. I think you wanted to just to clear it if you take a patient-centric view Cancer because of its complexity Actually works treatment works better when the patient has an idea of what they are going through and is actively working with With their doctor to figure out what's the best option for themselves, right? Unlike typical Infectious diseases where you know if you have malaria, you get malaria tablets, you're fine The complexity of cancer at the patient level and what that means to the individual to the community to their family Actually means that a better informed pay, you know cancer patient Ultimately can work with it with a care of doctors that they have to get to the best possible results And so to me that's where technology plays a particularly powerful role is empowering patients to actually own their health and own the Interventions that are that you know, and what's what's you know The drugs and the regimens that they will be on over the long term of the care that they have So information is going to be key the second one of course is How do you engage and manage patients within? You know health systems are already stressed in terms of you know You have a lot more people and you have you have a lot more demand and supply And so what does that do for scheduling patient engagement compliance and all these elements? Technology will be a core core part of making that much more effective. Thank you. Let me may add to two other examples I think the most impressive one probably is the fact that in many cases we do not have the right medical capabilities to do the appropriate diagnostics and In this case we can help with for example online educational training in order to bring Medical knowledge to rural places or places which are in the out outskirts of bigger cities And the second one is the fact that today for example when we are talking about imaging whether it's radio Images or MRI We can digitize the images transfer them to other places where you have Specialists looking at these images Maybe in a different continent maybe in a different place in a centralized specialized Lab or medical facility they can do the diagnostics send that back And then you can start with an appropriate specialized treatment So I think technology will be one of the key enablers in order to Have a decentralized Caring approach in the different cities by using centralized specialized knowledge and in fact to quickly add I think one of the interesting ad-necked notes is what's on the IBM? You know creation I think is actually now better at radiology than radiologist themselves Right, so that's an application of technology in a way that improves Detection earlier detection of cancer and therefore early interventions and treatment. Thank you very much I'll hold my fire for now. Can I get a sense from the room if there are any questions? Yes, we have a question over here. We get a microphone to you This radio I would like to talk about money, mr. Front and how much is rush Contributing like or at what prices are you giving away your diagnostics or your? Cancer drugs It is obvious that we have an interest in order to create a sustainable structure not to give away our diagnostics or Medicines for free, but it is also obvious that in for example environments with a very Limited purchasing power we have to adapt and be flexible with our prices and offer very Substantial discounts and this is exactly part of the partnering because this will be the content of Discussions with the public institutions in the different countries in order to come to a solution Where we can offer in the end of the day, which is most important something to the patient, which is either for free or Which is at a very low affordable? Pricing level, but to be honest I'm not talking about pricing at this point because my learning in this country was that there's such a multitude of different obstacles for the patient that You know the pricing issue is something which will we will solve it in the end But if there is no awareness and everybody shows up for example women show up with breast cancer in in Kenya 80 percent with Metastatic past cancer because for example there is no awareness of the disease or there are societal hurdles to speak up Etc. Then we have to solve these issues first. We have to make sure that there is an appropriate Diagnostics available. We have to make sure that for example of expensive Accelerators for for radiotherapy are not only existing but the spare parts Because the machine just has broken down this spare part is important within 24 hours and not within three Three months and that is reality in these countries. So look at what is really happening in these countries to make things work and that is Something not only our company can do but we have to team up with the government institutions with the NGOs and that's why we highly appreciate the effort of our UICC to Create working working Cancer care centers in the biggest cities of this world Thank You Kerry. I think you want to add to that. Yeah, I could just add to that I'd like to sing the praises of the World Health Organization who over the last few years working with experts around the world have actually spent time Developing an up-to-date list of essential medicines for cancer and essential technologies for cancer And I use the word essentials because that's the word that's used by the World Health Organization And that's driven from a set of cancer states No, the the cancers that we're all familiar with which can be dealt with with drugs the vast majority of which are generic drugs And they can be reduced by the many and not reliant on more innovative drugs And so certainly in the first phase is the way the city cancer challenge will be rolled out We'll be doing assessments against what cities have with regard to those essential medicines and essential technology lists Because and that includes for example very simple things like morphine availability, which is surprisingly not available in many parts of the world So I think we have a long way to go yet to get cities up to a level We'd say which is a baseline and of course that baseline would include pathology Imaging oncologist surgeons and at that point then you get to the opportunity to bring in more innovative drugs more personalized medicine Because you can deliver it in a more safe environment a more secure long-term sustainable environment So I think that the what we're doing here is we're putting in place What should have been in place for a long time working with cities to help them get to that level? Thank you, Edwin, please in my previous life I worked in the HIV AIDS space and one of the dramatic things that happened was being able to shift the Medicine element actually the entire ecosystem need for HIV AIDS care and treatment from being high-margin low volume To actually the reverse where your higher volume and lower margin Right so you can reach much more people because in almost any of these things They are dramatic in economies of scale that you get including the pharmaceutical for pharmaceutical space And so if this challenge part of what this challenge does is it helps unlock that? latent unmet demand and as that you know as and as that demand and those patients start being identified and coming forward and requiring Care and support as they go along then you will be able to write some of these curves For efficiency and therefore get to lower production cost and therefore get to lower cost of the actual product And so this is in some ways priming the pump for that reality that's coming down the line And that's what you think of it in an ecosystem and you're thinking of it in a city because that's where you have a lot of people Concentrated in one location that actually allows you to move much faster than in a highly distributed perspective Thank you Time for me to ask another question from our social media audience and because you you mentioned already breast cancer We had several young women asking us. How will types of cancer that affect? Like particularly women, how will that be reflected in the in the in the city cancer challenge and how you're taking account of that? Maybe I start and then and then you can can can a little bit add Gary. I think The value of this initiative is that we are focusing on the most important types of cancer and then look what is the Appropriate standard of care which we would like to see being delivered in all these cancer care centers in the cities and UICC has done a great job of developing this kind of Defining the right standards and let us remind I think a carry mentioned it already the essential Medicines list of the World Health Organization. We are proud as our company to having delivered 29 Medicines to this list, but only three of them still are patent protected. So in the end of the day, we are not talking about Very expensive medicines for most cases and for these cases We will solve this in the end, but they are most of them are available available but we have to make sure that the whole ecosystem is Working that we have the right trained people that we have the awareness that we have the right capability to do diagnostics and This is something which we will address now first in the three learning cities And at the risk of upsetting all men I don't want up to a man, but certainly when it comes down to curable women's cancers breast cancer and cervical cancer Feature very prominently in the ambition of the city cancer challenge and go beyond just a treatment perspective because it was you know avoidance of cervical cancer can be done through HPV vaccinations and we would like obviously to talk to cities and Countries around the world about rolling out population based HPV vaccinations because that eliminates a lot of the problem And you don't have to do as much treatment in terms of with the women who come through with cervical cancer breast cancer again is on the list of those that can be treated with essential medicines and with surgery and Also with radiotherapy. So yes, they are included. I'm hopeful that by the time we get to 2025 And 2013 we'll report back on those sustainable development goals that this community which is represented here and those of you Who wish to join the city cancer challenge can say with a fair amount of certainty that because of this initiative We are able to report thousands and thousands of lives being saved by 2030 because we can measure Over time the increase in the number of oncologists the number of radiotherapy machines the availability of essential meds around the world All these pinch points these 500 pinch points around the world and report back that we did respond to that 25 by 25 Challenge and so I'm very optimistic that this will lead to an outcome Which will satisfy all of us that we are not seeing unfortunately, you know unnecessary deaths around the world Thank you, and no minute too early We are holding up our promise and we're joined by the Health Minister of Malaysia Welcome Minister. Thank you for joining us. I know everybody has a tight schedule in Malay in Malaysia probably to but in So we're we're happy you can join Let me put you on the spot right away We've heard from the chairman of Russia about the role of the the private sector What is the role of the governments? What's the role of the public sector here in fighting cancer in cities? Right Governments role of course starts from the initially of course in the area of education and subsequently the area of prevention And Identifying inspectors and early screening to identify cancers at the early level and of course making available Treatment To all those who are who are affected of course It's easily said than done. There are many challenges in it Going from the Malaysian experience In areas of screening particularly and in prevention if you take prevention we have been We are quite lucky in that We have been able to vaccinate Our vaccination for both Hepatitis B and HPV particularly has reached about 95% that means 95% of all school girls at the age of 13 actually have been vaccinated with HPV So we hope in the next 20 to 30 years. We'll be seeing a serious reduction in the number of cervical cancers our screening program Particularly for breast cancer for cervical cancer and colorectal cancer, which you've taken as beer as part of the government screening programs so but as You probably know we cannot legislate compulsory screening So it has to be done on the basis of education and making sure the opportunities for screening available So we are quite happy that for example perhaps me the percentage of those who have been screened as Increased gradually till the last survey which we did nearly of all women over 20 years of age about 50 50 percent have had some kind of perhaps we are done in the last three years likewise in the And Nearly about 60% undergoes some kind of breast examination of course we self-examination and of course which leads to Examination by a medical professional and subsequently mammography and the latest MRI scans which available for for assessment of breast cancer Just as I was listening to you on the the availability of the facilities for managing this which is a bigger challenge for a population of 90s of 30 million people we've got 97 oncologists trained and and Unfortunately the bulk of them are in the private sector They all weigh the public sector training the public sector, but they all shift to the private sector because of the lucrativeness of the private sector But the public sector in Malaysia is very committed to provide access to cancer treatment So we have regional cancer centers. We have five regional cancer centers which are equipped with Nuclear medicine facilities diagnostic facilities and treatment facilities but the challenge is you know the the management of cancer is Evolving so fast and it's giving tremendous opportunities for for better cure of fall for better Periods of remission which is becoming longer and longer and the ability of governments in particularly in public system to be able to provide this particularly in the advent of newer technologies and newer medicines Which are available particularly in the area of Blood-related cancers. We are seeing a proliferation of new drugs which are formidable expensive and This is a challenge. I mean it is a challenge and As a public system, which is not based on any kind of insurance based on general taxation and giving it free of charge to the people We face that sustainability program when but not withstanding it our commitment to ensure that access to Diagnosis and management cancer is available to all sectors of our population Is something which motivates us to increase the the access and Availability to a wider spectrum of population Thank You minister follow-up question on that the the forum held its ASEAN event in in Kuala Lumpur earlier this year and I had the pleasure to be there and I noticed how young the population is there Do you feel that the young people have the necessary awareness of the of the risks? Yes Our health education Malaysians We have got a very peculiar situation Knowledge level is high But the change in behavior Subsequent to knowledge is poor and this is the this is the area which we have to tweak And we see that across All but so so it's it's how to make sure that that knowledge which they have Is Translated in changes of behavior but in in initially of course like breast cancer screening and and And and people willing to come for perhaps me are there were resistance, but I can see there's a change now So that is that that is something which is good But in in for example reducing risk factor because the one the biggest risk factor is tobacco and cigarette smoking and like most other book countries in the world We also fighting a big battle in trying to make sure that the hour in I think 50% of all Malaysian male smoke our Our total percentage of smoke is about 23% for those above 18 years of age So it's still high and that is a battle by all the with all the knowledge with all the Legislative requirements of labeling Packet packaging and all that still we are not be able to win the battle So this we have to find ways of knowledge is translated into behavioral change I think it's a much broader philosophical question on is human is humanity truly rational is a human being truly Thank you. Thank you very much and in the meantime we had another young woman writing on Facebook I know that she's young because her Her name on Facebook ends with her birthday, which I'm not gonna disclose here, but she said Okay, thank you for for raising these these women's health issues Unfortunately, do you do it from an all-male panel and yes, we do apologies It gives me the opportunity though to mention that we did Talk to Anne Hidalgo the mayor of Paris who's very supportive of the of the city cancer challenge Unfortunately, she is here in Davos, but she she couldn't make it in time to this panel So yes, we acknowledge that we need to to work on that as well But back to the issue at hand. Thank you to every everyone I know I've run hopelessly over time But I think it shows how important the issue is and and the challenges that lie ahead Thank you very much for being here today and talking about this issue. Thank you for being in the room And thank you for watching online. Thank you. Thank you very much