Dean of the faculty, Harvard School of Public Health
There are new forms of inequity, such as in the field of leukemia, where enormous progress has been made in treatment and survival of children. In the 35 poorest countries of the world, only about 10 percent of children with leukemia survive. In Canada, 90 percent of children with leukemia survive.
You are finding increasingly that the proportion of women who survive because breast cancer is detected early is staggeringly different depending on what part of the world you’re looking at. In the United States, about 60 percent of cases of breast cancer are detected in early-detection stages 0 and 1. In a middle-income country with a firmly developed health system like Mexico, that proportion is only 5 to 10 percent. That means that many more women have to undergo treatment that ends up being ineffective exactly in the regions of the world that can least afford it.
What we are seeing increasingly with a number of noncommunicable diseases is what we saw with AIDS. AIDS was a disease that affected both rich and poor people. But with the appearance of antiretroviral therapy, dying from AIDS became something that only happens to poor people.
More and more, breast cancer affects women poor and rich, but only poor women die. That gives many of the NCDs that same moral imperative that we had with AIDS.