I wrote an article in yesterday's Globe about a forum featuring the work of Felicia Marie Knaul, a prominent global health economist, and her husband Dr. Julio Frenk, the new dean of Harvard's School of Public Health.
The forum took place at the school's Boston campus last evening, with a panel including Dana-Farber Cancer Institute specialist Dr. Lawrence Shulman, as well as the School of Public Health's Dr. Jennifer Leaning, a global health expert from the Harvard Humanitarian Initiative, and Dr. Walter Willett, who has looked at breast cancer factors in developing countries.
The webcast and links to relevant articles should be available shortly on the school's webpage on the new forums.
Knaul, herself a breast cancer survivor, explained her research in Mexico showing the relentless advance of breast cancer among younger and poorer women, overtaking cervical cancer as a cause of death. The website of the non-profit group she founded there, Tomatelo a Pecho, contains many reports on the worsening problem, and the efforts to improve early detection in clinics across the country.
The panelists emphasized the critical importance of early detection to be able to offer a reasonable chance of effective treatment and to add years of quality life for the patient. There's no primary prevention, and self-exams are not effective in detecting breast cancers early; mammography remains a critical tool in diagnosis and treatment.
Shulman said expanding the use of digital mammography in Third World countries would allow more long-distance diagnosis. But he said it won't be of much use if treatment isn't available locally.
Willett took note of the paradox that the decline in family size in Third World countries has coincided with the rise in breast cancer, echoing patterns in the developed world. He said a pilot study now under way in Mexico, which will enroll 50,000 to 100,000 women, will provide more data to enable better comparisons between developed and developing countries.
Leaning said that confronting cultural prejudices, especially in countries in conflict, remains an underlying priority. Until women are valued as more than vessels for reproducing and caring for children, she said, they won't earn the protection and care they need and deserve.
Frenk concluded by saying the goal should be to focus not on breast cancer in isolation, but to address it as part of a broader research agenda combining science and development. He recalled that two decades ago, the School of Public Health joined a global effort to confront another unexpected health crisis -- HIV/AIDS -- with a similar concerted approach, and the result has been "a triumph of public health," with three million people now on anti-retrovirals worldwide. "It was thought impossible. Now it's a reality," he said.
About this blog
About James F. SmithJim Smith came home to his native Boston in 2002 to become the Boston Globe's foreign editor after spending 22 years abroad. He was previously based in Buenos Aires and Mexico City for the LA Times, and in Johannesburg, Tokyo and The Hague for the AP. In 2007 he became the Globe's national political editor, coordinating presidential campaign coverage. He is a Yale graduate, and has an MBA. He is married to Maxine Hart and has two sons, Matthew and Daniel.
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