Once thought to be a problem primarily in the developed world, cancer is now a leading cause of death and disability in poorer countries. Almost two-thirds of the 7.6 million cancer deaths in the world occur in low- and middle-income countries.According to a paper published online in the Lancet, the international community must discard the notion that cancer is a “disease of the rich” and instead approach it as a global health priority.The paper is authored by Paul Farmer, chair of the HMS Department of Global Health and Social Medicine; Julio Frenk, dean of the Harvard School of Public Health (HSPH); Felicia Knaul, director of the Harvard Global Equity Initiative (HGEI) and HMS associate professor of social medicine; and Lawrence Shulman, chief medical officer at Dana-Farber Cancer Institute (DFCI) and HMS associate professor of medicine at DFCI.“The provision of adequate health care in settings of poverty is by definition difficult, but the past two decades have taught us that setting our standards high can help bring new resources to bear on old problems,” says Farmer, who is also executive vice president and co-founder of Partners In Health. “The integration of cancer prevention and care where both are needed is precisely what we need to do if we are to make the response to the challenge as global as cancer itself. There are clearly effective interventions that can prevent or ease suffering due to many malignancies, and that is surely our duty as physicians or policymakers or health advocates.”Comparing cancer fatality rates between low- and high-income countries reveals stark disparities. By some estimates, fatality rates in low-income countries are 75 percent, in lower-middle-income countries 72 percent, and in upper-middle-income countries 64 percent. In contrast, high-income countries experience a 46 percent fatality rate.“The gaps in access to cancer care and control are one of the greatest challenges in global health in the world,” says Knaul. “I believe we must address this glaring inequity. Evidence shows that this can be done.”Many of the more than 4 million deaths from cancer each year in low- and middle-income countries could be averted through early detection and treatment. Millions more people with advanced or untreatable cancer but without access to palliative care will die with great and preventable suffering, often leaving those surviving them impoverished from attempting to meet even the most basic costs of the disease.This suffering and needless loss of life will persist without a rapid recalibration of global and local response. Said Frenk, “In most parts of the world, cancer is a sorely neglected health problem and a significant cause of premature death. To correct this situation we must address the staggering ‘5/80 cancer disequilibrium,’ that is, the fact that low- and middle-income countries account for almost 80 percent of the burden of disease due to cancer yet receive only 5 percent of global resources devoted to deal with this emerging challenge.”Among the additional authors are leaders from the global health and cancer communities representing the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries (GTF.CCC), including honorary co-presidents Lance Armstrong and HRH Princess Dina Mired of Jordan. GTF.CCC was launched in November 2009 by HMS, HSPH, HGEI, and DFCI.The authors, speaking on behalf of the GTF.CCC, propose, and are working toward, the following:· Raising global awareness of the impact of cancer on developing countries, creating a call to action on both the global and national level.· Defining the packages of essential services and treatments needed to provide care in low-resource settings for cancers that can be cured or palliated with available therapies.· Increasing access to the best treatment for cancer through the procurement of affordable drugs and services.· Reducing suffering from all cancers through universal access to pain control and palliation.· Developing and evaluating successful service delivery models in different economic and health system settings and sharing the lessons and evidence globally.· Expanding the leadership, stewardship, and evidence base for implementing the most efficient approaches to cancer care and control in developing countries.According to Shulman, “Access to life-saving cancer care is a human right, and must be brought to those in developing countries. We have shown we can do this in the treatment of other illnesses, and we can and must do this with cancer care. This should be viewed as an imperative rather than as an option.”
PMT following a different policy than PME is unusual, as both metal schemes have outsourced their investments to MN, and have been hinting at a possible merger for several years.PMT said it wanted to monitor carbon emissions closely, but preferred engagement with high emitters as a way to achieve reductions.The pension fund explained that it favours an “inclusive energy transition”, which takes into account the effects on staff.It added that it considered exclusion an ultimate remedy for companies that haven’t introduced a climate strategy within two years.Recently, PME said it wanted to reduce carbon emissions by 25% through engagement with the 10 highest emitting companies in its portfolio.If the dialogue fails, it could lead to exclusion of these firms as of next year, according to PME. Dutch pension fund PMT does not intend to set a target for the reduction of carbon emissions from its equity holdings, going against a trend among the largest schemes in the Netherlands.A spokesman for the €67bn pension fund for the metalworking and mechanical engineering industry explained that its investment policy was closely linked to its sector, with comprises 33,000 employers of predominantly production companies, but also garages and fitters.“The industry is carbon-sensitive, with many firms emitting CO2 as well as using fossil fuels,” the spokesman said. “Our rank and file comprises of companies that are ahead in energy transition but also firms that are about to start a transition to low carbon management.”Since 2015, civil service scheme ABP, healthcare pension fund PFZW, metal scheme PME, and BpfBOUW, the pension fund for the building sector, have decided to reduce carbon emissions in their portfolios by up to 50% by 2020.
“I get to be a guy who some kids might look up to me,” he said. “They can see somebody from Powder Springs, Ga., or Kennesaw, Ga., and playing at this stage. It’s honoring and humbling because I was at that point at one time.” Trammell said he will take that approach into the second half of the season, where he will look to make improvements in the Southern League as he looks to take the next step up in the minors. “The rest of the season I’m just hoping to calm myself down,” he said. “I know myself as a hitter. I’m a good hitter. I just need to calm down, not think about it and go out and play. People say that all the time, but going out there and doing it is a different story.” “I know I was safe,” Trammell said. “I thought I got my hand in there.”MORE: Watch ‘ChangeUp,’ a new MLB live whiparound show on DAZNTrammell, a first-round pick in 2016, put the first run on the board with an RBI single over the glove of Tampa Bay shortstop Wander Franco earlier in the inning. That was a clutch hit in a game dominated by pitching. Trammel would make the unsuccessful dash for home later in the inning, and that later proved to be the difference in a 2-2 tie with the American League.On the steal attempt, Trammell said he checked with NL team manager Omar Vizquel first before taking off for home, and he said the crowd noise helped make that decision for him. “I got a good jump, got my hand in there,” Trammell said. “It just stinks when you look and time is moving so slow and he goes (out). You know for sure that got in there.” Despite the call, Trammell brought excitement to the game. He figures to eventually bring some of that to a Reds organization that took a 41-45 record into the All-Star break but looks to be an improved team on the upswing. Trammell said he’s noticed the big club’s success. “I know changes that have been made with the coaching staffs and everything like that, you see it,” Trammell told Sporting News during pregame availability. “Our mindset is win. We want to win as an organization. We’re making changes. We’re getting guys and making the pursuit to win. “I think everybody’s goal in that clubhouse, in our clubhouse, in Triple-A is to have that whatever year trophy it is and win that World Series.” Trammell is hitting .253 with five homers and 30 RBIs at Double-A Chattanooga at the break, but it’s that next-level speed that could be an asset for the Reds down the line. He has 106 steals in three-plus seasons in the minors, and that includes 16 steals in 19 attempts in 2019. Trammell, a Powder Springs, Ga., native, said he models his game on and off the field after Dexter Fowler, an Atlanta native who is hitting .258 with 10 homers and 32 RBIs for the Cardinals. Fowler finished with 27 stolen bases in his first full season in 2009. Trammell sees a similar opportunity for himself. CLEVELAND — Reds prospect Taylor Trammell made his case for a replay. The outfielder tried to steal home with two outs in the fourth inning of the MLB Futures Game at Progressive Field on Sunday. It looked to many like he beat Kris Bubic’s throw to Jake Rogers at the plate, but he was called out. Trammell, popped up, clapped his hands and smiled. He also pleaded his case, but no instant replay was available for the game.