Agreement Against Cancer: A Citizen Proposal to Fight Cancer and Influence in Public Policies

Abstract

Background and context: The Constitution of Ecuador provides the right to free and specialized attention. The state has fallen short due various reasons: limited political support, weak infrastructure and limited resources, inadequate cancer information system, lack of integration and coordination of efforts to control the disease, scarce research, lack of monitoring and evaluation of interventions and social inequity. Agreement Against Cancer was born aiming to improve disease control and priority attention with a comprehensive approach: health promotion and prevention, early detection, adequate treatment, rehabilitation and palliative care: it adheres 18 organizations who have worked in the promotion and defense of the rights of cancer patients. Aim: Raise the national debate around cancer and influence in public policies to combat this catastrophic disease. Strategy/Tactics: 1) Social mobilization to awaken interest in the disease: 2) Proposal of a bill to fight cancer and include the issue in the public agenda Program/Policy process: Acc decided to act on 3 axis: Social: strategy to fight cancer was established: 1. Creation of National Cancer Control Council 2. Investigation 3. Prevention 4. Integral attention: timely diagnosis, treatment and rehabilitation, palliative care, access to blood products, emotional health 5. Education 6. Labor security 7. Mobility: transparent, prehospital care, hostels and home 8. Family surroundings 9. Infrastructure 10. Economic fund Communication: This proposal was taken to the 8 presidential candidates in 2017. Emphasis was placed on digital communication. A public relations campaign mobilized the media, stakeholders and opinion makers. The problem was risen at a national level and citizens demanded a response from the authorities, private company and other actors in society. However, this social demand needed a channel to introduce it to the government´s agenda. Political: it was decided the construction of a bill, that required the submission of citizen signatures to reach the National Assembly. A campaign was launched to collect a minimum of 35,000. Outcomes: • Approximately 150,000 citizens signed; more than 5000 volunteers mobilized. • Concert for Life, participation of more than 10,000 people. • Support of 8 presidential candidates. • Bill proposed to the National Assembly. Validation of 111,157 signatures. The bill meets all the requirements necessary by the law and is awaiting its analysis. What was learned: 1. Cancer management from the legal, political and social point of view. 2. Reality of cancer patients. 3. Collaborative network. 4. Public–private articulation to promote citizen initiatives. 5. Social mobilization supported by new technologies. 6. Use of volunteers and training. 7. Citizen participation mechanisms and their empowerment. 8. Structuring process of a bill.