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The expert project for the prevention and treatment of non-communicable diseases in Russia “Main Road” is paved in Nizhny Novgorod

03.03.2014

In Nizhny Novgorod, the first in the year 2014 event of the Main Road project was held intended to facilitate the development of strategic “road maps” to develop regional health care systems. The round table at the Nizhny Novgorod Regional Cancer Center brought together leading experts in the field of medicine, representatives of government and public institutions of Russia. The working group of the Main Road project has set a goal - to formulate effective approaches to prevention and treatment of non-communicable diseases. The round table adopted a resolution, which is an expert opinion on the promotion of reforming cancer care in the Nizhny Novgorod region.

National non-profit program “Main Road” was launched in February last year and gathered into a team of experts in various fields and areas of health care and social development who are able to carry out comprehensive analysis of the existing problems in controlling non-communicable diseases, develop a strategy and algorithms to introduce best practices in the Russian medicine. The priority task of Main Road is execution of the Russian Government Decree of 28.12.2012 No. 2599-R “On approval of the plan (Road Map) titled Changes in the social sphere aimed at improving health care.” This social initiative of experts is intended to help administrative territories of the Russian Federation to develop "road maps" which, in the course of their implementation, will be effective not only for the development of regional medicine in general, but also for each individual patient in particular.
Non-communicable diseases (cardiovascular diseases, cancer, diabetes, lung diseases, etc.) are the cause of 60% deaths in the world. The Nizhny Novgorod region is no exception, and cancer has been and remains the dominant problem in this segment. This is a serious social and demographic problem as the national human capital is at risk, namely, people of productive age.
Assessing the situation in the Nizhny Novgorod region, experts pointed out that in absolute figures cancer causes fewer deaths than the cardiovascular diseases. However, it makes a major contribution to the death toll among working-age population in the region and forms the main problems, which participants of the Main Road project are trying to solve. According to David Melik-Guseinov, Director of the non-profit partnership Social Economy Center and expert in health care, relevance of the project is substantiated by the main challenges the region faces now. They include insufficient funding of specialized care from the regional budget; low rates within the compulsory medical insurance system, which are significantly different from those in the neighboring regions and do not ensure proper execution of the region’s obligations under the program of state guarantees; insufficient use of up-to-date clinical practice guidelines for the prevention, diagnosis, treatment and rehabilitation of cancer patients; insufficient implementation of innovative methods for the diagnosis and treatment of malignant tumors; acute understaffing problems with regard to medical professionals in oncology; non-compliance of the bed capacity of cancer care institutions with the recommendations in international standards; poor development of palliative, rehabilitation and medical care, as well as psychosocial assistance to cancer patients.
The Resolution formulated and adopted at the Roundtable in Nizhny Novgorod can be a response to the above challenges. The main recommendations to improve the system of cancer care in the Nizhny Novgorod region from participants of the discussion are the following:
- Create and approve the regional targeted (agency-level) program in oncology, as part of the development of the entire health care system of the Nizhny Novgorod region up to the year 2020, with targeted financing of treatment of the most common forms of cancer – breast cancer, colon cancer, stomach cancer, ovarian cancer and skin cancer. Today, in the Nizhny Novgorod region patients whose disease is treatable die despite doctors have access to appropriate technologies and medicines, which are included in the program of state guarantees. Correction of this situation will ensure patients the right to receive necessary treatment guaranteed by law and will allow reducing high cancer mortality rates in the region.
- Develop and implement as soon as possible economically justified approaches to increases standard rates to cover costs of cancer treatment in the Nizhny Novgorod region, clinical and statistical groups with the possibility of a balanced approach in terms of the treatment of different on complexity types and localizations of cancer.
- Attract additional funding (from budget, insurance system, as well as private funding) for the health care system and the procurement of cancer drugs for the use both in hospital and outpatient settings.
Vitaly Mikhailovich Terekhov, candidate of medical sciences, chief oncologist of the Nizhny Novgorod Ministry of Health and chief medical officer of the Regional Cancer Center analyzed the cancer epidemiological status of the region and noted that the Nizhny Novgorod region has objective preconditions for the development of this health sector, namely: positive experience of screening programs for early diagnosis of cancer, the availability of hierarchical network of specialized cancer care institutions, centralized provision of medicines to treat cancer and funding and equipping of cancer care institutions from the federal and regional budgets.
Expert Group, composed of representatives of the executive bodies of the Nizhny Novgorod region, professional and public associations, professionals and organizers of health care in the Russian Federation determined three main directions requiring the attention of all stakeholders who participate in the organization, prevention, diagnosis and treatment of cancer:
- Prioritized funding from budget of prevention and treatment of cancer, which is a socially significant disease.
- Improving early diagnosis of malignant tumors by increasing public awareness and changing people's behavior.
- Reduction of cancer mortality by increasing collaboration between health care sectors.
To achieve these goals the working group identified a scope of specific joint tasks and measures for the prevention, diagnosis, treatment of cancer in the Nizhny Novgorod region, and for the improvement of the socio-economic relations in the regional health care. These tasks and measures include: rising the rates for reimbursement of cancer treatment at least 2-fold; development and implementation of a regional program for the treatment of the most common forms of cancer, engaging the media for regular provision of information on the prevention of malignant neoplasms, wide use of screening methods for detection of cancer in the Nizhny Novgorod region, development of an algorithm for care provision (“patient’s route”) for patients with diagnosed cancer, development of an algorithm for co-financing of treatment through voluntary health insurance, launching the program to monitor the availability of all necessary medicines for cancer patients in hospitals, and so on.
Summarizing the meeting of the Round Table, Chairman of the Executive Committee, member of the Coordinating Council of interregional public movement “Movement Against Cancer”, member of the Council of public organizations for the protection of patients' rights under the Russian Ministry of Health Nikolay Dronov noted that thanks to the Main Road project regions received a great opportunity to take the help of leading federal experts. Working groups of health professionals are able to comprehensively analyze and predict local situations, develop specific scenarios of “road maps” and propose effective solutions that will work for the benefit of every doctor and patient, as well as for the development of the health system as a whole.