Editorial 1: Cancer’s gender problem
Recent Context:
- As per recent, Lancet Commission report on gender inequity in cancer care , Titled ‘Women, Power and Cancer’, highlighted that around 6.9 million cancer deaths among women in India were preventable and 4.03 million were treatable.
- Around 63% premature deaths due to cancers in Indian women could have been prevented by reducing risk factors, screening, and diagnosis while 37% could have been averted with timely and optimal treatment
Women are more vulnerable to cancer-based mortality
- The report highlighted that even though men are at a higher risk of cancers that affect both genders, cancer incidence and mortality in women remains high.
- Globally, women account for 48% of the new cancer cases and 44% of cancer deaths. This happens even though some of the cancers in women, such as breast and cervical cancers, are highly preventable and treatable.
Reasons behind the poorer outcomes for women?
- The report said women face challenges in accessing timely and appropriate care in the absence of knowledge, decision-making and financial powers and availability of services at the primary level closer to home.
- Irrespective of which part of the world they live in and which strata of the society they belong to, women are more likely than men to lack the knowledge and power to make informed decisions. It added that they are also much more likely to experience financial catastrophe due to cancer.
- Report highlighted that when it comes to providing cancer care, women are under-represented as leaders, are likely to face gender-based discrimination and sexual harassment, and also constitute the largest unpaid workforce.
- The report estimated that the value of unpaid cancer care-giving by women is about 3.66% of India’s national health expenditure.
Expert’s view over gender-based vulnerability”
- There is of course a gendered aspect to cancer care. The healthcare-seeking behaviour is very less among women, especially in the poor sections of the society.
- While the risk of certain cancers, such as the ones related to exposure to smoke or tobacco, may be similar in men and women, treatment of women is not the priority. This is the reason they are likely to fare worse than men.”
- There is a need for societal changes as well. As the most common cancers in women are breast and cervical cancer. However, women hesitate to approach male doctors with these problems or even let a female doctor check the genital area, leading to delays in diagnosis and treatment
- The need for travel to district hospitals, state capitals, or to big tertiary hospitals in other states for screening, diagnostic tests, and treatment also leads to delays in treatment, resulting in poorer outcomes
The role of Government
- One of the most important interventions needed is creating awareness among people, especially women, so they come forward for screening and seek care.
- As it was observed during the information campaign by government to tell people that Covid-19 vaccines can prevent deaths due to the infection, people turned up in large numbers to get the shot. The same is needed for cancer prevention.”
- The vaccine for HPV that causes cervical cancer is already available in the country and an indigenous one has also been developed.
- The government need to include the vaccine in the universal immunisation programme for young girls. The vaccine has to be administered in women below the age of 25 years before sexual activity. It prevents the virus from entering the body
What are the recommendations of the report? (Way forward)
- The report said that there is a need to regularly collect data on gender and social demographics for cancer health statistics.
- It called for developing, strengthening, and enforcing laws and policies that reduce exposures to known cancer risks.
- Stating that cancer care and research is dominated by men who decide what is prioritised, funded, or studied, it called for equitable access to cancer research resources, leadership, and funding opportunities for women.
Editorial 2: On ASEAN’s plate
Recent Context:
- At the ASEAN meet earlier this month, Indonesia succeeded in putting new nuances into often contentious ASEAN positions.
- Eight ASEAN countries came together at the highest level. As is usual now, Myanmar was not invited at the political level for the Jakarta Summit; Thailand is in the throes of constituting a new government
About ASEAN
- The Association of Southeast Asian Nations, or ASEAN, was established on 8 August 1967 in Bangkok, Thailand, with the signing of the ASEAN Declaration (Bangkok Declaration) by the Founding Fathers of ASEAN: Indonesia, Malaysia, Philippines, Singapore and Thailand.
- Brunei Darussalam joined ASEAN on 7 January 1984, followed by Vietnam on 28 July 1995, Lao PDR and Myanmar on 23 July 1997, and Cambodia on 30 April 1999, making up what is today the ten Member States of ASEAN
ASEAN Indo-Pacific Forum (AIPF)
- At the meet, Indonesia’s plan included an initiative to embrace the Indo-Pacific. It arranged the first ASEAN Indo-Pacific Forum (AIPF), which had government leaders from ASEAN, some of its partners and a large number of participants from the business sector.
- It shows that global economic growth was now centred in the Indo-Pacific region.
- Indonesian interlocutors took pains to emphasise that not only did they embrace the Indo-Pacific without worrying too much about what China may say, they also adopted a functional approach to the Indo-Pacific.
- This is akin to the Quad’s soft approach to the Indo-Pacific — seeing it more as a cooperative venture than a strategic concept.
China as a major challenge for ASEAN:
- China remains the major challenge for ASEAN, in particular, with regard to big-power rivalry in the region.
- Its call for peace and prosperity is a muted way of saying that the US and China will not exhibit their rivalry in the region.
- The progress on the code of conduct is slow and repeated emphasis on the United Nations Convention on the Law of the Sea appears as a sticking point between the ASEAN’s and China’s views on the South China Sea (SCS).
- The matter was complicated by the issue of what China calls its new standard map, which annoys many countries whose territories are shown as part of China.
- Besides India and Japan, the Philippines, Vietnam, Malaysia and Indonesia raised it bilaterally with China. Indonesia played it quiet mainly because it was the host of the ASEAN and East Asia Summit (EAS), which the Chinese Premier attended.
- The closer embrace of the ASEAN Outlook on Indo-Pacific (AOIP), the willingness to have more ASEAN coordination among their coast guards and to have a common exercise among their defence forces have been a robust response to the lack of achievement on the code of conduct.
Concern over consensus on AIPF:
- However, as ASEAN asserts its centrality, its unity has question marks. Myanmar was unrepresented. Thailand’s slow transition after an election led to an official-level representation.
- In this light, there is a movement under Indonesia’s chairmanship of coordinated rules on how ASEAN should act in the absence of a consensus.
- Emergent situations cannot wait for a time-consuming 10-country consensus. This means that decision making could move away from a full consensus into a coalition of the willing.
Conclusion:
- The Indonesian presidency must be complimented for keeping ASEAN on an even keel, despite its many challenges. In a dynamic world, the stability of ASEAN remains important. Indonesia has formed a troika with the next chairs Laos and Malaysia to steer the course ahead.