UHC Provision:
Cancer has the power to bring people together

In the current phase of the project we are utilizing educational and promotional materials that cater to a culturally diverse set of values. By harnessing the reach of beauty salons, we aim to raise disease awareness and encourage participation in our digital registry portal through a pilot study. The projected outcome is significant: contributing to the wellbeing of over one million Malaysian citizens.

The anticipated outcome includes enhanced cancer health education and literacy, with the impact being the promotion of cancer prevention and early detection. The ACF and NCSM have carefully monitored these outcomes and impacts during earlier phases of the project, with the goal of ensuring sustainability of the activities initiated and constructing a system for accurate diagnosis and timely treatment.

Now that the project is up and running, it is timely to consider its impact. Our efforts in Malaysia are twofold: enhancing cancer health education and literacy, and, critically, bridging the gap to early detection and timely, effective treatment. In her lecture earlier in the lecture series, Dr. Saunthari Somasundaram highlighted the gap between public and private hospitals in Malaysia, citing this as one of the crucial challenges that the country faces. 

We have identified a stark disparity in early cancer detection and treatment between urban and rural areas. The segmentation of healthcare networks across economic classes necessitates a prioritized, case-by-case approach. The diagram below represents the relationship between major hospitals in Malaysia. It's clear that the medical network is fragmented, not just between public and private hospitals but within sectors themselves. Addressing these disparities is paramount.

Fig. 2: The medical sector in Malaysia 

It is our awareness of these issues that informs ongoing efforts, including collaboration with the company PMCARE, which is engaging in workplace cancer screenings as part of a public-private partnership, and which was covered in an earlier lecture. 

Through this project, we strive not just for health equality but for a robust medical infrastructure that supports early intervention across Malaysia."

Based on Japan’s experiences, we believe that Japan has two significant contributions to offer Malaysia. The first is "Enhancing Diagnostic Accuracy." Japan differentiates itself in the global medical field with its widespread use of endoscopic examinations. Even in rural areas, gastric and colonoscopies are readily available, a rarity in many countries. Moreover, Japanese universities' ongoing collaborations with Malaysian institutions open doors for international cooperation.

The second contribution that Japan is well positioned to make to Malaysia is: "Leveraging DX in Healthcare Resource Provision." In the fight against cancer care disparities, the development of Medical Digital Transformation (DX) is evident. As cancer care grows more advanced and complex, the importance of professionals with specialized knowledge in this field is increasing. Systems are being developed for urban professionals to support rural areas, particularly in the realm of second opinions, provided remotely through online systems. Future plans include extending this support to treatment facilities.

Currently we are planning next year's initiatives using the training programs of Japan's Ministry of Economy, Trade, and Industry. The Asia Cancer Forum is committed to addressing regional disparities in medical care through domestic DX efforts, and we believe the time has come to leverage this expertise. The challenges we face domestically mirror those in Asia. As a leader in addressing these issues, Japan has much to offer.

In Malaysia, economic classes can be broadly defined as T20 (upper), M40 (middle), and B40 (low income) classes. In establishing a system for proper diagnosis and early treatment, it is of critical importance to consider the financial environment and situation of individuals. A tailored support system that matches economic circumstances is needed. In Malaysia, there are cases where even with early detection, patients fall into poor prognoses due to financial constraints, and it is known that many who develop diseases find themselves in economically challenging situations. 

Fig. 3: Activities for cancer control and treatment in Malaysia 

In the M40 income class, we see corporations grappling with the rising costs of employee healthcare, increasing by 15% annually. This surge is becoming a major corporate concern, because costs are rising irrevocably, creating a burden on corporate activities. In the midst of this situation we are focusing on the promotion of screenings in medically accessible areas and the cost containment through early detection.

A collaboration is in progress with PMCare (a member of the Sumitomo Group) to launch managed care services. Looking ahead, we plan to conduct research and raise awareness for workplace cancer screenings, aiming to curb healthcare expenses through a triple collaboration. 

When considering the B40 income category, a long-term perspective is vital, starting with school education. We aim to explore educational programs beginning from primary schools. In Melaka's primary schools, ACF is advancing cancer education based on programs developed in rural China with the support of the Japan International Cooperation Agency (JICA), alongside Japan's integrated learning curriculum. With the cooperation of JICA Melaka, we are preparing to not only educate families through children, but also to develop systems where children can learn about health as part of their community interactions.

For children in particular, cancer seems distant from everyday life, so the place we start is with food-related education. Under the guidance of Professor Hattori from the University of Tokyo, and with support from the Toyota Foundation, we plan to initiate food education programs where Japanese middle school students can also take part in the learning process. 

In Malaysia's educational scene, this program promises significant benefits for the next generation and regional development. Our goal is for children to take what they learn in school out into their communities, working in tandem with local barbershops and beauty salons to engage in community advocacy that will encourage parents of children and those who visit barbershops and beauty salons to receive cancer screening. 

The BEAUTY and Health Project is a vital piece of the UHC ecosystem we envision for Asian solidarity. ACF is committed to illuminating the realities of cancer care across Asia. We analyze costs, map out regulations, and consider the socioeconomic and cultural landscapes to pioneer a cancer UHC vision.

Our blueprint stands on four pillars. First is implementation, where we refine data for UHC, revealing the realities of medical practices, patient backgrounds, treatment outcomes, and regulatory landscapes. This creates a wealth of data that identifies industry challenges and investment opportunities.

Second is validation, where, with academic support, we help companies deploy the desired form of cancer care and screening in Asia, fostering innovation. We also aim to match companies with local healthcare institutions and administrative bodies related to the Union of International Cancer Control (UICC).

The third pillar is ideation. Here we delve into the essence of UHC through interdisciplinary research, aiming to contribute conceptual resources to UHC policies.

The fourth pillar is advocacy, a vital tool for synthesizing UHC for Asian cancer care into a unified policy concept.

Together, we are building the “UHC Provision Ecosystem,” a data ecosystem that binds industry, academic research, and policy under the banner of UHC for cancer care.

In summing up our efforts to date and what we aim to achieve in the future, it should be noted that Asia, a region of remarkable economic strides, still grapples with the weight of its historical debts. Here, the tension between globalization and nationalism is starkly etched. 

In fostering Asian cooperation, we need an academic foundation that interlinks historical and cultural contexts. We are building on the concept proposed by Professor Hideyuki Akaza in 2011, namely “Cancer as a Mirror,” advancing Cross-boundary Cancer Studies from our base at the University of Tokyo. 

Key to cancer control and treatment strategies is efforts to transform all stakeholders – patients, insurers, providers, suppliers – into activists. Beyond the medical realm, we value the interdisciplinary perspective of Cross-boundary Cancer Studies to drive the creation of shared value for a sustainable society.

This project is a joint endeavor between NCSM and ACF, two non-profits aiming for a sustainable cancer care ecosystem. We shoulder the duty of scaling up partnership strategies across different organizations. Our methods vary across diverse socio-cultural landscapes, and although we have encountered disparities in understanding, thanks to mutual trust and camaraderie we have always found a solution. 

These differences echo the historical challenges our predecessors faced, and that our business communities tackle daily. Our experiences offer a salutary and universal lesson in multicultural coexistence, especially between Japan and Malaysia. 

The economic surge of ASEAN countries is astounding. The societal transformations driven by AI and social media are accelerating day by day. Maintaining an open mind is critical, as our perceptions may lag behind reality. We strive for sustainable information sharing amidst language barriers and diverse business customs, always with mutual respect. 

In this spirit, ACF collaborates with The Partnering Initiative (TPI, Oxford), pioneering theories of cross-sector partnerships. In this regard, we are advancing the Japanese translation of the Better Together Guidebook, providing strategic direction for our engagement in this project. 

Next year, this lecture series will continue, delving deeper into ecosystem creation with TPI’s much-appreciated support. We aim explore how to forge connections with diverse entities for sharper sustainability insights. We believe our collaborative efforts in cancer care will ultimately act as a bridge to Asia's future.