it also plans to send a team of experts to china to help authorities struggling to contain the outbreak the death toll there is a least $490.00 and at hong kong around $800.00 people are being held on cruise ship while health authorities carry out tests for the corona virus 30 crew members have reported symptoms including fever japan has also quarantined a ship in yokohama after 10 cases the virus were found on board. twitter has announced it will place a warning on photos or videos it says are significantly and deceptive the altered or fabricated the social media platform also said it will remove content that deliberately mislead users could result in threats to physical safety widespread civil unrest or privacy risks you have to dates with the headlines inside story is coming up next but by. polls to elect a new guy. with criticism over the housing crisis. and unemployment in

the country will the current prime minister manage to just decision to. take the country. it kills almost $10000000.00 people a year and that figure is rising fast the poor countries of the biggest losers in the fight against cancer why is there such a gap with nations and how to leverage it this is inside story. and i welcome to the program that clark most of us probably know somebody affected by cancer but your chance of beating the disease depends greatly on where you live the world health organization is marking well cancer day by highlighting what it calls unacceptable inequalities between rich and poor nations it says cancer

services are available in the public health systems of 9 out of 10 wealthy countries compare that to less than 15 percent or one in 7 low income countries poor people are less likely to know about cancer risks and when they are diagnosed many counter for the high cost of treatment well the w.h.o. warns if current trends continue the number of cancer cases will rise at least 60 percent over the next 20 years and the increase could be more than 80 percent and what the w.h.o. designates as low and middle income countries the disease is the 2nd leading cause of death globally with an estimated one in 6 people falling victim to it more than 2 thirds of those who die are in low and middle income countries smoking is one of the main causes accounting for almost a quarter of deaths w.h.o. says more investment in the fight against cancer could save at least 7000000 lives

over the next decade. all right let's bring in our guest right away we have in geneva today about who's a tactical officer of consequent roll of the world health organization from new delhi we have talked in that the sharon had been on colleges and associate director of medical oncology at max health care deli and also in geneva kerry adams chief executive of the union for international kinds of control thank you all for joining us and i'd like to start with the world health organization on. so 1st of all it's interesting to note the kinds of cases worldwide are expected to more than double over the next 20 years before we get into the nitty gritty of what's going on why is that and what's driving it andre. thanks nick one of the primary drivers here is the success that we've seen in the not come countries to treat some of the earlier cause of death infectious diseases maternal deaths and as we see those low not from

countries achieve greater life expectancy people are also being exposed to risk factors and those risk factors over time will cause them to increase the likelihood of cancer developing so one of the biggest causes of cancer is in fact the successes of treating what previously had been called the communicable or infectious diseases now what we expect as you said is an 80 percent increase in the and middle income countries and while percentages can in their own right be concerning what this really means is an almost doubling in the capacity to care for people with cancer in those settings so what does this actually mean in the context between between the rich and poor nations the gulf between rich and poor nations. yes perhaps the best way to understand it is the ability of the system of the hospitals the health care system more broadly to take care of cancer patients when we have as you mentioned a significant deficit in poor countries and their ability to take care to diagnose to treat and even to palliate people with cancer and you compound that with the

doubling in the cancer number in the next 2 decades that creates a very difficult situation in which we put individuals and communities who have cancer under great distress all right and carry items from the union for international council control and we have to say in the last 50 years or so we have had great advances in the treatment and prevention of kind of how far has the world come and to what degree do you think the poor nations have been left behind or left out of this. well in the last 50 years we've seen major advances in our understanding of cancer as a disease major breakthroughs in treatment and care and also increasing awareness of cancer and its risk factors around the world as andre just said you know the burden in the future is going to be predominately within lower middle income countries but most of that's driven by an aging population and also the numbers of people the population growth that we're seeing in those parts of the world but i think we can sit here in 22020 and think that we've made

a lot of progress where we have not made progress is to address the differences between high income countries and lower middle income countries and make available for example the essential medicines which we know that work the essential technologies that we know are work that work and also to give low and middle income countries the skill sets the resources the abilities for them to actually deal with the burden which they're facing now so much progress and a lot of opportunity but still a lot to do ok well let's speak to an oncologist radtke from delhi in india let's imagine a scenario if you will which i'm sure you see all the time a patient let's say contract a form of lung cancer in india what's likely what's likely to happen to the patient if they cannot afford to pay for treatment. so i think the points that have been made so far quite apt that there is a huge difference between the treatment given based on affordability and as most of

you know india itself is divided into rich and poor so so that while the rich a new deal of the affordable population of india can access the best care as in even the world the poor population gets a double whammy a biggest diagnosed at a more advanced age and i think that's where a lot of work needs to go with more innovation and maybe a disruption and b. the current really afford the standard of care so so when you ask for an example if i even start with the only sage lung cancer diagnosed in a poor man in delhi who cannot afford one of the private hospitals like myself he will mean not he may not be able to get surgery and the standard radiation or chemotherapy which costs anything between india groupies about $10.00 lakh rupees

which is roughly $5000.00 so that discrepancy results in loss of life so as does the fact as already pointed out there's a bigger tobacco abuse bigger smoking in fact a higher of basically board anyone in the poor in india along with late diagnosis because they can't be ignored they have because they live on day to day basis and i think that's the crux of the problem right ok and you mentioned tobacco there which admissions brings us neatly into the next element of this conversation andrea about the way. you are talking about it's being a question of awareness making people aware and aware of the dangers and tobacco is a perfect example. yeah nic and thanks for raising that because in fact a bacco is one of the biggest challenges for us in both the 20th and now in the 21st century the type of the challenge continues to evolve so as we've made strides now one what measure that we have at the world health organization is to see how many countries have taken on an essential package of measures called the empower

measures to reduce tobacco exposure and to increase for example tobacco taxation we have seen progress in that regard but there is a persistence in the number of tobacco users globally and this is a major concern for us as we look to the next decade in the cancer burden that will exist as we've just heard this will be a point of increasing concern in high income countries but also in the in milk i'm countries where we see tobacco rates persist and in some situations increase in spite of the public health understanding that tobacco is in fact a killer not just for cancer but as a killer across the board for heart disease and other chronic diseases and if it comes to making people aware of the threats and therefore negates the need for treatment down the line that poor countries may not be able to afford anyway. yeah thanks and that's exactly part of the challenge now one point to highlight though with tobacco and in fact with many of the risk factors for cancer is that it is an

individual's capacity to be aware of risk factors and perhaps dr adams can speak about the recent survey that u.s.a.c. has conducted but in fact there's a system approach that's needed to back a control isn't just about individuals and awareness but it's also about how can the government regulate or provide greater support because of a child is seeing an advertisement at the age of 10 and is exposed to tobacco is that really a child's responsibility or fault this is in fact the responsibility of a community to identify and communicate that tobacco is a public health hazard this is not a decision that we can place just on individuals but governments communities schools media businesses we all have a responsibility to control tobacco and we have a responsibility to do it now as you said people will still develop cancer even if we have our best prevention measures now the goal there is to also think in parallel what must we do to provide treatment for those who need it we have made approximately 200000000 people will require cancer treatment in the next decade so

we have to have a mechanism to do both to prevent and to treat right you mentioned that survey and conducted by the international a unit for international control carried out and tell us about that survey what did you find. well nick it was quite a large survey 15000 people from 20 countries representing all regions of the world and there were some really interesting pieces of data that came out 1st of all awareness of cancer around the world is pretty consistent it doesn't matter low middle income why income people are aware of cancer they've been affected as andre said earlier everyone has been affected you said it touched by cancer however the knowledge of risk factors is really quite interesting so what we found is that it doesn't matter which country you're in if you're in a lower income bracket or you've had lower levels of education your knowledge of risk factors is a lot lower than the higher educated or the hiring come people know applies to all countries around the world interestingly the majority of people do know about the

risk of tobacco but none not all of them are able to actually take action to give up the tobacco use because it's actually addictive but there are worrying signs in there that even people's understanding for example of alcohol obesity and diet they're not as aware of these particular risk factors for cancer and those as understand for other n c d's so what we've taken from this is that we saw one point which is really important the the general public belief the government must play a role in changing in educating and change in the mindsets of the general population although there is an individual responsibility to understand the risk maybe change your own behavior it is really important the systemic issues are addressed so over 80 percent of people interviewed said we need the government to step up to put taxes on to tobacco for example to educate young children about the obesity and the impact that has on their a chronic diseases in the future to for example look at labeling of food to make it

clear about what is in the food itself lowering sort of sugar levels so there's a whole series of things that the government can do which can improve the way in which the public perceives or if risk factors and then are able to react to those not just by themselves but because the environment around them has been changed through. law and through policy so these are critical conclusions of come out from the study and we're sharing that widely for others to take on and think about where does the government play a role to really address risk factors and the behavior of the work of their population to address them. in india to what degree does the government play a role in addressing risk factors. so i think there's a very important points being made and and i completely agree that the government has to raise the bar and the education has to really start from age of 7 and 8 and 9 and 10 and not when they're teenagers and willing to believe that nothing will happen to them and that's the crux of the problem that even the people who are of

there that this is risky don't think it'll happen to me so the government has to step up and i don't think the indian government has done enough in that respect it has to dechen eyes that in considering that india has stuff 15 polluted cities in the world those tobacco is even a bigger this factor than many other countries but i really do feel our government is not all to be blamed i think the communities are too large are not accepting about the risk of alcohol about the risk of obesity about the risk of lack of exercise these are things that w.h.o. has reiterated for over 3 decades and if we as a group as a society don't exist sponsibility i don't think anything much can change even to patients who are already patients and their relatives if one message can go across accidently and clearly and separative leigh that you need to lose weight you need to exercise you cut down your risk i think it works and i don't think you've done back enough the thing is done through awareness is one thing about smoking about

obesity about having exercise and so forth but awareness of say something like pollution which is very pertinent where you are in the great city of new delhi is really something that people can't do anything about because it's all around them and they have to breathe the air that's. that's correct but when you are living in a city like delhi it's obligate tree i'm not saying it's it's your choice and think it's obligated treat to stop smoking lose weight do not have high fat not have processed red meat these are additional just fact those and why do we blame the government and i think we should actually as i said raise the bar where is our responsibility in all of this knowing that cancer treatment is difficult knowing that cancer still causes debt and knowing that concentrate on is expensive the least you can do is work at not getting that right well we'll move on from smoking

but i will just say this about a quarter of all kinds of deaths well why the cause by tobacco use 25 percent of cancer deaths is judas making and 80 percent of world smokers live in low and middle income countries let's move on to other measures it's not just being aware it's also screening and so forth tell us about what sort of things can help on that front. this is a very important public health message in cancer and perhaps the most important which is the early identification of cancer is one of the most important measures for an individual for community and for governments to prioritize and the cancer agenda if cancer is found early the likelihood of successful treatment has increased significantly the likelihood that treatment will be less expensive less complex less demanding on the body of that individual is also increased so the overarching goal is to identify cancer as early as possible now the question is how

do we do this because of course it's not just about screening in fact there are 2 approaches that we highlight one is the early diagnosis that is for people who develop symptoms and the other is for screening that is a government or public health program where an otherwise healthy individual goes to a screening clinic or to a doctor and asked to be evaluated for the likelihood that they have a specific cancer or a pre-cancerous finding now as it pertains to the cool obols need to improve the early identification of cancer early diagnosis is critical now early diagnosis again is how can we find help people find their symptoms or early signs of cancer as quickly as possible to get to primary care providers who understand that those symptoms may in fact be cancer and to get them to a treatment site where they can be diagnosed appropriately and can have access to care and have access to care that is not prohibitively expensive if we do those

measures which are highlighted in this report in fact that is perhaps one of the best investments that we can make so you are absolutely right nic to bring it up early diagnosis is the priority intervention in the cancer agenda for those that develop cancer but also vaccinations for various things including h.p.v. and hepatitis a tell us about that. yes well actually we are entering a year where the h.p.v. vaccination is going to play center stage in the world health assembly in may because under dr ted rall salute the world health organization there is going to be a call to eliminate cervical cancer in the hopefully in our lifetimes and maybe longer than that but at least cooked a call to action for governments around the world for people to see how we can address one cancer which can be prevented through vaccination by giving it to young girls by early detection as andrea mentioned early detection that cervical cancer before it becomes a problem and then of course making available treatment as well so this is a great example in fact it's probably the one example that we have today where if

we really give a concerted global effort where society and community and governments and scientists and the private sector get together then we can give a message of hope to future generations that one cancer at least can be eliminated during the century and i think that's a very powerful statement so facts are nations critical where they work and i agree we do need to improve the way that we detect cancers no doubt about it the majority of cancers when they get stage 3 and stage 4 are highly complicated to treat and most countries even in america and europe which have the most advanced technologies and the most advanced drugs really struggle to control a stage 4 cancer and to treat the place through to cure so it's important to early detection and screening takes place as well but i i hold up cervical cancer as the hope for our generation going forward ok that's interesting is that. we've talked about. governments of poorer nations needing to step up we talked about communities

needing to step up to what degree do the governments of the rich nations need to help bridge the gap. in the 3 interesting question and so i call cancer vaccine elimination arsenic accounts in the world which is this year's theme fits quite well with back. the problem here is that the societies and the health care systems are extremely different so i do think that we need to be richer countries in the world to support the cause but that just will not come with. education that will not come with more discussion alone dr not going with governments raising the bar but i do also come to destruction and innovation we are talking about health care out of pocket health care in india so can you really push for example and this is not a solution can you give tax incentives to people who are not vaccinated far so

michael council can you be more disruptive them that if you go to schools and and provide more support so i do think all of this will happen with more support from the west but i do think our countries and i governments are evil enough to do that if they get their act together as a society ok under about what he had all this is crucial isn't there but ultimately the the golden chalice if you like is a killer tell us how far away we all to get even close to that. this is always the question it that we struggle with that patients that families and governments want to hear which is when will we find the cure cancer and this is in fact one of the perpetual goals since we've as you said invested more in cancer in the past 5 to 6 decades now how far are we perhaps the best way to understand that question is to understand that in fact cancer isn't just one disease it is a variety of diseases for which different quote unquote cure treatments can be

available at a different pace as dr adams highlights there are ways now that we can detect and treat cervical cancer there are medicines for example in testicular cancer or in leukemia as that can effectively cure the vast vast majority of individuals but there are other diseases for which we have not made such pride. lung cancer liver cancer and chris cancer now in those cancers we are very far from a cure and in the increasing age of genome mix and personalized medicine we've come to the recognition that the likelihood that there will be one medicine that will cure all cancer for all people is likely a dream of decades away if it can be achieved at all so the reality for us today is to continue investing in cancer and i think your question about what can different income countries do is a very important provocative one we should start by saying that cancer investing in cancer is in fact a development issue we don't ask why to invest in roads or an education because we

know that it has a positive return in cancer it's the same we can have a positive return we can positively impact communities we can increase productivity and we can at societal value by investing in cancer if we frame it through the lens of a positive investment we will continue to see progress we will continue to see innovation and we will get closer but at the same time as we've heard throughout this discussion we have to leave no one behind while we want to see this progress we already know essential medicines those cures are important quote cures that are vailable for leukemias are unavailable to the vast vast majority of people in the world that is not acceptable ok so we want to see progress we need to see innovation but we also must think about universal health coverage right sorry we're just coming towards the end of the program had dr adams and if we can leave it with you we've talked about this the income gap and how poor nations are affected but it's far from perfect in the rich world of course i see reading today that the u.k. is at the bottom of the list of countries right by survival rates of some of the

deadliest cancers as a whole and that seems extraordinary to me. well our survey would probably suggest that that is not a surprise because although there is the inequity big issue that we've talked about between the high income countries and the lower middle income countries in every country there is an equity issue and you find that they had the data that we've analyzed that you know the approach of the low income individuals to risk factors and their survival rates is much lower than those who have a higher education hiring come in any country so it doesn't surprise me that going to see differences of cross europe or differences within the country i once heard that in washington 10 blocks down from the white house there are significant problems of breast cancer months that black women so you know there are lots of pockets of problems in countries in cities around the world so we shouldn't we shouldn't think it's just a high income versus low middle income his shoe but i would like to say that

reiterate that there are lots of opportunities to address those gaps available today with generic drugs we have radiotherapy and surgery and treatment that we know work for that for many cancers so we do there are problems of pancreatic liver long we haven't made the breakthroughs there but on breast cancer cervical cancer to stick you look at such other cancers we have a made a lot of progress last 2030 years and the challenge we face as a community as a society is our generation is getting that treatment available to everyone who needs it at the point that they do need it i think right now i'm i'm optimistic for the future but we still have a large challenge i think we'd all heartily concur with that gentlemen thanks very much indeed thank you to all our guests about we need to. carry out and sank you very much and thank you too for watching you can see the program again every time by visiting our website al-jazeera dot com and for further discussion go to our facebook page that's facebook dot com for the inside story and you can also join

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produce and we're in the midst of a great race for data and big tech companies are in the chase and cars are rising on a wealth of information and we need other commodities and the 2nd the far series the re-examined for the fall for regimes are call of nice internet like american power of big tech on a just 0. 0 explores prominent figures of the 20th century and how liable reigns influenced the course of history was the cuban revolution communist away feel castro is a feudal east another coming east the custer wanted his country che wanted international revolution became a point when the relationship came to an end the icons of revolution who changed the course of latin american politics. and fidel castro face to face on al-jazeera .

al-jazeera. after. the. hong kong corn scenes a cruise ship turned away from taiwan as the coronavirus death toll climbs in china . you're watching us here on live from a headquarters and. also ahead it's america's future is blazing bright. the years of economic to k. are over. president donald trump boasts off a great american comeback in his state of the union address that underlines the

deepening political divisions the democrats opinion was clear house speaker nancy pelosi tearing up the trump speech after he appeared to refuse to shake her hands. more political uncertainty in malawi the president plans to appeal a court decision overturning last year's election results. hello china has seen the biggest jump and deaths from the coronavirus as the outbreak continues to spread their wrists 65 more confirmed deaths bringing china's total death toll to 490 and the number of global cases has now hit more than 24000 officials with the world health organization has called on all countries to improve data sharing on the coronavirus more than 2 dozen countries have reported the virus and 10 people who were on board a cruise ship in japan are confirmed to have the virus the.