Concluding Speech of the Slovenian Minister of Health Zofija Mazej Kukovič (Conference "The Burden of Cancer - How Can it be Reduced")

Distinguished guests, ladies and gentlemen,

Two long, strenuous but very fruitful days are behind us. I would like to thank you all for your exceptional contributions, fresh ideas and suggestions you shared with us on this conference.

The contributions, discussions, and most of all, the atmosphere here at the conference, make me believe that this event is an important contribution to better mutual cooperation.

This conference is a meeting place of those who help formulating health policies as well as medical experts, researchers, patient representatives and all those who care and feel responsible for health policies.

Our actions should be primarily oriented towards the improvement of health conditions and achievement of a higher quality of life of the citizens of the European Union. We are bound to this by the legislation and the expectations of the people.

Only healthy and creative citizens can participate in and make considerable contributions to a more competitive and more successful economy, which is also the goal of the Lisbon Strategy. Furtermore, it is important that all citizens quickly receive all the necessary and best care and support if they suffer from a severe illness. If we manage to control cancer, which might become the greatest public healthcare challenge in the near future, we will also be more successful in the economic aspect.

Integral cancer control is an exceptionally complex and demanding field of work. A two-day conference is not enough to enable an absorbed discussion on all the aspects that influence the results. Thanks to the commitment of the active participants and all the discussants, we have managed to illuminate some key problems and define the opportunities for further actions.

One of the problems is huge differences between individual Member States regarding the available financial and human resources, which leads to different results in the field of healthcare and unacceptable differences. The entry of the new Member States increased these differences, and further EU enlargements will result in even greater gaps.

Major inequalities also exist in health results between different groups of population, which calls for special measures and strategies. The Portuguese Presidency drew attention to these aspects, underlining the immigration problem in this context.

Cohesion policy and structural funds resources present appropriate instruments to help ensuring the implementation of integral health strategies which, I firmly believe, also include integral cancer control.

Investments in health must become a priority task at the national level, and each individual country should make sure that convergence resources are earmarked also for the development of health services.

The current Community Health Programme should represent the tool for cooperation between the Member States in the field of cancer control as well. Similarly, "Europe Against Cancer" was a successful programme in the past. It is important that together we utilise all the possibilities this horizontal programme offers in the field of health by 2013.

Yesterday, I emphasised that we are not starting from scratch, in fact, much has already been done and it is only right that we continue our work on these bases.

Ladies and gentlemen,

Let me point out the areas where I see the possibilities for a strengthened mutual cooperation and added value at the European Union level.

• Successful cancer control calls for an integral strategy or national plan, including all the necessary elements: illness prevention, early detection, treatment, rehabilitation, palliative care, as well as research.
  
• Strategic planning, monitoring and assessment of the implementation of measures demand corresponding data, necessary for cancer studies and cancer research, assessment of the efficiency of all the measures taken, and professional and political decision making. The data, provided by the population cancer registries, are needed at the national, as well as at the European Community level. Any limitations to accessing these data should be considered carefully because these measures could harm cancer control.
  
• In the last few years, many good strategies and other measures have been taken in the field of health promotion and health control at the level of the European Union and in the Member States. Our greatest challenge from here on will be their implementation in everyday life.
  
  Here, I am referring to the Obesity Strategy for the fight against obesity by means of introducing balanced nutrition and promoting physical activities, and the Alcohol Strategy in the field of the reduction of harmful consequences of alcohol use.
  
  In the field of tobacco, major measures have been taken by the Member States and at the European Union level. We have to endeavour for Europe to become a tobacco smoke free environment in all public and work places. Namely, tobacco remains the most important independent cancer risk factor.
  
  Cancer risk factors are present in the environment as well. We have to do our best to reduce the exposure to all the already known risk factors and intensify research work in order to acquire new information on the influence of the environment on the occurrence of cancer.
  
  Investing into the strengthening and promotion of health, providing the conditions for a suitable living and working environment, implementing the "health in all policies" approach, and motivating the citizens to adopt a more healthy way of living, will simultaneously contribute to the prevention of other chronic diseases.
  
  All this considered, it is important that the citizens are provided with sufficient information on what they themselves can do to decrease the risk for the occurrence and development of cancer. We have the European Code Against Cancer and we should see that all European citizens learn about it.
  
• Another important field is early detection of those cancers that cannot be prevented. Substantiated scientific evidence exists which speaks in favour of the introduction of organised mass screenings for cervical and breast cancer, and cancer of the colon and rectum.
  
  Implementation of the EU Council Recommendations on Screenings, confirmed by the health ministers in 2003, presents a major challenge for each individual country. At yesterday's workshops, you shared extensive experience of your countries regarding the implementation of these screenings. It was revealed that the implementation of those recommendations is hindered by a number of obstacles.
  
  We can justify the invested resources and achieve the goals of the screening programmes only by means of well organised and conducted programmes and adequate response to them, linked up with the population registries, and constant monitoring of quality.
  
  In 2003, Slovenia introduced organised screenings for cervical cancer, but we encountered minor difficulties. Today, these data indicate that we have achieved a 70% response and most importantly, cervical cancer incidence has reduced by 25 percent. This year, Slovenia will start organised screenings for breast cancer and cancer of the colon and rectum.
  
  I must stress that without cooperation and help from the European experts some of whom are present here at the conference - who have acquired experience in the implementation of screening tests in their own countries, Slovenia would find it much more difficult to implement these screenings. In our opinion, such help has a large added value. We believe that the efforts for the implementation of a sustainable organised way of such cooperation at the EU level should be supported.
  
  We have great expectations in receiving the official report of the Committee on the implementation of the screening recommendations and its conclusions.

There is no doubt that the prevention and early detection of cancer represent the areas that deserve more attention and resources at all levels. Each Euro invested in the prevention is the best long-term investment. We have to bear this fact in mind each time we adopt important decisions on priorities in the health field.

Ladies and gentlemen,

• Despite good prevention programmes, cancer will remain a frequent disease. All those who suffer from cancer have the right to a quality health care, as well as diagnostics, treatment, rehabilitation, psychological and social support, and palliative care.
  
  Furthermore, they have the right to play an active role and cooperate in the planning and implementation of the medical treatment and by doing so, become an equal partner in the healing process.
  
  The workshop on medical care revealed the areas, where cooperation and exchange of experience between the Member States are very useful. As a small Member State, Slovenia sees major cooperation opportunities in the field of reference networks regarding rare medical conditions in particular, including individual types of cancer.
  
  Experts have presented their experience regarding the meaning of the psycho-social aid and the development of the palliative care, which should become a constituent part of the integral strategy. These two fields deserve the care and attention equal to other fields of health care.
  
• Let me share some ideas about cancer research, referring to the above mentioned fields of work.
  
  In the last few years, we have recorded a major progress in discovering new technologies in cancer treatment and cancer detection. Research activities play an important role in finding and establishing the cancer risk factors, as well as in the evaluation of the efficiency and effectiveness of our measures.
  
  Most of all, we have to strive to achieve a balance in the research activities in all fields of cancer control.
  
  We should provide more support to independent academic studies in the field of cancer, and the integration of studies and clinical practice.
  
  The 7th indicative research programme devoted special attention to the field of cancer research. This is an opportunity to build the necessary capacities and enhance cooperation in this field. A more active cooperation of the new Member States in the research programmes presents a special challenge.

It is essential to establish partner cooperation in order to achieve progress in all of the above mentioned fields.

"Nothing about us without us", is the motto of the civil society representing patients. People who suffered from cancer themselves best know and understand the needs of the patients. Thus, it is the right thing for the representatives of the civil society to be included into the process of planning the activities in the field of cancer control. This conference is just another place to prove the valuable contribution of the civil society.

Unfortunately, cancer is not the problem of the developed world alone. The developing countries, already heavily burdened with a number of other diseases, are increasingly facing cancer as well. Again, the representatives of the World Health Organisation have drawn our attention to the necessity of global acting in this field.

The fact that the European Union is a well developed institution gives it a special role and responsibility in the modern world, as we have already mentioned in the new Health Strategy. Solving our own problems, however, we have to endeavour for an efficient partnership in finding corresponding solutions in cancer control also at the global level.

Ladies and gentlemen,

The motto of the Slovenian Presidency is SI.NERGIJA for Europe. Let this be the guidance to our common endeavours for cancer control. We can only be successful if our work is complementary.

We have to strive for more synergy among the Member States, European institutions and civil society, as well as international organisations at the global level.

I strongly believe that the Slovenian initiative on cancer presents a new opportunity to strengthen our endeavours to reduce the cancer burden. Great interest and your commitment here at the conference confirm my belief that we are going to use this opportunity to our advantage.

Ladies and gentlemen,

Let me use this final opportunity to express my sincere thanks for your contributions and cooperation.

I would like to wish all those who have decided to stay here for another day or two to have a pleasant stay. Have a safe trip home, and I truly hope you will return to Slovenia again in future.