The health dividend of peace: Cancer knows no borders - Deirdre Heenan

Cross-border cooperation on tackling cancer has been a Good Friday Agreement success story, but we can still do more

Deirdre Heenan

Deirdre Heenan

Deirdre is a columnist for The Irish News specialising in health and social care and politics. A Professor of Social Policy at Ulster University, she co-founded the Northern Ireland Life and Times Survey.

Narrow Water Point and Warrenpoint Port seen from from Flagstaff Viewpoint on the hills outside Newry where the Newry River flows out to Carlingford Lough, the UK and Republic of Ireland share a border through the lough (Liam McBurney/PA)
The legal border might run though Carlingford Lough, but cancer recognises no frontiers on the island. A success of the Good Friday Agreement has been cross-border cooperation to tackle cancer

In the week leading up to St Patrick’s Day, a series of events took place in Washington to highlight the impact of the Belfast Good Friday Agreement, not on peace, but on cancer research and cancer care on the island of Ireland.

Twenty-five years ago this year, as a direct result of the Good Friday Agreement, a memorandum of understanding was signed between the governments of Ireland, Northern Ireland and the United States, giving rise to the Ireland – Northern Ireland – US National Cancer Institute Cancer Consortium.

While we are very familiar with how the Agreement led to the establishment of lasting peace in Northern Ireland, what is less well known is the substantial impact that it had on cancer research and cancer care on the island of Ireland.

The mission of the consortium was: “To reduce cancer incidence and mortality on the island of Ireland through cross-border and transatlantic collaborations in cancer research and education.”

In the mid to late 1990s cancer outcomes in Northern Ireland were the worst in the UK and the situation in the Republic of Ireland wasn’t much better.

Thanks to the actions of the consortium and the implementation of cancer strategies both north and south, there were significant improvements, with Northern Ireland having the best outcomes for breast cancer in the UK and the Republic showing significant improvements in oesophageal cancer.

The first 20 years of the consortium led to a significant increase in both the quantity and quality of joint cancer research activities between the Republic of Ireland and Northern Ireland.

Cancer research is a necessity, not a luxury, and is an absolute requirement to help deliver the very latest advances in cancer research directly to patients. Working together, we can be unbeatable

The last 25 years have seen significant successes for this Good Friday Agreement-inspired initiative. The collaborative cancer research, as judged by joint scientific papers, has increased more than 13-fold between scientists in Ireland and Northern Ireland, while there has been a significant increase in collaborative publications with their counterparts in premier US cancer research institutions.

But not only are we doing more together, we are also doing it better together. There has been a significant enhancement in the quality of the cancer research that is being performed, being published in the very highest impact scientific and medical journals.

Additionally, over 550 clinicians, allied health care professionals and scientists received premier quality training and mentorship at the NCI, many of whom returned to help enhance cancer research and care on the island of Ireland.

Critically, over 35,000 patients received innovative drugs in cancer clinical trials in the last 25 years, saving thousands of lives and enhancing quality of life of those living beyond cancer. We have seen a 10-15% improvement in cancer outcomes.

We are currently at a crucial crossroads for cancer research and care on the island of Ireland, particularly given the impact that the Covid-19 pandemic has had on cancer across the island of Ireland and the lack of implementation of the Northern Ireland Cancer Strategy.

Not one of the Department of Health’s statutory targets for waiting times for cancer patients are being met. Some of the figures are the worst on record.

This is not acceptable. We must be both ambitious and optimistic. Treatment delays add unnecessarily to the stress and risks faced by cancer patients. In 2012, 99.9% of urgent breast cancer referrals were seen within the target of 14 days.

Analysing Research in Ireland North and South (ARINS), a joint initiative between the Royal Irish Academy and the University of Notre Dame, have funded Professor Mark Lawler from QUB and I to develop a policy framework that will help deliver the benefits of cancer research and cancer care across the island of Ireland.

Cancer research is a necessity, not a luxury, and is an absolute requirement to help deliver the very latest advances in cancer research directly to patients. Working together with a prestigious US partner, we can be unbeatable, delivering tangible benefits for citizens and wider society.

We must be bold and ambitious, but we must be collaborative – we need to compete, not against each other, but against our common enemy, which is cancer. Cancer doesn’t recognise borders... neither should we.