A public consultation on the Action Plan for the implementation of the National Strategic Framework Against Cancer, adopted in 2020, ended in April, but the long-awaited document has not yet been adopted, although it should help Croatia reduce a devastatingly high cancer death rate, the second-highest in the EU.

The Action Plan was put to public consultation more than two years after the adoption of the National Strategic Framework and foresees a series of activities during the first three years of implementation, namely until 2025.

30 Croats die of cancer every day

Dissatisfied with the delay, patients’ associations launched the “It’s Time” campaign in early 2022 to encourage the health administration to adopt a plan, as 30 people die of cancer in Croatia every day, and 25,000 people fall ill every year.

Cancer is the leading public health problem in Croatia, responsible for 27% of deaths, and although Croatia has seen a decline in mortality in recent years, only Hungary has a higher mortality rate in the EU.

The Action Plan is worth €8.5 billion and includes the renewal of radiological equipment, the acquisition of 21 linear accelerators for clinical institutions, the establishment of an oncology network and an oncology database important for monitoring treatment outcomes, as well as prevention, early detection, treatment and rehabilitation of patients.

The president of the Croatian Forum Against Breast Cancer Europa, Donna Vesna Ramljak, says that there are many reasons why the National Strategic Framework for Cancer, although adopted in December 2020, has not yet come to life.

Sluggish administration responsible for lost years

“The complete state administration, and thus the health administration, is rather sluggish and has difficulty arranging priorities. For the implementation of the document, there is no appointed person or institution responsible for the implementation of its chapters, as well as the document as a whole. Another reason is that a new commission, different from the one that led the process of its creation and writing, has been appointed” says Ramljak.

She stressed that a network of oncology institutions, which is a prerequisite for optimal diagnosis and treatment of patients, has not yet been established, nor is it clear who should lead it and how.

“By 2025, they should have a comprehensive oncology centre, as part of the EU Beating Cancer Plan, but we will see how that will be achieved,” Ramljak said, adding that three years have been lost.

Ahead of the upcoming European elections and a review of the European Beating Cancer Plan in the middle of the program period scheduled for 2024, a European forum on the fight against cancer was held in Brussels to see what to do in the coming period for member states to intensify the fight against cancer.

In the EU, there are large differences between countries and regions, some countries do not even maintain a cancer registry, while at the same time, Sweden is on the verge of eliminating cervical cancer due to high vaccination rates against HPV.

Croatia lags in oncology drugs availability

In the coming period, special attention should be paid to the fight against lung cancer, namely early diagnosis and better availability of innovative therapies.

According to European Commission data, Croatia lags in the availability of oncology drugs. Reduced productivity due to the disease accounts for 44% of cancer treatment costs, which is three times more than the EU average.

Also, 26% of the total cancer expenditure in Croatia goes to health care, including medicines, while the EU average is 49 percent.

In Croatia, less than 8% of GDP is allocated to health care, which is €963 per inhabitant, while developed EU countries allocate more than 11%. Slovenia allocates €2,107 per inhabitant, Slovakia €1,220, and the Czech Republic €1,860.