Discussing Delivering Hope at Columbia University

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Today at Columbia University, Lance Armstrong participated in a discussion about the global epidemics of cancer and other chronic diseases with Dr. Paul Farmer of Partners in Health, Dr.  Lawrence Shulman, Chief Medical Officer at Dana-Farber and Dr. Wafaa El-Sadr, Columbia Professor and Director of the International Center for AIDS Care and Treatment Programs.
Dr. Sanjay Gupta of CNN moderated the discussion before an audience of approximately 500 students and guests at Low Memorial Library.

The event launched this year’s Columbia University World Leaders Forum, as noted by University President Lee C. Bollinger in his opening remarks.  Dean of the Mailman School of Public Health, Dr. Linda Fried, then spoke to the crowd about the emerging global health challenge of noncommunicable diseases, an issue that is a significant focus on this week’s United Nations General Assembly.

The conversation started with a segment of the LIVESTRONG documentary, Delivering Hope, which illuminates through patient stories the possibility and promise of treating cancer in settings with limited resources.

A significant theme of the discussion was the need to battle low expectations.  Dr. Shulman recalled treating patients in Rwanda and he agreed with Dr. Farmer and Dr. El-Sadr that, as was the case once with HIV and tuberculosis prevention and treatment, expectations for what we can do to counter cancer are too low and we should not be satisfied with that.

Lance talked about the importance of patient voices.  Lance remarked how much has changed since 1996, when he was diagnosed with late-stage testicular cancer.  He recalled that he went to the library to seek information about cancer since one couldn’t simple Google their diagnosis then.  The panel agreed that there has been much progress in patient information, empowerment and advocacy.

Dr. El-Sadr stressed the importance of preventing cancer and noncommunicable disease, but added that, just like with HIV, we must not choose prevention and neglect treatment.  She said that the false compromise of prevention versus treatment has been a major lesson in the HIV community.

Dr. Shulman mentioned that many of the basic cancer medications that are needed to treat many cancers are not protected by patents and are included on WHO’s essential medicines list.  Though treatment is assumed to be expensive, this is not necessarily true.

Dr. Shulman also added that one must consider the cost of inaction.  Letting a person succumb to disease costs money in terms of care but also because economies lose a productive member of society.  Inaction has a high price.  Shulman said that, either way, there is a cost and we should chose investing in prevention and care.

Lance was asked by a student about building LIVESTRONG.  Lance noted that, in global health and in cycling, nothing is accomplished without a great team of dedicated people.

There was a discussion about who decided how resources are allocated.  Dr. El-Sadr mentioned the emerging perspective of country-focused or people-focused care.  The panel discussed this issue in response to a question from Dr. Irwin Redlener about global health prioritization.

The event was filmed and will be archived for viewing in the next few days at: http://www.worldleaders.columbia.edu We send many thanks to the students, faculty and administration of Columbia University for their hospitality and hosting of today’s event.

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