Mireille, thanks very much for coming in because you’ve got a wealth of background about organising cancer science, actually making it happen. Here in France it’s pretty well an ideal situation because you’re well funded, you’re well organised, you’ve got cancer centres, you’ve got organisations to make cancer happen, but you’re also interested in Africa, I know, a great deal. What have you found from the meeting here in Lyon of National Cancer Institute Directors are the real keys to improving cancer care?

First of all, this is the third time I’m participating in such a meeting and what I can see, foresee, is a strong signal that cancer issues are like quote-unquote a TGV high speed train coming on us and if we don’t take care we will be squashed. And this is the case for Africa.

Which are the issues you’re talking about?

I’m talking about issues on cancer. We are treating communicable diseases not quite properly but there are great improvements. But on cancer we are still in the dark. So I think that for these countries and those people here it’s very important to share their concerns and to launch and to send a strong signal on how we could not only help but help them to build their own capacities.

So to tackle the problem of non-communicable diseases and cancer specifically here, what measures, if you’re in a country which is less well funded than France, what are the first measures that you need to prioritise in your view?

You know, as a diplomat and not as a medical doctor I would enhance the fact that we really need a political push. Because in our globalised world with the scarcity of money and the crisis maybe we have to be sure that the different leaders are fully understanding what is going on, not in terms of expertise, we are not asking them to become experts, but we are asking them to understand what is going on.

Typically what have been the difficulties? You have been working a lot with Francophone Africa, what are the difficulties that you encounter?

Yesterday, for example, we had a good talk about a professor from Senegal, one of the brightest we could have in such countries, very high level, and he said, ‘I don’t feel a political engagement in Senegal for what I’m doing.’ So it’s a signal, it’s a wake-up call. What I think is that we should create a good not co-ordination but collaboration and exchanges of data because data are fundamental for the political leaders. When they see data they begin to understand. So a true collaboration at a political level but also this collaboration shall be based on science, data, evidence.

I know you have a lot of experience in pooling scientific expertise and also organising studies, multi-centre studies. Can countries be involved in this and how should they be involved and how do you get the politicians to support this?

Of course they can, not only they can but they already are. But we don’t have a broad picture on where they are, what they do. So in a sense they are too much isolated in their own silos. They are not alone, they have a lot of fellow partners everywhere in the world, in fact they are working with many developed countries and many universities. But we are not able to have a good picture of who they are, what they do and try to connect them and then to connect that with the political system.

In reporting about cancer science, as we do at ecancer.tv, we are aware of many, many treatments but you don’t even need the latest treatments, you just need to apply known treatments really well in a well-organised way. Could you finally give me a sort of action plan that you think needs to be done to improve cancer care in perhaps resource poor settings as well as more well-funded settings?

My main message, my main belief, I don’t know if it’s quite personal, it’s not only personal, is that we shall involve the private sector. Because the experience we had, for example, on HIV/AIDS, TB and malaria was extraordinary. Finally, by telling quite loudly that these diseases were a priority we pushed the market and the market dynamic finally entered into the field and with the private sector we are trying to shape the market. So this is also one of our main challenges because medicines and drugs are too costly and we know for sure that we could reduce the cost and make these drugs accessible and affordable.

Indeed HIV care and treatment has been a model then, you’re saying, for how to raise awareness?

At least such an experience that we can learn a lot about that. I wouldn’t say a model because it’s not a pure model, we have some failures. But it’s a true picture of what we could do and what we could do is also to shape the market because we have many experts, we have not such bad science, of course we shall improve it and so on. So as soon as the market is able to be shaped to make these drugs accessible, affordable to the poorest, we can talk to the political leaders telling them, ‘Look, now it’s possible. Here is a huge opportunity, please jump in.’

And one point you are making is that you can involve the private sector under contract, as you have done here in France of course.

Yes, we try. But in France we try but it’s much more difficult because even if we are right now in the crisis, we are a wealthy country. So the industry has not a huge willingness to push down the cost or the prices. They know they can make business with us, we have a lot of money, social security and so on. But for those countries we have to change the paradigm, right? We have to push on shaping the market and making the market see and trust that they can make business with underdeveloped countries.