The implementation of the Plan Esperanza and response to the imPACT Review.

Following the implementation of the National Cancer Prevention and Control Results-based Budget Programme (PpR Cancer-024) in 2011, the Peruvian Government approved the Plan Esperanza-a population-based national cancer control plan-in 2012. Legislation that ensured full government-supported funding for people who were otherwise unable to access or afford care and treatment accompanied the Plan. In 2013, the Ministry of Health requested an integrated mission of the Programme of Action for Cancer Therapy (imPACT) report to strengthen cancer control in Peru. The imPACT Review, which was executed in 2014, assessed Peru's achievements in cancer control, and areas for improvement, including cancer control planning, further development of population-based cancer registration, increased prevention, early diagnosis, treatment and palliative care, and the engagement and participation of civil society in the health-care system. This Series paper gives a brief history of the development of the Plan Esperanza, describes the innovative funding model that supports it, and summarises how funds are disseminated on the basis of disease, geography, and demographics. An overview of the imPACT Review, and the government's response in the context of the Plan Esperanza, is provided. The development and execution of the Plan Esperanza and the execution of and response to the imPACT Review demonstrates the Peruvian Government's commitment to fighting cancer across the country, including in remote and urban areas.

Experiencias de la educación a distancia durante la pesquisa activa en la contingencia epidemiológica en Camajuaní / Experiences of distance education during door-to-door active screening in the epidemiological contingency in Camajuaní

RESUMEN La contingencia epidemiológica llevó a la reorganización del curso académico, por lo que se hizo necesario utilizar la modalidad a distancia, a la vez que se desarrollaba el proceso de la pesquisa como vía útil para la detección de enfermedades. A esta se incorporó, de forma escalonada, a todos los estudiantes de las Ciencias Médicas del municipio (396), que realizaron la pesquisa en los ocho consejos populares. Para esto se conformaron dúos, supervisados por los profesores, que los capacitaron en medidas de bioseguridad, lo que evidenció la connotación del binomio profesor-estudiante en el enfrentamiento a la Covid-19, proceso que garantizó la continuidad en la adquisición de los conocimientos en esta etapa.

ABSTRACT The epidemiological contingency led to the reorganization of the academic year, which made it necessary to use the distance modality, while developing the research process as a useful way to detect diseases. All the students of the medical sciences of the municipality (396), who carried out the door-to-door active screening in the eight popular councils, joined this in a staggered manner. For this, duos were formed, supervised by the teachers who trained them in biosafety measures, which evidenced the connotation of the teacher-student binomial in the confrontation with COVID-19, a process that guaranteed continuity in the acquisition of knowledge in this stage.

Molecular mass of Poly-3-hydroxybutyrate (P3HB) produced by Azotobacter vinelandii is influenced by the polymer content in the inoculum.

Poly-3-hydroxybutyrate (P3HB) is a biopolymer produced by Azotobacter vinelandii. The physicochemical properties and applications of P3HB are strongly influenced by its weight-average molecular mass (Mw), and in A. vinelandii, it could be influenced by the culture conditions. The aim of this study was to evaluate the effect of the P3HB content of the inoculum on the Mw of the polymer produced by A. vinelandii OP in bioreactor cultures. A. vinelandii cells containing 20, 50 and 70% of P3HB were used as inoculum. The P3HB content in the inoculum affected the volumetric P3HB productivity (qP3HB) and the Mw of P3HB. Those cultures inoculated with cells containing 20% of P3HB, achieved the highest qP3HB (0.17±0.018gP3HBL-1h-1); whereas a P3HB content of 70% was reflected as a low qP3HB (0.021±0.002gP3HBL-1h-1). On the other hand, using an inoculum with 70% of polymer content, the Mw of the biopolymer remained stable at values close to 3200kDa; whereas, when an inoculum with 20% of P3HB was used, the Mw decreased drastically during early stages of cultivation. These results show that manipulating the P3HB content of the inoculum is possible to produce biopolymers with a suitable Mw.

[Accelerating cancer control innovations in Peru]. / Acelerando la innovación en el control del cáncer en el Perú.

Against a backdrop of global equity in cancer prevention and control, the National Institute of Neoplastic Diseases (INEN), a national reference center, has designed and developed innovative strategies and programs with the intent to meet institutional goals through health promotion interventions and cancer prevention, diagnosis, and treatments that benefit the national population. The INEN Schools and Centers of Excellence have played an important role in the process of determining the results of these actions. The Center of Excellence in Cervical Cancer Training is an interventional pioneer that has applied a methodological design intended to improve health professional skills and has disseminated this model to other Schools of Excellence. Through this intervention, the skills of 12,194 health professionals trained by the INEN have been strengthened with respect to nationwide promotion and primary and secondary prevention during the period of 2012-2015.

[The role of the National Institute of Neoplastic Diseases in the control of cancer in Peru]. / El Instituto Nacional de Enfermedades Neoplásicas en el control del cáncer en el Perú.

With a mortality rate that constitutes the second nationwide, the estimated incidence of cancer in Peru is 150 cases x 100 000 inhabitants. Around 75% of the cases are diagnosed at an advanced stage and mainly in Lima. In this context, the National Institute of Neoplastic Diseases (INEN) has promoted the decentralization of oncological care creating regional institutes of neoplastic diseases, oncological units and prevention centers. In addition, INEN has designed, developed and implemented the Budgetary Program for Cancer Prevention and Control, which, since 2011, has allowed for more than 7000 centers around the country to allocate resources to the prevention, promotion and early detection of the most frequent cancers in Peru. With the financial support of the state's health insurance system, the basic strategic central points were integrated to provide low-income cancer patients with comprehensive medical care. Through this way, and within the framework of a state policy integrated to and articulated with the health sector, the National Plan for Comprehensive Medical Care for Cancer Patients and the Improvement in the Access to Oncological Services in Peru, known as "The Hope Plan", was born. This article elaborates on the role that INEN plays in the control of cancer as a public health issue, highlighting the importance of the Strategic Budgetary Program for Cancer Prevention and Control and its role in the "The Hope Plan".

Acelerando la innovación en el control del cáncer en el Perú / Accelerating cancer control innovations in Peru

RESUMEN En el marco de las acciones globales en la prevención y control del cáncer, el Instituto Nacional de Enfermedades Neoplásicas (INEN), centro de referencia nacional, ha diseñado y desarrollado estrategias y programas innovadores que están orientados al cumplimiento de los objetivos institucionales a través de las intervenciones de promoción de la salud, prevención, diagnóstico y tratamiento del cáncer, que benefician a la población a nivel nacional. En el proceso de obtener resultados de estas acciones, las escuelas y centros de excelencia del INEN, han desarrollado un papel muy importante. El Centro de Excelencia en la Capacitación en Cáncer de Cuello Uterino es el pionero en estas intervenciones con diseño metodológico aplicado a la mejora de las competencias de los profesionales de la salud, siendo este modelo diseminado a las otras escuelas de excelencias. Como resultado de su intervención, se han logrado fortalecer las competencias de 12 194 profesionales de la salud, capacitados por el INEN en promoción y prevención primaria y secundaria, a nivel nacional, durante el periodo del 2012-2015.

ABSTRACT Against a backdrop of global equity in cancer prevention and control, the National Institute of Neoplastic Diseases (INEN), a national reference center, has designed and developed innovative strategies and programs with the intent to meet institutional goals through health promotion interventions and cancer prevention, diagnosis, and treatments that benefit the national population. The INEN Schools and Centers of Excellence have played an important role in the process of determining the results of these actions. The Center of Excellence in Cervical Cancer Training is an interventional pioneer that has applied a methodological design intended to improve health professional skills and has disseminated this model to other Schools of Excellence. Through this intervention, the skills of 12,194 health professionals trained by the INEN have been strengthened with respect to nationwide promotion and primary and secondary prevention during the period of 2012-2015.

El Instituto Nacional de Enfermedades Neoplásicas en el control del cáncer en el Perú / The role of the National Institute of Neoplastic Diseases in the control of cancer in Peru

La incidencia estimada de cáncer en el Perú es de 150 casos x 100 000 habitantes. Este ocupa el segundo lugar de las causas mortalidad a nivel nacional y se estima que el 75% de los casos se diagnostican en etapa avanzada y principalmente en Lima. En ese contexto, el Instituto Nacional de Enfermedades Neoplásicas (INEN) ha promovido la descentralización de la atención oncológica con la creación de los institutos regionales de enfermedades neoplásicas, las unidades oncológicas y los preventorios. Asimismo ha diseñado, desarrollado e implementado el Programa Presupuestal de Prevención y Control de Cáncer, por lo que desde el año 2011, más de 7000 establecimientos del país asignan recursos para la prevención, promoción y detección precoz de los cánceres más frecuentes en el Perú. Con el financiamiento del seguro estatal, se integraron los ejes estratégicos básicos para una atención integral del cáncer en la población de menores recursos. De esta manera y dentro de una política de estado integradora y articulada con el sector salud, nace el Plan Nacional para la Atención Integral del Cáncer y el Mejoramiento del Acceso a los Servicios Oncológicos en el Perú, denominado “Plan Esperanza”. En este artículo, desarrollamos el papel que viene cumpliendo el INEN en el control del cáncer como problema de salud pública, destacando la importancia del Programa Estratégico Presupuestal de Prevención y Control del Cáncer y de su papel en el “Plan Esperanza”.

With a mortality rate that constitutes the second nationwide, the estimated incidence of cancer in Peru is 150 cases x 100 000 inhabitants. Around 75% of the cases are diagnosed at an advanced stage and mainly in Lima. In this context, the National Institute of Neoplastic Diseases (INEN) has promoted the decentralization of oncological care creating regional institutes of neoplastic diseases, oncological units and prevention centers. In addition, INEN has designed, developed and implemented the Budgetary Program for Cancer Prevention and Control, which, since 2011, has allowed for more than 7000 centers around the country to allocate resources to the prevention, promotion and early detection of the most frequent cancers in Peru. With the financial support of the state’s health insurance system, the basic strategic central points were integrated to provide low-income cancer patients with comprehensive medical care. Through this way, and within the framework of a state policy integrated to and articulated with the health sector, the National Plan for Comprehensive Medical Care for Cancer Patients and the Improvement in the Access to Oncological Services in Peru, known as “The Hope Plan”, was born. This article elaborates on the role that INEN plays in the control of cancer as a public health issue, highlighting the importance of the Strategic Budgetary Program for Cancer Prevention and Control and its role in the “The Hope Plan”.