Final Annotated Agenda - WHO

1 1 Annotated Agenda Day 1: 17th March Avil s (Asturias), Spain 8:30-9:00 Registration 9:00-9:15 Welcome: -Mar a Neira (Director of Public Health and Environment (PHE), WHO, Switzerland) Introduction of Participants Scope and purpose of the meeting. Working procedures. Session : ENVIRONMENTAL DETERMINANTS OF CANCER. SUMMARIZING THE SCIENTIFIC EVIDENCE, KEY POLICY OPTIONS AND ENVIRONMENTAL INTERVENTIONS Co-Chair: -Andreas Ullrich (Chronic Diseases and Health Promotion (CHP), WHO, Switzerland) -Joachim Sch z (International Agency for Research on Cancer (IARC), France) -Alojz Peterle (ex-Prime Minister of Slovenia, Member of the European Parliament, Belgium)(20 min) The chain from evidence to the policy making process and the implementation of environmental policies in national and international cancer control programmes: main challenges.

2 Factors triggering cancer prevention measures and barriers. Economic impact of cancer in health systems (figures). Funds allocated to research (figures) and in which areas (lead topics of research). 9:15-10:15 Plenary discussion. Topics for discussion (40 min): Opportunities for primary prevention of cancer through modification of environmental determinants. Economic burden of cancer on health systems in high-, middle- and low-income countries and the importance of primary prevention. Defining and prioritizing cancer research topics for the purpose of primary prevention. Barriers to translating research into strategies for primary prevention of cancer and reducing the burden of cancer attributable to environmental and occupational risks.

3 Should we switch to a new cancer prevention paradigm? Who should be involved? Potential synergies. Future trends. Conclusions. Introduction to the "Asturias Declaration: A Call to Action". 2 10:15-10:40 COFFEE BREAK 11:00-11:40 Opening ceremony. Opening statements: Welcoming statements and addresses made by representatives of the Government of Spain: Mayor of the City of Aviles, Do a Pilar Varela WHO Director of the Department of Public Health and Environment, Dr. Maria Neira Health Minister of Spain, Ms. Leire Pajin Government of Principado de Asturias the Princess of Asturias Session : ENVIRONMENTAL DETERMINANTS OF CANCER. SUMMARIZING THE SCIENTIFIC EVIDENCE, KEY POLICY OPTIONS AND ENVIRONMENTAL INTERVENTIONS Co-Chair: -Andreas Ullrich (CHP, WHO, Switzerland) -Joachim Sch z (IARC, France) Presenter 1 (30 min): -Mar a Neira (Director of PHE, WHO, Switzerland) The magnitude of the problem: overview of the major environmental risk factors related to cancer and interventions for primary prevention of cancer.

4 To set the scene by outlining broadly the major environmental risks factors related to cancer. Difficulties in quantifying/assessing the cancer risks due to environmental carcinogens and the associated cancer burden. Introducing environment on the global cancer Agenda . the Princess of Asturias meets and greets the participants and experts invited by WHO 11:45-12:15 12:20 Group Photo with participants and High Level Authorities 12:30-13:30 COCKTAIL & TAPAS Session 2: ENVIRONMENTAL AND OCCUPATIONAL HEALTH POLICIES FOR PRIMARY PREVENTION OF CANCER: Learning example on asbestos and cancer Chair: -Andr Cicolella (Scientific Director's Advisor, Institut National de l'EnviRonnement industriel et des rISques (INERIS), France) Presenter 1 (10 min): Update of the scientific evidence on asbestos and cancer.

5 -Kurt Straif (Head of the Section of IARC Monographs, IARC, France) 13:30-14:30 Presenter 2 (20 min): Review of existing interventions on asbestos and cancer. -Barry Castleman (Environmental Consultant, US) 3 Plenary discussion. Topics for discussion (30 min) Analysing the example, including the role of governments in implementing existing regulation/policies and international agreements on environmental and occupational matters. Are the current regulatory systems effective? Availability and cost of safer substitutes and protective equipment for workers. Challenges and factors that create barriers for implementation of environmental and occupational health policies at country level.

6 Global inequities: trade to developing countries, Beyond the asbestos, how much research on environmental and occupational risks has been translated to cancer prevention policies in the last 20 years? Innovative approaches to strengthen primary prevention of environmental and occupational cancers. Major gaps and identification of barriers. Conclusions. Session 3: INTERVENTIONS TARGETING INDIVIDUAL BEHAVIOURAL CHANGE: Learning example on solar exposure, sunbeds and cancer Chair: -Eduardo Cazap (President, Union for International Cancer Control (UICC), Argentina) Presenter 1 (10 min): Scientific evidence on solar exposure and cancer. -Hajo Zeeb (Professor, Bremen Institute for Prevention Research and Social Medicine, Germany) Presenter 2 (20 min): Successful solar exposure campaigns and regulation of the use of sunbeds: the Australian Experience.

7 -Terry Slevin (Education and Research Director, Cancer Council Western Australia, Australia) Plenary discussion. Topics for discussion (30 min) Analysing the example, including social mobilization and communication. Are the current control measures attractive and available to the public?. Mechanisms available for changing people's behaviour. Are there regulations/policies in place to protect workers from solar exposure?. Innovative approaches to strengthen primary prevention of environmental and occupational cancers. Major gaps and identification of barriers. Conclusions. 15:30-16:00 COFFEE BREAK & REFRESHMENTS Session 4: MODELS FOR PREVENTION WITH UNCERTAIN RISKS OR DIVERSE PUBLIC RISK PERCEPTIONS Chair: -Ildefonso Hern ndez (Professor of Preventive Medicine and Public Health, University Miguel Hern ndez, Spain) 16:00-17:00 Presenter 1 (15 min): Learning example on outdoor and indoor air pollution and cancer (including second-hand smoke).

8 4 - Michal Krzyzanowski (EURO,WHO) Plenary discussion. Topics for discussion (30 min) Analysing the examples, including lack of appropriate interventions, broad population exposure, competing priorities, public perception (strong public interest or resistance, limited awareness) and policies. Making policy decisions in the face of scientific uncertainty: how much evidence do we need to develop public health policy? What are models for prevention when public health risks are uncertain? Major gaps (such as the need to strengthen epidemiological surveillance systems) and identification of barriers (political, financial constrains, etc.). Conclusions. Session 5: REVIEW OF MAJOR GAPS AND WAYS FORWARD ON KNOWLEDGE OF ENVIRONMENTAL AND OCCUPATIONAL DETERMINANTS OF CANCER AND INTERVENTIONS FOR PRIMARY PREVENTION OF CANCER Chair: Jose Ram n Quir s (Regional Minister of Health of the Principality of Asturias, Spain) Panel: -Mar a Neira (Director of PHE, WHO, Switzerland) -Andreas Ullrich (CHP, WHO, Switzerland) -Joachim Sch z (IARC, France) -Andr Cicolella (INERIS, France) -Eduardo Cazap (President, UICC, Argentina) -Ildefonso Hern ndez (Professor, University Miguel Hern ndez, Spain) 17:00-18:30 Plenary discussion.

9 Topics for discussion (1h 30 min) Mapping existing interventions and policy options for environmental and occupational risks; good practices. Developing a policy framework for the primary prevention of environmental and occupational cancers. Establishing partnerships. Designing a roadmap for further collective action and innovative approaches. The "Asturias Declaration: A Call to Action". 5 Day 2: 18th March Gij n (Asturias), Spain 8:30-9:00 Registration 9:00-9:15 Opening ceremony: -Paz Fern ndez Felgueroso (Mayor of Gij n, Spain) -Mar a Neira (Director of PHE, WHO, Switzerland) -Eduardo Cazap (President, UICC, Argentina) -Sandra Ibarra (President, Sandra Ibarra de Solidaridad Frente al C ncer Foundation, Spain) -Jose Ram n Quir s (Regional Minister of Health of the Principality of Asturias, Spain) -Paz Fern ndez Felgueroso (Mayor of Gij n, Spain) 9:15-9:30 Session 1: SUMMARIZING THE SCIENTIFIC EVIDENCE, KEY POLICY OPTIONS AND ENVIRONMENTAL INTERVENTIONS.

10 Presenter (15 min): -Maria Neira (Director of PHE, WHO, Switzerland) Overview of the main issues discussed the day before and an outline of the "Asturias Pledge: Call to Action". Round Table 1: IMPLEMENTATION OF PRIMARY PREVENTION MEASURES Chair: -Phil Landrigan (Dean for Global Health, Mount Sinai School of Medicine, US) Panel: -Dominique Belpomme (Professor in Clinical Oncology, University Ren Descartes, France) -Robert Percival (Professor of Law and Director of the Environmental Law Program, University of Maryland, US) -Elena Zhukovskaya (Professor, International POPs (Persistent Organic Pollutants) Elimination Network (IPEN)) -Miquel Porta (Professor and Head, Clinical & Molecular Epidemiology of Cancer Unit, Institut Municipal d'Investigaci M dica (IMIM), Spain) -Jack Siemiatycki (Canada Research Chair and Professor, University of Montreal, Canada) -Coral Larrosa (Health journalist, Informativos Tele5, Spain) 9:30-10.