INTRODUCTION

What is Cancer?

ƒ…‡”‹•ƒ‰‡‡”‹…–‡”—•‡†–‘†‡•…”‹„‡ƒ‰”‘—’‘ˆ‘˜‡”͕͔͔†‹•‡ƒ•‡•–Šƒ–‘……—”™Š‡ƒŽ‹‰ƒ–ˆ‘”•‘ˆƒ„‘”ƒŽ

Source: NCD report 2010

—””‡–Ž› ‹– ‹• ‡•–‹ƒ–‡† –Šƒ– ƒ„‘—– ͔͜ ’‡”…‡– ‘ˆ …ƒ…‡”•

ƒ”‡ †—‡ –‘ ‘—” ‡˜‹”‘‡– ‘” Ž‹ˆ‡•–›Ž‡ ƒ† –Š‡”‡ˆ‘”‡ ƒ”‡

’‘–‡–‹ƒŽŽ› ’”‡˜‡–ƒ„Ž‡Ǥ^͕ ‘” •‘‡ …ƒ…‡”• –Š‡ ”‹• ˆƒ…–‘”•

Šƒ˜‡„‡‡…Ž‡ƒ”Ž›‹†‡–‹Ƥ‡†ǡ™Š‹Ž‡ˆ‘”‘–Š‡”•ˆ—”–Š‡””‡•‡ƒ”…Š

‹•‡‡†‡†Ǥ Global Overview

ƒ…‡”Šƒ•„‡‡‘–‡†ƒ•‘‡‘ˆƒŒ‘”Ž‹ˆ‡–Š”‡ƒ–‡‹‰‘

‘—‹…ƒ„Ž‡‹•‡ƒ•‡•™‘”Ž†™‹†‡Ǥ„‘—–͛Ǥ͚‹ŽŽ‹‘’‡‘’Ž‡

†‹‡ˆ”‘…ƒ…‡”™Š‹…Š‹•‡“—‹˜ƒŽ‡––‘͖͕Ψ‘ˆƒŽŽ†‡ƒ–Š•

‰Ž‘„ƒŽŽ›Ǥ‡ƒ”Ž›–™‘–Š‹”†•‘ˆƒŽŽ…ƒ…‡”†‹ƒ‰‘•‡•‘……—””‹‰

‹Ž‘™Ǧƒ†‹††Ž‡Ǧ‹…‘‡…‘—–”‹‡•Ǥ^͖ Cancer burden in Tanzania

ƒœƒ‹ƒǡŽ‹‡ƒ›‘–Š‡”…‘—–”‹‡•ǡŠƒ•ƒ‹…”‡ƒ•‹‰—„‡”

Figure 2: Reported Cancer Cases at the ORCI

Š‡—„‡”‘ˆ…ƒ•‡•‹†‹…ƒ–‡†Š‡”‡ƒ›Š‘™‡˜‡”‘–†‡’‹…––Š‡ƒ…–—ƒŽ•‹–—ƒ–‹‘‹–Š‡…‘—–”›†—‡–‘–Š‡ˆƒ…–

–Šƒ–ƒ„‘—–͔͜Ǧ͔͝Ψ‘ˆ…ƒ…‡”’ƒ–‹‡–•ƒ”‡—ƒ„Ž‡–‘ƒ……‡••†‹ƒ‰‘•–‹…ƒ†–”‡ƒ–‡–ˆƒ…‹Ž‹–‹‡•ƒ†‡†—’†›‹‰ƒ–

Š‘‡‘”ƒ––”ƒ†‹–‹‘ƒŽŠ‡ƒŽ‡”•ǯ…Ž‹‹…•Ǥ–‹•ƒŽ•‘ƒƒ––‡”‘ˆ…‘…‡”„‡…ƒ—•‡ƒ„‘—–͙͛Ǧ͔͜Ψ‘ˆ–Š‡’ƒ–‹‡–•ƒ––‡†–‘

Š‘•’‹–ƒŽ•ƒ–ƒ†˜ƒ…‡†•–ƒ‰‡•™Š‡‹–‹•‘–’‘••‹„Ž‡–‘…‘’Ž‡–‡Ž›…—”‡–Š‡Ǥ

ƒœƒ‹ƒ–Š‡Ž‡ƒ†‹‰…ƒ…‡”•ˆ‘”„‘–Š•‡š‡•ƒ”‡…ƒ”…‹‘ƒ‘ˆ…‡”˜‹šǡƒ’‘•‹ǯ••ƒ”…‘ƒƒ†„”‡ƒ•–…ƒ…‡”ǤŠ‡

Ƥ”•–ƒ†–Š‡–Š‹”†…ƒ„‡•…”‡‡‡†ƒ††‡–‡…–‡†‹–Š‡‹”‡ƒ”Ž›•–ƒ‰‡•‹ˆ‡ơ‡…–‹˜‡ƒơ‘”†ƒ„Ž‡…ƒ…‡”…‘–”‘Ž’”‘‰”ƒ•

ƒ”‡’—–‹’Žƒ…‡ǤŠ‹•Šƒ’’‡‡†‹–Š‡™‡•–‡”…‘—–”‹‡•†—”‹‰–Š‡Žƒ•––Š‹”–››‡ƒ”•ƒ†–Š‡”‡Šƒ•„‡‡ƒ•‹‰‹Ƥ…ƒ–

†‡…”‡ƒ•‡‹–Š‡‹…‹†‡…‡ƒ†‘”–ƒŽ‹–›‘ˆ…‡”˜‹…ƒŽ…ƒ…‡”•Ǥ^͙ Figure 3: Top 10 Cancer among males in Tanzania

͙Ž‘„‘…ƒǡǡ͖͔͔͖

Figure 4: Top 10 Cancer among Females in Tanzania

Figure 5:ƒ’‘ˆƒœƒ‹ƒ•Š‘™‹‰‡•–‹ƒ–‡†‡™…ƒ…‡”…ƒ•‡•‹‡ƒ…Š”‡‰‹‘ˆ‘”͖͔͔͛ȋƒ’’”‘š͕‹͕͔͔͔

ƒœƒ‹ƒ•†‡˜‡Ž‘’•…ƒ…‡”‡ƒ…Š›‡ƒ”Ȍ‘˜‡ƒ’–‘ƒ…‡”‹–—ƒ–‹‘‹ƒœƒ‹ƒǤ

Cancer Prevention and Control Strategies

‘–”‘Žƒ†’”‡˜‡–‹‘‘ˆ…ƒ…‡””‡“—‹”‡•ƒ’Žƒ‡†ǡ•›•–‡ƒ–‹…ƒ†…‘‘”†‹ƒ–‡†ƒ’’”‘ƒ…Šƒ–ƒŽŽ•–ƒ‰‡•‘ˆƒ…ƒ…‡”

…‘–‹——ȋ’”‹ƒ”›’”‡˜‡–‹‘ǡ‡ƒ”Ž›†‡–‡…–‹‘ǡ”‡‰‹•–”ƒ–‹‘ǡ–”ƒ‹‹‰ǡ‡†—…ƒ–‹‘ǡ†‹ƒ‰‘•‹•ǡ–”‡ƒ–‡–ǡ’ƒŽŽ‹ƒ–‹˜‡

…ƒ”‡ǡƒ†”‡•‡ƒ”…ŠȌǤ–ƒŽ•‘”‡“—‹”‡•”‡•‘—”…‡•ǡ™Š‹…Šƒ”‡ƒŽ™ƒ›•Ž‹‡Ž›–‘„‡Ž‹‹–‡†Ǥ–‹•‡‹‡––Šƒ––Š‡†‹•‡ƒ•‡

…ƒ‘–„‡…‘’Ž‡–‡Ž›‡”ƒ†‹…ƒ–‡†‹–Š‡ˆ‘”‡•‡‡ƒ„Ž‡ˆ—–—”‡ǡ„—–‹–•‡ơ‡…–•…ƒ„‡‹‹‹œ‡†ǤŠ‡‡•–ƒ„Ž‹•Š‡–‘ˆ

–Š‡‘ơ‡”•–Š‡‘•–”ƒ–‹‘ƒŽ‡ƒ•‘ˆƒ…Š‹‡˜‹‰–Š‡ƒš‹—†‡‰”‡‡‘ˆ…ƒ…‡”…‘–”‘Žǡ‡˜‡™Š‡”‡•‘—”…‡•

ƒ”‡…‘•–”ƒ‹‡†Ǥ

ƒ…‡” …‘–”‘Ž •–”ƒ–‡‰› ‡…‘’ƒ•• ƒŽŽ ƒ•’‡…–• ‘ˆ …ƒ…‡” …ƒ”‡ǡ Š‘™‡˜‡” ‹ ‹–• †‘…—‡– ‘Managerial Guidelines of National Cancer Control ProgramȋȌŠƒ•‹†‡–‹Ƥ‡†ƒ†…Žƒ••‹Ƥ‡†…ƒ…‡”•™Š‹…Šƒ”‡’”‡˜‡–ƒ„Ž‡ǡ

‡ƒ•‹Ž›†‡–‡…–ƒ„Ž‡ǡƒ†‡ơ‡…–‹˜‡Ž›–”‡ƒ–ƒ„Ž‡ƒ•™‡ŽŽƒ•–Š‘•‡ˆ‘”™Š‹…Š‘Ž›’ƒŽŽ‹ƒ–‹˜‡…ƒ”‡‹•ƒ˜ƒ‹Žƒ„Ž‡Ǥ–Š‡”ƒ”‡ƒ•

–Šƒ–‡‡†–‘„‡…‘•‹†‡”‡†ƒ”‡‡“—‹–›‘ˆƒ……‡••–‘•‡”˜‹…‡•ǡ™‘”ˆ‘”…‡†‡˜‡Ž‘’‡–ǡ‡‡†ˆ‘””‡Ž‡˜ƒ–”‡•‡ƒ”…Šǡ

‘‹–‘”‹‰ǡ†ƒ–ƒ…‘ŽŽ‡…–‹‘ƒ†ƒƒŽ›•‡•Ǥ

Š‹• ’”‘˜‹†‡• –Š‡ …‘”‡”•–‘‡ ˆ‘” ˆ‘”—Žƒ–‹‘ ‘ˆ †‡’‡†‹‰ ‘ …‘—–”›ǯ• …ƒ…‡” Ž‘ƒ† ƒ† ’ƒ––‡”Ǥ

–Š—•‹ƒ•–‹……‘‹–‡–‘ˆ–Š‡‰‘˜‡”‡–ƒ•™‡ŽŽƒ•–Š‘•‡‘ˆ‘Ǧ‰‘˜‡”‡–‘”‰ƒ‹œƒ–‹‘•ƒ”‡Š‹‰ŠŽ›‡‡†‡†

–‘ ƒ‡ –Š‡ •–”ƒ–‡‰› ‡ơ‡…–‹˜‡Ǥ ‰Ž‘••› †‘…—‡– –Šƒ– ‹• ‘– ƒ…–‡† —’‘ ™‹ŽŽ Šƒ˜‡ Ž‹––Ž‡ ‡ơ‡…– ‘ …ƒ…‡” ‹

ƒœƒ‹ƒǤ–ƒ‡Š‘Ž†‡”‹’—–ƒ†Ž‘‰Ǧ–‡”‹˜‘Ž˜‡‡–ƒ”‡‡••‡–‹ƒŽ–‘–Š‡•—……‡••‘ˆ–Š‹•‹’‘”–ƒ–‹‹–‹ƒ–‹˜‡Ǥ The Cancer Control Continuum

‡†—…‹‰–Š‡‹…‹†‡…‡ƒ†‹’ƒ…–‘ˆ…ƒ…‡””‡“—‹”‡•ƒ’Žƒ‡†ǡ•›•–‡ƒ–‹…ƒ†…‘‘”†‹ƒ–‡†ƒ’’”‘ƒ…Š–‘ƒ›”‹ƒ†

‘ˆƒ…–‹˜‹–‹‡•™‹–Š‹™Šƒ–‹•‘™ƒ•–Š‡Ǯ…ƒ…‡”…‘–”‘Ž…‘–‹——ǯǤ

Cancer control situation in Tanzania Primary Prevention

……‘”†‹‰–‘–Š‡ȋ͖͔͔͖Ȍǡ…ƒ…‡”’”‡˜‡–‹‘•Š‘—Ž†„‡ƒ‡›‡Ž‡‡–‹ƒŽŽ…ƒ…‡”…‘–”‘Ž’”‘‰”ƒ•Ǥƒ…‡”

Š‡‘˜‡”‡–‘ˆƒœƒ‹ƒ–Š”‘—‰Š–Š‡‹‹•–”›‘ˆ‡ƒŽ–Š‡•–ƒ„Ž‹•Š‡†ƒƒ…–‘–‘„ƒ……‘‹͖͔͔͗™Š‹…Š™ƒ• Cancer Registration and surveillance

ƒ…‡””‡‰‹•–”›‹•ƒ‹ˆ‘”ƒ–‹‘•›•–‡†‡•‹‰‡†ˆ‘”–Š‡…‘ŽŽ‡…–‹‘ǡ•–‘”ƒ‰‡ǡƒƒ‰‡‡–ƒ†ƒƒŽ›•‹•‘ˆ†ƒ–ƒ‘

Š‡Š‘•’‹–ƒŽǦ„ƒ•‡†…ƒ…‡””‡‰‹•–”›™ƒ•‡•–ƒ„Ž‹•Š‡†‹͖͔͔͔™‹–Š–Š‡ƒ‹‘ˆ‹’”‘˜‹‰–Š‡…ƒ”‡‘ˆ…ƒ…‡” Early Detection (Screening and Diagnosis)

Š‡ƒ‹‘ˆ‡ƒ”Ž›†‡–‡…–‹‘‹•–‘‹†‡–‹ˆ›–Š‡…ƒ…‡”™Š‡‹–‹•Ž‘…ƒŽ‹œ‡†ȋ„‡ˆ‘”‡‹–Šƒ•–‹‡–‘•’”‡ƒ†–‘‘–Š‡”’ƒ”–•

͖͔͔͚ǡ”‡…‡‹˜‡†ˆ—†•ˆ”‘–Š‡‰‘˜‡”‡–‹‘”†‡”–‘…‘†—…–ƒ–‹‘™‹†‡…ƒ…‡”…‘–”‘Žƒ…–‹˜‹–‹‡•ǤŠ‡ Treatment

”‡ƒ–‡–‘ˆ…ƒ…‡”‹•…‘’Ž‡šǡ‹˜‘Ž˜‹‰ƒ”ƒ‰‡‘ˆ–Š‡”ƒ’‹‡•ǤŠ‡•‡‹…Ž—†‡•—”‰‡”›ǡ”ƒ†‹ƒ–‹‘ǡ…Š‡‘–Š‡”ƒ’›

Palliative Care

Training, Education, Research, and Human Resources Development

•‹‘–Š‡”ƒ”‡ƒ•‘ˆ…ƒ…‡”…‘–”‘Žǡ”‡•‡ƒ”…Š‹˜‘Ž˜‡•–Š‡—•‡‘ˆ—Ž–‹†‹•…‹’Ž‹ƒ”›ƒ’’”‘ƒ…Š‡•Ǥ

‡•‡ƒ”…Š‹•…—””‡–Ž›„‡‹‰…‘†—…–‡†‹ƒœƒ‹ƒ‹‘•–Ƥ‡Ž†•‘ˆ…ƒ…‡”…‘–”‘Žǡ„—––Š‡‡ơ‘”–‹••‘‡™Šƒ–

Rationale for the National Cancer Control Strategy

ƒ…‡”…‘–”‘Ž•‡”˜‹…‡•‹ƒœƒ‹ƒŠƒ˜‡Žƒ”‰‡Ž›„‡‡ƒ„—•‹‡••‘ˆ–Š‡ǤŠ‹•Šƒ•Ž‡ˆ–‰ƒ’•ƒ†ˆ”ƒ‰‡–ƒ–‹‘

͚Ǥ ••‹•–‹‰’‡‘’Ž‡ǡƒ†–Š‡‹”ˆƒ‹Ž‹‡•ǡ‡š’‡”‹‡…‹‰…ƒ…‡”–‘ˆ—ŽŽ›’ƒ”–‹…‹’ƒ–‡‹ƒŽŽ†‡…‹•‹‘Ǧƒ‹‰”‡Žƒ–‡†

–‘–Š‡‹”–”‡ƒ–‡–ƒ†…ƒ”‡

͛Ǥ ‡†—…‹‰„ƒ””‹‡”•–‘…ƒ…‡”•‡”˜‹…‡•ˆ‘”•‘…‹ƒŽŽ›ƒ†‰‡‘‰”ƒ’Š‹…ƒŽŽ›†‹•ƒ†˜ƒ–ƒ‰‡†‰”‘—’•

͜Ǥ ‘‘”†‹ƒ–‹‰…ƒ…‡””‡•‡ƒ”…Šǡ–”ƒ‹‹‰‡†—…ƒ–‹‘ǡ”‡‰‹•–”ƒ–‹‘ƒ†•—”˜‡‹ŽŽƒ…‡

͝Ǥ —”–Š‡”‹‰–Š‡†‡˜‡Ž‘’‡–‘ˆ–Š‡…ƒ…‡”…‘–”‘Ž™‘”ˆ‘”…‡ƒ†‹…”‡ƒ•‹‰•’‡…‹ƒŽ‹•––”ƒ‹‹‰‘’’‘”–—‹–‹‡•

͕͔Ǥ ‡‰—Žƒ”Ž›‘‹–‘”‹‰…ƒ…‡”…‘–”‘Žƒ…–‹˜‹–‹‡•–‘‡•—”‡–Š‡›ƒ”‡‡ơ‡…–‹˜‡ƒ†”‡ƒ‹‡ơ‡…–‹˜‡Ǥ Who is the Strategy for?

Š‡‹•ˆ‘”ƒŽŽƒœƒ‹ƒ•ǡ„—–‹–™‹ŽŽŠƒ˜‡’ƒ”–‹…—Žƒ””‡Ž‡˜ƒ…‡–‘ǣ

‰‘˜‡”‡–ƒ†‘Ǧ‰‘˜‡”‡–ƒ‰‡…‹‡•™Š‘•‡™‘”‹’ƒ…–•‘–Š‡†‡Ž‹˜‡”›‘ˆ…ƒ…‡”•‡”˜‹…‡•ƒ†

ƒ…–‹˜‹–‹‡•

–Š‡™‹†‡”ƒ‰‡‘ˆ‹†‹˜‹†—ƒŽ•‹˜‘Ž˜‡†‹–Š‡ƒƒ‰‡‡–ƒ††‡Ž‹˜‡”›‘ˆ…ƒ…‡”ƒ…–‹˜‹–‹‡•ƒ†•‡”˜‹…‡•

–Š‘•‡’‡‘’Ž‡ƒơ‡…–‡†„›…ƒ…‡”

›’”‘‘–‹‰ƒ‹–‡‰”ƒ–‡†ƒ’’”‘ƒ…Š–‘–Š‡’”‘˜‹•‹‘‘ˆ…ƒ…‡”…‘–”‘Žƒ…–‹˜‹–‹‡•ƒ†•‡”˜‹…‡•ǡ–Š‡•–”ƒ–‡‰›™‹ŽŽǣ

‡…‘—”ƒ‰‡ƒ†ƒ••‹•–‰‘˜‡”‡–ƒ†‘Ǧ‰‘˜‡”‡–•‡”˜‹…‡’”‘˜‹†‡”•–‘™‘”‘”‡…Ž‘•‡Ž›–‘‰‡–Š‡”

’”‘˜‹†‡ƒ…‘‘—†‡”•–ƒ†‹‰‘ˆ™Š‡”‡–Š‡›Ƥ–‹–Š‡‘˜‡”ƒŽŽ•’‡…–”—‘ˆ…ƒ…‡”…‘–”‘Ž

Strengths, Weaknesses, Opportunities, Challenges

CHAPTER 2:

STRATEGIC FRAMEWORK TO GUIDE EXISTING AND FUTURE ACTIONS

VISION

‘ƒ‡ƒœƒ‹ƒƒ‘‰…‘—–”‹‡•™‹–ŠŽ‘™…ƒ…‡”„—”†‡

MISSION

‘’”‘˜‹†‡ƒ…‘‘”†‹ƒ–‡†ǡ…‘’”‡Š‡•‹˜‡ƒ†”‡•’‘•‹˜‡ǡ

ƒ–‹‘ƒŽ…ƒ…‡”…‘–”‘Ž’”‘‰”ƒˆ‘”ƒœƒ‹ƒǤ

The Goal

Š‡‰‘ƒŽ‘ˆ–Š‡‹•–‘•–”‡‰–Š‡ƒ†ƒ……‡Ž‡”ƒ–‡–Š‡–”ƒ•Žƒ–‹‘‘ˆ…ƒ…‡”…‘–”‘Ž‘™Ž‡†‰‡‹–‘’—„Ž‹…Š‡ƒŽ–Š

™‹–Šˆ‘…—•‘”‡†—…–‹‘‘ˆ…ƒ…‡”…ƒ•‡•ƒ††‡ƒ–Šƒ•™‡ŽŽƒ•‹’”‘˜‡‡–‘ˆ“—ƒŽ‹–›‘ˆŽ‹ˆ‡‘ˆ’ƒ–‹‡–•ƒ†–Š‡‹”

ˆƒ‹Ž‹‡•Ǥ

Š—•ǡ–Š‡–”ƒ–‡‰›™‹ŽŽŽ‡ƒ†—•–‘™ƒ”†•ƒˆ—–—”‡™Š‡”‡ǣ

Ȉơ‡…–‹˜‡’”‡˜‡–‹‘™‹ŽŽ‡ƒ„Ž‡ƒ›ƒœƒ‹ƒ•–‘‡Œ‘›…ƒ…‡”Ǧˆ”‡‡Ž‹˜‡•

Ȉ…”‡‡‹‰ˆ‘”…‘‘…ƒ…‡”•™‹ŽŽ„‡ƒ”‡‰—Žƒ”’ƒ”–‘ˆ™‡ŽŽ‡••ƒ…–‹˜‹–‹‡•

Ȉƒ…‡”™‹ŽŽ„‡†‡–‡…–‡†‡ƒ”Ž›ǡƒ†’ƒ–‹‡–•™‹ŽŽŠƒ˜‡ƒ……‡••–‘Š‹‰Š“—ƒŽ‹–›–”‡ƒ–‡–ƒ†…ƒ”‡–Š”‘—‰Š‘—–

–Š‡…‘—”•‡‘ˆ–Š‡‹”‹ŽŽ‡••ǡƒ†”‡…‡‹˜‡•—’’‘”–ƒ†”‡Šƒ„‹Ž‹–ƒ–‹‘™Š‡‡‡†‡†ǡ™Š‡”‡˜‡”–Š‡›Ž‹˜‡‹

ƒœƒ‹ƒ

Ȉ––Š‡–‹‡™Š‡’‡‘’Ž‡ƒ”‡‘•–˜—Ž‡”ƒ„Ž‡ǡ…‘ˆ—•‡†ƒ†•…ƒ”‡†ǡ–Š‡‰—‹†‡™‹ŽŽ’”‘˜‹†‡ƒ••‹•–ƒ…‡‹

–”‡ƒ–‡–ƒ†…ƒ”‡„›‡•—”‹‰–Šƒ––Š‡‹”‡‡†•ƒ”‡Š‡ƒ”†ƒ†‡–

ȈŠ‡…ƒ…‡”…ƒ‘–„‡…—”‡†ǡ‘”Š‡Ž†‹”‡‹••‹‘ǡƒ††‡ƒ–Š‹•–Š‡†‡•–‹›ǡ‹–™‹ŽŽŠƒ’’‡™‹–Š‘—–

‡†—”‹‰—‡…‡••ƒ”›’ƒ‹ƒ†„›„‡‹‰…Ž‘•‡–‘ˆƒ‹Ž‹‡•ƒ†ˆ”‹‡†•

ȈŠ‡”‡™‹ŽŽ„‡‘ˆ‡ƒ”–Šƒ––Š‡Š‡ƒŽ–Š…ƒ”‡•›•–‡™‹ŽŽƒ„ƒ†‘–Š‡’‡‘’Ž‡ƒ•…ƒ…‡”…‘–”‘Ž•‡”˜‹…‡•™‹ŽŽ

„‡‹–‡‰”ƒ–‡†‹–‘–Š‡‡š‹•–‹‰Š‡ƒŽ–Š…ƒ”‡†‡Ž‹˜‡”›•‘–Šƒ–ƒ‹‹—’ƒ…ƒ‰‡‘ˆ…ƒ”‡™‹ŽŽ„‡ƒ˜ƒ‹Žƒ„Ž‡

ƒ–‡ƒ…ŠŽ‡˜‡Ž

Objectives of the strategy

Š‡‘„Œ‡…–‹˜‡•‘ˆ–Š‡•–”ƒ–‡‰›ƒ”‡–‘ǣ

Ȉ–‡‰”ƒ–‡…ƒ…‡”…‘–”‘Ž‹–‘‡š‹•–‹‰Š‡ƒŽ–Š…ƒ”‡†‡Ž‹˜‡”›•›•–‡

Ȉ‡†—…‡–Š‡‹…‹†‡…‡ƒ†‹’ƒ…–‘ˆ…ƒ…‡”

ȈŠƒ…‡“—ƒŽ‹–›‘ˆŽ‹ˆ‡ˆ‘”–Š‘•‡™‹–Š…ƒ…‡”

Ȉ‡†—…‡‹‡“—ƒŽ‹–‹‡•™‹–Š”‡•’‡…––‘ƒ……‡••–‘…ƒ…‡”…ƒ”‡

Principles of the National Cancer Control Strategy

Š‡ •‡–•’”‹…‹’Ž‡•–‘‰—‹†‡…—””‡–ƒ†ˆ—–—”‡ƒ…–‹‘•–‘™ƒ”†•…ƒ…‡”…‘–”‘Ž‹…Ž—†‹‰Ǣ Ȉ‡†—…‡Š‡ƒŽ–Š‹‡“—ƒŽ‹–‹‡•ƒ‘‰†‹ơ‡”‡–’‘’—Žƒ–‹‘‰”‘—’•Ǥ

Ȉ•—”‡ –‹‡Ž› ƒ† ‡“—‹–ƒ„Ž‡ ƒ……‡•• ˆ‘” ƒŽŽ ƒœƒ‹ƒ• –‘ ƒ …‘’”‡Š‡•‹˜‡ ”ƒ‰‡ ‘ˆ …ƒ…‡” •‡”˜‹…‡•ǡ

”‡‰ƒ”†Ž‡••‘ˆƒ„‹Ž‹–›–‘’ƒ›ǤŠ‹•’”‹…‹’Ž‡ƒ…‘™Ž‡†‰‡•–Š‡‡‡†–‘ƒ††”‡••ǡ‹ƒˆƒ‹”™ƒ›ǡˆƒ…–‘”•–Šƒ–

‹’ƒ…–‘–Š‡ƒ„‹Ž‹–›‘ˆ’‡‘’Ž‡–‘ƒ……‡•••‡”˜‹…‡•ƒ…”‘••–Š‡…‘–‹——‘ˆ…ƒ…‡”…‘–”‘Ž‹•—ƥ…‹‡–

–‹‡–‘„‡‘ˆ„‡‡Ƥ–Ǥ

Ȉ‡ ‘ˆ Š‹‰Š “—ƒŽ‹–›Ǥ Š‹• ’”‹…‹’Ž‡ ‹†‡–‹Ƥ‡• –Š‡ ‹’‘”–ƒ…‡ ‘ˆ †‡˜‡Ž‘’‹‰ •–ƒ†ƒ”†• ƒ† ‰—‹†‡Ž‹‡•ǡ

‘‹–‘”‹‰’‡”ˆ‘”ƒ…‡ǡƒ†‡˜ƒŽ—ƒ–‹‰‘—–…‘‡–‘‡•—”‡Š‹‰Š“—ƒŽ‹–›Ǥ

Ȉ‡•—•–ƒ‹ƒ„Ž‡ǤŠ‹•’”‹…‹’Ž‡‹†‡–‹Ƥ‡•–Š‡‹’‘”–ƒ…‡‘ˆŠƒ˜‹‰•—ƥ…‹‡–”‡•‘—”…‡•ǡ‹…Ž—†‹‰Š—ƒ

”‡•‘—”…‡•ǡ”‡“—‹”‡†‘˜‡”ƒ’‡”‹‘†‘ˆ–‹‡–‘‡•—”‡ƒŠ‹‰Š•–ƒ†ƒ”†‘ˆ’‡”ˆ‘”ƒ…‡Ǥ

Ȉ•‡ ƒ ‡˜‹†‡…‡Ǧ„ƒ•‡† ƒ’’”‘ƒ…ŠǤ Š‹• ’”‹…‹’Ž‡ ƒ…‘™Ž‡†‰‡• –Š‡ ‡‡† ˆ‘” ƒ…–‹‘• –‘ „‡ „ƒ•‡† ‘

„‡•–’”ƒ…–‹…‡ǡ™Š‹…Š‹••—’’‘”–‡†„›ƒ•›•–‡ƒ–‹…”‡˜‹‡™‘ˆ•…‹‡–‹Ƥ…‘™Ž‡†‰‡ƒ†‹…Ž—†‡•‘‰‘‹‰

”‡•‡ƒ”…Šƒ††‡˜‡Ž‘’‡–Ǥ

Ȉ‡ƪ‡…–ƒ’‡”•‘Ǧ…‡–‡”‡†ƒ’’”‘ƒ…ŠǤŠ‹•’”‹…‹’Ž‡”‡…‘‰‹œ‡•ƒ’‡”•‘ǯ•–‘–ƒŽ™‡ŽŽ„‡‹‰ǡ‹…Ž—†‹‰Š‡”

‘”Š‹•’Š›•‹…ƒŽǡ‡‘–‹‘ƒŽǡ•’‹”‹–—ƒŽǡ•‘…‹ƒŽƒ†’”ƒ…–‹…ƒŽ‡‡†•™‹–Š‹–Š‡…‘–‡š–‘ˆˆƒ‹Ž›Ǥ

Ȉ…–‹˜‡Ž› ‹˜‘Ž˜‡ ’ƒ–‹‡–• ƒ† …‘—‹–‹‡•Ǥ Š‹• ’”‹…‹’Ž‡ ‹†‡–‹Ƥ‡• –Š‡ ‡‡† –‘ Šƒ˜‡ ’ƒ–‹‡–• ƒ†

…‘—‹–‹‡• ‹˜‘Ž˜‡† ‹ –Š‡ †‡…‹•‹‘• –Šƒ– ƒơ‡…– –Š‡ ƒ† –‘ ’”‘˜‹†‡ ‘’’‘”–—‹–‹‡• ˆ‘” ’ƒ–‹‡–•ǯ

’ƒ”–‹…‹’ƒ–‹‘Ǥ–ƒŽ•‘‡ƒ•–Šƒ–•‡”˜‹…‡••Š‘—Ž†”‡ƪ‡…––Š‡‡‡†•‘ˆ‹†‹˜‹†—ƒŽ•ƒ†…‘—‹–‹‡•Ǥ Ȉ‡…‘‰‹œ‡ ƒ† ”‡•’‡…– …—Ž–—”ƒŽ †‹˜‡”•‹–›Ǥ Š‹• ’”‹…‹’Ž‡ ”‡…‘‰‹œ‡• –Š‡ ‹’‘”–ƒ…‡ ‘ˆ ƒ…–‹‘• „‡‹‰

…—Ž–—”ƒŽŽ›ƒ’’”‘’”‹ƒ–‡Ǣ–Šƒ–‹•ǡ”‡•’‘•‹˜‡–‘ǡƒ†”‡•’‡…–ˆ—Ž‘ˆǡ–Š‡Š‹•–‘”›ǡ–”ƒ†‹–‹‘•ƒ†…—Ž–—”ƒŽ˜ƒŽ—‡•

‘ˆƒŽŽƒœƒ‹ƒ•Ǥ

Ȉ‡—†‡”–ƒ‡™‹–Š‹–Š‡…‘–‡š–‘ˆƒ’Žƒ‡†ǡ…‘‘”†‹ƒ–‡†ƒ†‹–‡‰”ƒ–‡†ƒ’’”‘ƒ…ŠǤŠ‹•’”‹…‹’Ž‡

—†‡”•…‘”‡•–Š‡‹’‘”–ƒ…‡‘ˆƒ†‘’–‹‰ƒ•›•–‡ƒ–‹…ƒ†…‘‘”†‹ƒ–‡†ƒ’’”‘ƒ…Š–‘‡•—”‡‡ơ‡…–‹˜‡‡••

ƒ†–Šƒ–”‡•‘—”…‡•ƒ”‡—•‡†‡ƥ…‹‡–Ž›Ǥ–ƒŽ•‘ƒ…‘™Ž‡†‰‡•–Šƒ–ƒ…–‹˜‹–‹‡•–‘…‘–”‘Ž…ƒ…‡”•Š‘—Ž†„‡

’ƒ”–‘ˆƒ’‘’—Žƒ–‹‘Ǧ„ƒ•‡†ƒ’’”‘ƒ…Š–‘Š‡ƒŽ–ŠǤ

STRATEGIC OBJECTIVES TO MEET THE GOALS

GOAL 1 PRIMARY PREVENTION: Reduce the incidence of cancer through primary prevention

”‡˜‡–‹‘ƒ’’”‘ƒ…Š‡•–Šƒ–ƒ‹–‘”‡†—…‡‡š’‘•—”‡–‘…ƒ…‡”Ǧ…ƒ—•‹‰”‹•ˆƒ…–‘”•‘ơ‡”–Š‡‰”‡ƒ–‡•–Š‡ƒŽ–Š‰ƒ‹ Key strategies:

Strategic Objective 1.1: Reduce the number of people who develop cancers due to tobacco use.

š’‘•—”‡–‘–‘„ƒ……‘•‘‡‹…”‡ƒ•‡•–Š‡”‹•‘ˆ†‡˜‡Ž‘’‹‰Ž—‰…ƒ…‡”ƒ†ƒ›‘–Š‡”–›’‡•‘ˆ…ƒ…‡”•Ǥ‘„ƒ……‘

—•‡‹•”‡•’‘•‹„Ž‡ˆ‘”–Š”‡‡‘ˆ–Š‡–‘’͙…ƒ…‡”•‹ƒœƒ‹ƒǤ^͕͖

—„Ž‹…Š‡ƒŽ–Š‹‹–‹ƒ–‹˜‡•ƒ‹‡†ƒ–†‹•…‘—”ƒ‰‹‰•‘‹‰ƒ†™ƒ”‹‰’‡‘’Ž‡‘ˆ–Š‡†ƒ‰‡”•‘ˆ•‘‹‰Šƒ˜‡‘–

…ƒ—•‡†—…Š†‡…Ž‹‡‘ˆ•‘‹‰ƒ‘‰ƒ†—Ž–•Ǥ„‘—–͖͛Ψ‘ˆƒ†—Ž–ƒ†͜Ψ‘ˆ›‘—–ŠŠƒ˜‡•‘‡††—”‹‰–Š‡‹”Ž‹ˆ‡Ǥ

‘‹‰”ƒ–‡•ƒ‘‰›‘—‰’‡‘’Ž‡ǡ’ƒ”–‹…—Žƒ”Ž›ƒ†‘Ž‡•…‡–•ǡ•Š‘™ƒ—’™ƒ”†–”‡†.

Priority areas for action

‹Ǥ ‡†—…‡‡š’‘•—”‡–‘–‘„ƒ……‘•‘‡ƒ†’”‡˜‡––Š‡—’–ƒ‡‘ˆ•‘‹‰–Š”‘—‰Šƒ…‘’”‡Š‡•‹˜‡–‘„ƒ……‘

Strategic Objective 1.2: Reduce the number of people developing physical inactivity and obesity-related cancers

‘”‡ ƒ† ‘”‡ ’‡‘’Ž‡ ƒ”‡ „‡…‘‹‰ ‘„‡•‡ ‹ –Š‡ ƒœƒ‹ƒ ’‘’—Žƒ–‹‘ǡ ’ƒ”–‹…—Žƒ”Ž› —”„ƒ †™‡ŽŽ‡”•Ǥ ‡‘’Ž‡

™Š‘ƒ”‡‘„‡•‡ƒ”‡‘”‡Ž‹‡Ž›–‘†‡˜‡Ž‘’…‡”–ƒ‹–›’‡•‘ˆ…ƒ…‡”ǡ‹…Ž—†‹‰„‘™‡Žǡ„”‡ƒ•–ȋ’‘•–Ǧ‡‘’ƒ—•ƒŽȌƒ†

‡•‘’Šƒ‰‡ƒŽ…ƒ…‡”Ǥ

‡‘’Ž‡™Š‘ƒ”‡’Š›•‹…ƒŽŽ›ƒ…–‹˜‡ƒ”‡Ž‡••Ž‹‡Ž›–‘†‡˜‡Ž‘’„‘™‡Ž…ƒ…‡”•ǡ„”‡ƒ•–ǡ’”‘•–ƒ–‡ǡŽ—‰ƒ†—–‡”‹‡…ƒ…‡”•Ǥ Priority areas for action

‹Ǥ ‘•–‡”‹…”‡ƒ•‡†’Š›•‹…ƒŽƒ…–‹˜‹–›–Š”‘—‰Š•ƒˆ‡ƒ†ƒ……‡••‹„Ž‡‡˜‹”‘‡–•ǡƒ…–‹˜‡–”ƒ•’‘”–ǡ™‘”’Žƒ…‡•ǡ

•…Š‘‘Ž•ǡ …‘—‹–‹‡• ƒ† –Š‡ ƒ•• ‡†‹ƒǡ ƒ† †‡˜‡Ž‘’ ‡˜‹†‡…‡ ƒ† ƒ ”ƒ–‹‘ƒŽ‡ ˆ‘” ‹–‡”˜‡–‹‘• –‘

ƒ††”‡••‘„‡•‹–›ƒ•ƒ”‹•ˆƒ…–‘”ˆ‘”…ƒ…‡”Ǥ

‹‹Ǥ ”‘˜‹†‡ƒ†•—’’‘”–…‘’”‡Š‡•‹˜‡ƒ••‡†‹ƒ…ƒ’ƒ‹‰•–Šƒ–’”‘‘–‡ƒ†•—’’‘”–Ž‹ˆ‡•–›Ž‡…Šƒ‰‡ǡ

’Š›•‹…ƒŽ ƒ…–‹˜‹–›ǡ –Š‡ †‡˜‡Ž‘’‡– ‘ˆ •ƒˆ‡ ƒ† ƒ……‡••‹„Ž‡ ’—„Ž‹… ‡˜‹”‘‡–• –Šƒ– ‡…‘—”ƒ‰‡ ’‡‘’Ž‡

–‘—•‡‘”‡’Š›•‹…ƒŽŽ›ƒ…–‹˜‡‡ƒ•‘ˆ–”ƒ•’‘”–ƒ–‹‘ǡ•—…Šƒ•™ƒŽ‹‰ǡƒ†ƒ†˜‘…ƒ–‡ˆ‘”ƒ†•—’’‘”–

™‘”’Žƒ…‡•–Šƒ–‡…‘—”ƒ‰‡‡’Ž‘›‡‡•–‘„‡’Š›•‹…ƒŽŽ›ƒ…–‹˜‡Ǥ

‹‹‹Ǥ —”–Š‡”„—‹Ž†–Š‡‡˜‹†‡…‡„ƒ•‡ˆ‘”‹–‡”˜‡–‹‘•ƒ††”‡••‹‰‘„‡•‹–›ƒ•ƒ”‹•ˆƒ…–‘”ƒ†‡…‘—”ƒ‰‡ƒ…–‹‘

–‘’”‡˜‡––Š‡†‡˜‡Ž‘’‡–‘ˆ‘„‡•‹–›‹…Š‹Ž†”‡Ǥ

‹˜Ǥ —’’‘”–ƒ’’”‘’”‹ƒ–‡‹–‡”˜‡–‹‘•ˆ‘”–Š‡’”‡˜‡–‹‘‘ˆ‘„‡•‹–›ǡƒ†–‘‹…”‡ƒ•‡”ƒ–‡•‘ˆ’Š›•‹…ƒŽƒ…–‹˜‹–›

ˆ‘”ƒŽŽƒœƒ‹ƒ•Ǥ

Strategic Objective 1.3: Reduce the number of people developing nutrition-related cancers

Š‡”‡‹•‡˜‹†‡…‡–Šƒ–Ž‹•„‘™‡Žƒ†”‡…–ƒŽ…ƒ…‡”•™‹–Šƒ—„‡”‘ˆˆ‘‘†ƒ††‹‡–ƒ”›Šƒ„‹–•ǤŠ‡…‘’‘•‹–‹‘

‘ˆ†‹‡–‹•…‘•‹†‡”‡†‹’‘”–ƒ–ǡ‹–Šƒ–ˆ”—‹–ƒ†˜‡‰‡–ƒ„Ž‡•ǡ‹…”‡ƒ•‡†Ƥ„”‡ƒ†”‡†—…‡†ˆƒ–‹–ƒ‡ƒ›†‡…”‡ƒ•‡

–Š‡”‹•‘ˆ…‡”–ƒ‹–›’‡•‘ˆ…ƒ…‡”•ǡ‹…Ž—†‹‰ǡ‘”ƒŽǡ•–‘ƒ…Šƒ†„‘™‡Ž…ƒ…‡”•

Priority areas for action

‹Ǥ ƒ‡–Š‡Š‡ƒŽ–Š›ˆ‘‘†…Š‘‹…‡–Š‡‡ƒ•›…Š‘‹…‡„›‹’”‘˜‹‰ƒ……‡••–‘ƒ†ƒ˜ƒ‹Žƒ„‹Ž‹–›‘ˆŠ‡ƒŽ–Š›ˆ‘‘†•Ǥ

‹‹Ǥ ‡†—…‡–Š‡’”‘‘–‹‘‘ˆ—Š‡ƒŽ–Š›ˆ‘‘†…Š‘‹…‡•–‘…Š‹Ž†”‡ȋˆ‘”‡šƒ’Ž‡ǡ–Š”‘—‰Šƒ†˜‡”–‹•‹‰ȌǤ

‹‹‹Ǥ —’’‘”–ƒ…‘’”‡Š‡•‹˜‡…ƒ’ƒ‹‰–‘”ƒ‹•‡ƒ™ƒ”‡‡••‘ˆŠ‡ƒŽ–Š›ˆ‘‘†…Š‘‹…‡•Ǥ

‹˜Ǥ ‡•‡ƒ”…Š‹–‘‡‡”‰‹‰—–”‹–‹‘‹••—‡•Ǥ

Strategic Objective 1.4: Reduce the number of people developing infectious disease-related cancers

Š‡’”‡•‡…‡‘ˆ•‘‡‹ˆ‡…–‹‘—•†‹•‡ƒ•‡•Šƒ•„‡‡ƒ••‘…‹ƒ–‡†™‹–Š–Š‡†‡˜‡Ž‘’‡–‘ˆŽ‹˜‡”…ƒ…‡”ǡ…‡”˜‹…ƒŽ…ƒ…‡”

ƒ†•–‘ƒ…Š…ƒ…‡”Ǥ ‘”‡šƒ’Ž‡ǡ’‡‘’Ž‡™Š‘Šƒ˜‡Šƒ†‡’ƒ–‹–‹•ƒ†ƒ”‡‘”‡Ž‹‡Ž›–‘†‡˜‡Ž‘’Ž‹˜‡”…ƒ…‡”Ǥ Priority areas for action

‹Ǥ ‘–‹—‡–‘’”‘‘–‡•ƒˆ‡•‡š’”ƒ…–‹…‡•Ǥ

‹‹Ǥ ”‘‘–‡‡’ƒ–‹–‹•ƒ†˜ƒ……‹ƒ–‹‘ǡ’ƒ”–‹…—Žƒ”Ž›ˆ‘”Š‹‰ŠǦ”‹•’‘’—Žƒ–‹‘•

‹‹‹Ǥ ”‘–‡…–„Ž‘‘†’”‘†—…–•—’’Ž‹‡•ˆ”‘ƒŽŽ’‘••‹„Ž‡‹ˆ‡…–‹‘—•†‹•‡ƒ•‡…‘–ƒ‹ƒ–‹‘Ǥ

‹˜Ǥ …”‡ƒ•‹‰Š‡ƒŽ–Š’”‘‘–‹‘ƒ”‘—†‹ˆ‡…–‹‘—•†‹•‡ƒ•‡Ǧ”‡Žƒ–‡†…ƒ…‡”•

Strategic Objective 5: Reduce the number of people developing alcohol-related cancers

„‘—–22Ψ‘ˆƒœƒ‹ƒǯ•ƒ†—Ž–’‘’—Žƒ–‹‘†”‹•ƒŽ…‘Š‘Žǡƒ†–Š‡”‡‹•…‘•‹†‡”ƒ„Ž‡˜ƒ”‹ƒ–‹‘‹–Š‡ƒ‘—–…‘•—‡†

„›‹†‹˜‹†—ƒŽ•ƒ†”‡‰‹‘•Ǥ^͕͗

Š‡”‡‹••–”‘‰‡˜‹†‡…‡–Šƒ–…‘•—’–‹‘‘ˆƒŽ…‘Š‘Ž‹…”‡ƒ•‡•”‹•‘ˆ…ƒ…‡”•‘ˆ–Š‡‘”ƒŽ…ƒ˜‹–›ǡ’Šƒ”›šǡ‡•‘’Šƒ‰—•

ƒ†Žƒ”›šǤ–’”‘„ƒ„Ž›ƒŽ•‘‹…”‡ƒ•‡•”‹•‘ˆ…ƒ…‡”•‘ˆ–Š‡•–‘ƒ…Šǡ„‘™‡Žǡ”‡…–—ǡŽ‹˜‡”ǡ„”‡ƒ•–ƒ†‘˜ƒ”›Ǥ Priority areas for action

‹Ǥ ƒ‹•‡ƒ™ƒ”‡‡••‘Šƒ”ˆ—Ž‡ơ‡…–•‘ˆƒŽ…‘Š‘Žƒ†‹–•”‡Žƒ–‹‘•Š‹’™‹–Š…ƒ…‡”Ǥ

‹‹Ǥ ‡†—…‡‡š’‘•—”‡–‘ƒŽ…‘Š‘Žƒ†˜‡”–‹•‹‰Ǥ

‹‹‹Ǥ ”‘‘–‡Š‡ƒŽ–Š™ƒ”‹‰•‘ƒŽ…‘Š‘Ž„‡˜‡”ƒ‰‡•ƒ„‘—––Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ƒŽ…‘Š‘Žƒ†…ƒ…‡”Ǥ

‹˜Ǥ …”‡ƒ•‡–ƒšƒ–‹‘‘ƒŽ…‘Š‘Ž’”‘†—…–•Ǥ

Strategic Objective 1.6: Reduce the number of people developing occupational-related cancers

—„‡”‘ˆ…ƒ•‡•‘ˆ‘……—’ƒ–‹‘ƒŽ…ƒ…‡”‘……—”‡ƒ…Š›‡ƒ”‹ƒœƒ‹ƒǡŠ‘™‡˜‡”ǡ’”‘’‡”†‘…—‡–ƒ–‹‘‘ˆ–Š‡…ƒ•‡•

ˆ‘”…ƒ—•ƒŽǦŽ‹Šƒ•‘–„‡‡†‘‡Ǥ‡‰—Žƒ–‹‘•ƒ”‡‹’Žƒ…‡–‘’”‘–‡…–™‘”‡”•ƒ‰ƒ‹•–ƒ›‘™…ƒ”…‹‘‰‡•Ǥ

Š‡……—’ƒ–‹‘ƒŽƒˆ‡–›ƒ†‡ƒŽ–Š—–Š‘”‹–›‹•”‡•’‘•‹„Ž‡ˆ‘”‡•—”‹‰–Šƒ––Š‡Ž‡‰‹•Žƒ–‹˜‡’”‘–‡…–‹‘ˆ‘”™‘”‡”•

‹•—’Š‡Ž†‹™‘”’Žƒ…‡•Ǥ —”–Š‡”‡ơ‘”–•ƒ†ƒ…–‹‘•ƒ”‡”‡“—‹”‡†–‘‹†‡–‹ˆ›‘–Š‡”’‘–‡–‹ƒŽ…ƒ”…‹‘‰‡•ǡ†‡˜‡Ž‘’

•–”ƒ–‡‰‹‡•–‘”‡†—…‡™‘”‡”•ǯ‡š’‘•—”‡ǡƒ†Š‡…‡”‡†—…‡–Š‡‹…‹†‡…‡‘ˆ‘……—’ƒ–‹‘ƒŽ…ƒ…‡”•‹–Š‡ˆ—–—”‡Ǥ Priority areas for action

‹Ǥ –”‡‰–Š‡ƒ†‡ˆ‘”…‡–Š‡Ž‡‰ƒŽˆ”ƒ‡™‘”†‡•‹‰‡†–‘’”‘–‡…–™‘”‡”•ƒ‰ƒ‹•–…ƒ”…‹‘‰‡‹……‘’‘—†•

GOAL 2: EARLY DETECTION (Screening and Diagnosis): •—”‡‡ơ‡…–‹˜‡•…”‡‡‹‰ǡ‡ƒ”Ž›†‡–‡…–‹‘ƒ††‹ƒ‰‘•‹•

–‘”‡†—…‡…ƒ…‡”‹…‹†‡…‡ƒ†‘”–ƒŽ‹–›

Key strategies:

Strategic Objective 2.1: Provide at a national level a systematic approach to cancer screening and early

†‡–‡…–‹‘–‘‡•—”‡“—ƒŽ‹–›ǡƒ……‡’–ƒ„‹Ž‹–›ƒ†‡ơ‡…–‹˜‡‡••

Priority areas for action

‹Ǥ ‡ơ‡…–‹˜‡ƒ–‹‘ƒŽ‡…Šƒ‹•ǡ•—…Šƒ•ƒƒ–‹‘ƒŽ…ƒ…‡”•…”‡‡‹‰…‘‹––‡‡ǡ‹•‡‡†‡†–‘’”‘˜‹†‡

Š‹‰ŠǦŽ‡˜‡Ž•–”ƒ–‡‰‹…‘˜‡”•‹‰Š–‘ˆ‡š‹•–‹‰ƒ†’‘–‡–‹ƒŽ…ƒ…‡”•…”‡‡‹‰Ǥ

Strategic Objective 2.2: Establish a process to assess the value of early detection of cancer other than that obtained through organized screening

Š‡”‡‹•‡˜‹†‡…‡–Šƒ–•—”˜‹˜ƒŽˆ”‘•‘‡…ƒ…‡”•ƒ›„‡‹’”‘˜‡†„›‡ƒ”Ž›†‡–‡…–‹‘ƒ†–”‡ƒ–‡–ƒ†–Šƒ–

Priority areas for action

‹Ǥ ‘‹†‡–‹ˆ›ƒ†‹’Ž‡‡–•–”ƒ–‡‰‹‡•–‘”‡†—…‡†‡Žƒ›•‹†‹ƒ‰‘•‹•ƒ†–”‡ƒ–‡–™Š‡”‡–Š‡•‡ƒ”‡•Š‘™

–‘„‡‡ơ‡…–‹˜‡‹”‡†—…‹‰‘”–ƒŽ‹–›ƒ†‘”„‹†‹–›ˆ”‘•‡Ž‡…–‡†…ƒ…‡”•ǤŠ‡•‡•–”ƒ–‡‰‹‡•™‘—Ž†‹…Ž—†‡ǣ Ȉ ˆ‘”ƒŽ ƒ••‡••‡– ‘ˆ –Š‡ ”‡ƒ•‘• ˆ‘” †‡Žƒ›• ‹ ‡ƒ”Ž› †‡–‡…–‹‘ ‘ˆ –Š‡•‡ …ƒ…‡”• ‹ ƒœƒ‹ƒǡ

ˆ‘…—•‹‰‘™Š‘‹•ƒơ‡…–‡†ƒ†™Š›

ȈŠ‡‹’Ž‡‡–ƒ–‹‘‘ˆ’”‘‰”ƒ•–‘‘˜‡”…‘‡–Š‡†‡Žƒ›•, ƒ†–Š‡‡˜ƒŽ—ƒ–‹‘‘ˆ–Š‡‹”‡ơ‡…–‹˜‡‡••

Strategic Objective 2.3: Educate health care providers about strategies to encourage patients about the importance of yearly physical examinationǤ

Priority areas for action

‹Ǥ ‡˜‡Ž‘’•‹’Ž‡ƒ—ƒŽ•–‘–”ƒ‹Š‡ƒŽ–Š…ƒ”‡’”‘˜‹†‡”•

‹‹Ǥ ‹••‡‹ƒ–‡ƒ—ƒŽ•–‘–ƒ”‰‡–‡†’‡”•‘•

‹‹‹Ǥ ƒ…‹Ž‹–ƒ–‡’”‘˜‹†‡”•–‘ƒ†˜‘…ƒ–‡–Š‡•–”ƒ–‡‰‹‡•

Strategic Objective 2.4: Develop and disseminate educational material on the importance of screening and early detection targeted at entire population with more emphasis to rural and vulnerable groups.

Priority areas for actions

‹Ǥ ‡˜‡Ž‘’•‹’Ž‡’‘•–‡”•ȀŽ‡ƒƪ‡–•–‘ƒ†˜‘…ƒ–‡–Š‡‹’‘”–ƒ…‡‘ˆ•…”‡‡‹‰ƒ†‡ƒ”Ž›†‡–‡…–‹‘‘ˆ…ƒ…‡”•

‹‹Ǥ ‹••‡‹ƒ–‡ƒ–‡”‹ƒŽ•–‘–ƒ”‰‡–‡†’‘’—Žƒ–‹‘

‹‹‹Ǥ ƒ…‹Ž‹–ƒ–‡ƒ†˜‘…ƒ…›‘ˆ…ƒ…‡”•…”‡‡‹‰

Strategic Objective 2.5: Adopt available local/ international Cancer Screening Programs to create a National Cancer Screening Program for early detection of cancers for which treatment exists.

Priority areas for actions

‹Ǥ ‡˜‡Ž‘’ƒƒ–‹‘ƒŽ…”‡‡‹‰‘†‡Žˆ‘”‡ƒ”Ž›†‡–‡…–‹‘‘ˆ…ƒ…‡”•

‹‹Ǥ ‡˜‡Ž‘’ƒƒ–‹‘ƒŽ…”‡‡‹‰”‘‰”ƒˆ‘”‡ƒ”Ž›†‡–‡…–‹‘‘ˆ†‹ơ‡”‡–…ƒ…‡”•

‹‹‹Ǥ ƒ…‹Ž‹–ƒ–‡’”‘…‡••‘ˆ’”‘‰”ƒƒ’’”‘˜ƒŽ

‹˜Ǥ ‹••‡‹ƒ–‡ƒ–‡”‹ƒŽ•–‘–ƒ”‰‡–‡†•–‹–—–‹‘•

Strategic Objective 2.6: Collaborate with employers to promote cancer early detection, screening and treatment among their employees.

Priority areas for actions

‹Ǥ ˆ‘”…‡ƒ–‹‘ƒŽ…”‡‡‹‰’”‘‰”ƒƒ–™‘”’Žƒ…‡

‹‹Ǥ ‘‹–‘”ƒ†‡˜ƒŽ—ƒ–‡–Š‡‡ơ‡…–‹˜‡‡••‘ˆ–Š‡’”‘‰”ƒƒ––Š‡•‡…–‘”ƒŽŽ‡˜‡Ž

Strategic Objective 2.7: Implement patient and provider reminders and prompts to increase breast and cervical cancer screening rates.

Priority areas for actions

͕Ǥ ‡˜‡Ž‘’…‘’”‡Š‡•‹˜‡‰—‹†‡Ž‹‡•ˆ‘”’ƒ–‹‡–ƒ†’”‘˜‹†‡””‡‹†‡”•

Key strategies:

Strategic Objective 3.1: Provide optimal treatment for those with cancer

’–‹‹œ‹‰•—”˜‹˜ƒŽƒ†“—ƒŽ‹–›‘ˆŽ‹ˆ‡ˆ‘”–Š‘•‡™‹–Š…ƒ…‡”ǡ‡ƒ•Šƒ˜‹‰ƒ……‡••–‘–”‡ƒ–‡–™Š‹…Š‘–Š‡„ƒ•‹• Priority areas for action

͕Ǥ •—”‹‰ƒ˜ƒ‹Žƒ„‹Ž‹–›‘ˆ–”‡ƒ–‡–ˆƒ…‹Ž‹–‹‡•‹œ‘ƒŽ…‘•—Ž–ƒ–Š‘•’‹–ƒŽ•

Š‡ƒ’’Ž‹…ƒ–‹‘‘ˆ‰—‹†‡Ž‹‡•ƒ†’”‘–‘…‘Ž•‹–Š‹•…‘—–”›™‘—Ž†„‡ƒ’”ƒ…–‹…ƒŽƒ†„‡‡Ƥ…‹ƒŽƒ’’”‘ƒ…ŠǤŠ‡”‡ƒ”‡ Priority areas for action

͕Ǥ Š‡†‡˜‡Ž‘’‡–ǡ‹’Ž‡‡–ƒ–‹‘ƒ†‘‰‘‹‰”‡Ƥ‡‡–‘ˆ”‡‰‹‘ƒŽƒ†

ƒ–‹‘ƒŽ•–ƒ†ƒ”†•ǡ‰—‹†‡Ž‹‡•ƒ†’”‘–‘…‘Ž•

͖Ǥ —Ž–‹†‹•…‹’Ž‹ƒ”›ƒ’’”‘ƒ…Š‡•–‘–”‡ƒ–‡–ƒ†…ƒ”‡

͗Ǥ Š‡†‡˜‡Ž‘’‡–‘ˆƒ‹‹ƒŽ†ƒ–ƒ•‡––‘‡ƒ•—”‡’‡”ˆ‘”ƒ…‡ƒ†‘—–…‘‡Ǥ

Strategic Objective 3.3: Provide people experiencing cancers access to the best available drugs, surgery and treatment procedures

ƒ…‡”–”‡ƒ–‡––‡…Š‘Ž‘‰‹‡•‹…Ž—†‡’”‘…‡†—”‡•ˆ‘”†‹ƒ‰‘•‹•ƒ†•–ƒ‰‹‰ȋ”ƒ†‹‘Ž‘‰›ƒ†’ƒ–Š‘Ž‘‰›Ȍǡ•—”‰‡”›ǡ Priority areas for action

‹Ǥ ‡˜‡Ž‘’ƒƒ–‹‘ƒŽŽ›…‘‘”†‹ƒ–‡†ƒ†…‘•‹•–‡–’”‘…‡••ˆ‘”‹–”‘†—…‹‰‡™–”‡ƒ–‡––‡…Š‘Ž‘‰‹‡•ƒ†

Goal 4 [Palliative Care]: Improve quality of life for those living with, recovering from and dying of cancer and their families through support, rehabilitation and palliative care

˜‹†‡…‡•Š‘™•–Šƒ–™Š‡’‡‘’Ž‡‡š’‡”‹‡…‹‰…ƒ…‡””‡…‡‹˜‡‰‘‘†•‘…‹ƒŽƒ†’•›…Š‘Ž‘‰‹…ƒŽ•—’’‘”–ǡ–Š‡‹”“—ƒŽ‹–›

‘ˆŽ‹ˆ‡‹’”‘˜‡•Ǥ‘”†‡”–‘ƒ…Š‹‡˜‡–Š‡„‡•–’‘••‹„Ž‡‘—–…‘‡ˆ‘”’‡‘’Ž‡Ž‹˜‹‰™‹–Šǡ”‡…‘˜‡”‹‰ˆ”‘ǡ‘”†›‹‰‘ˆ

…ƒ…‡”ǡ‡˜‡”›ƒ•’‡…–‘ˆ–Š‡‹”…ƒ…‡”–”‡ƒ–‡–ƒ†…ƒ”‡—•–”‡…‘‰‹œ‡–Šƒ–’‡”•‘ǯ•–‘–ƒŽ‡‡†•ǤŠ‡‹”’Š›•‹…ƒŽǡ

•‘…‹ƒŽǡ’•›…Š‘Ž‘‰‹…ƒŽǡ—–”‹–‹‘ƒŽǡ‹ˆ‘”ƒ–‹‘ƒ†•’‹”‹–—ƒŽ‡‡†•ƒ”‡ƒŽŽ‡“—ƒŽŽ›‹’‘”–ƒ–Ǥ

Strategic Objective 4.1: Improve the quality of life of people with life-threatening cancer and those for whom

–”‡ƒ–‡–‹•‘Ž‘‰‡”‡ơ‡…–‹˜‡

Priority areas for action

‹Ǥ •—”‡’‘Ž‹…›ˆ‘”—Žƒ–‹‘ˆ‘”’ƒŽŽ‹ƒ–‹˜‡…ƒ”‡•‡”˜‹…‡•‹–Š‡…‘—–”›

‹‹Ǥ •—”‡ƒ˜ƒ‹Žƒ„‹Ž‹–›‘ˆ–”ƒ‹‹‰’”‘‰”ƒˆ‘”’ƒŽŽ‹ƒ–‹˜‡…ƒ”‡ˆ‘”Š‡ƒŽ–Š™‘”‡”•

‹‹‹Ǥ •—”‡ƒ˜ƒ‹Žƒ„‹Ž‹–›‘ˆ’ƒŽŽ‹ƒ–‹˜‡…ƒ”‡–‡ƒ•ƒ†•‡”˜‹…‡•‹ƒŽŽ”‡‰‹‘ƒŽƒ††‹•–”‹…–Š‘•’‹–ƒŽ•

‹˜Ǥ •—”‡ƒ˜ƒ‹Žƒ„‹Ž‹–›‘ˆŠ‘‡Ǧ„ƒ•‡†’ƒŽŽ‹ƒ–‹˜‡…ƒ”‡•‡”˜‹…‡•

Strategic Objective 4.2: Ensure availability of oral morphine and other symptoms control medicines for patients with care in all regional and district hospitals

”ƒŽ‘”’Š‹‡‹•‡••‡–‹ƒŽˆ‘”…‘–”‘ŽŽ‹‰’ƒ‹‡•’‡…‹ƒŽŽ›ƒ‘‰’ƒ–‹‡–•™‹–Šƒ†˜ƒ…‡†…ƒ…‡”•Ǥ Priority areas for action

͕Ǥ •—”‡’‘Ž‹…›ˆ‘”—Žƒ–‹‘ˆ‘”‘”ƒŽ‘”’Š‹‡ƒ˜ƒ‹Žƒ„‹Ž‹–›‹–Š‡…‘—–”›

͖Ǥ •—”‡–”ƒ‹‹‰‘–Š‡—•‡‘ˆ‘”ƒŽ‘”’Š‹‡ƒ‘‰’”‹ƒ”›Š‡ƒŽ–Š…ƒ”‡™‘”‡”•

͗Ǥ •—”‡‘”ƒŽ‘”’Š‹‡‹•ƒ……‡••‡†„›ƒŽŽ’ƒ–‹‡–•‹‡‡†

Strategic Objective 4.3: Improve return to work and quality of life of cancer patients through systematic assessment and appropriate multidisciplinary intervention for their social and vocational needs

„‘—–͖͔Ψ‘ˆ’‡‘’Ž‡™‹–Š…ƒ…‡”™‹ŽŽ„‡Ž‘‰Ǧ–‡”•—”˜‹˜‘”•ǡƒ›‘ˆ–Š‡‘ˆ™‘”‹‰ƒ‰‡Ǥƒ›™‹ŽŽ™ƒ––‘

Priority areas for action

‹Ǥ ‡˜‡Ž‘’‹‹–‹ƒŽ•…”‡‡‹‰–‘‘Ž™‹–ŠǮ–”‹‰‰‡”•ǯ–‘ƒ••‡••–Š‡˜‘…ƒ–‹‘ƒŽ”‡Šƒ„‹Ž‹–ƒ–‹‘‡‡†•‘ˆ…ƒ…‡”’ƒ–‹‡–•Ǥ

‹‹Ǥ ‡˜‡Ž‘’ƒ˜‘…ƒ–‹‘ƒŽ’Žƒ–Šƒ–‹…Ž—†‡•”‡ƒŽ‹•–‹…‰‘ƒŽ•ǡ–‹‡Ž‹‡•ƒ†‘—–…‘‡•ˆ‘”ƒŽŽ’ƒ”–‹…‹’ƒ–•Ǥ

‹‹‹Ǥ †‡”–ƒ‡ƒ…ƒ’ƒ‹‰‘ˆ’—„Ž‹…‡†—…ƒ–‹‘ƒ††‹••‡‹ƒ–‹‘‘ˆ‹ˆ‘”ƒ–‹‘–‘ƒ††”‡••‹••—‡•”‡Žƒ–‹‰–‘

†‹•…”‹‹ƒ–‹‘ƒ†‘–Š‡”’‘–‡–‹ƒŽ„ƒ””‹‡”•–‘”‡–—”‹‰–‘™‘”Ǥ

Strategic Objective 4.4: Ensure all survivors of childhood cancer receive timely and ongoing support and

”‡Šƒ„‹Ž‹–ƒ–‹‘ǡ‹…Ž—†‹‰‡ƒ”Ž›‹†‡–‹Ƥ…ƒ–‹‘‘ˆƒ†‹–‡”˜‡–‹‘‹Žƒ–‡‡ơ‡…–•

Priority areas for action

‹Ǥ Š‡ ‹‹•–”‹‡• ‘ˆ ‡ƒŽ–Š ƒ† †—…ƒ–‹‘ǡ ‹ …‘ŽŽƒ„‘”ƒ–‹‘ ™‹–Š ”‡Ž‡˜ƒ– ‡› •–ƒ‡Š‘Ž†‡”•ǡ •Š‘—Ž† ™‘”

…‘‘’‡”ƒ–‹˜‡Ž› –‘ ‘˜‡”•‡‡ –Š‡ †‡˜‡Ž‘’‡– ‘ˆ ƒ–‹‘ƒŽ ‰—‹†‡Ž‹‡• ˆ‘” –Š‡ •—’’‘”– ƒ† ”‡Šƒ„‹Ž‹–ƒ–‹‘ ‘ˆ

…Š‹Ž†”‡ƒ†ƒ†‘Ž‡•…‡–•™‹–Š…ƒ…‡”Ǥ

‹‹Ǥ ’’”‘’”‹ƒ–‡‡†—…ƒ–‹‘ƒŽƒ†‘Ǧ‰‘˜‡”‡–•‡”˜‹…‡••Š‘—Ž†‹’Ž‡‡––Š‡•‡‰—‹†‡Ž‹‡•Ǥ

GOAL 5: CANCER REGISTRATION AND SURVEILLANCE:- Improve collection and analysis of information across Key strategies:

”‘‘–‡’‘Ž‹…‹‡•ˆ‘”…ƒ…‡”‘–‹Ƥ…ƒ–‹‘‹–Š‡…‘—–”›

•—”‡–”ƒ‹‹‰ˆ‘”…ƒ…‡””‡‰‹•–”ƒ”•

”‘‘–‡‡•–ƒ„Ž‹•Š‡–‘ˆŠ‘•’‹–ƒŽǦ„ƒ•‡†…ƒ…‡””‡‰‹•–”‹‡•

”‘‘–‡‡•–ƒ„Ž‹•Š‡–‘ˆ’‘’—Žƒ–‹‘Ǧ„ƒ•‡†…ƒ…‡””‡‰‹•–”‹‡•‹…Ž—†‹‰ƒ–‹‘ƒŽ…ƒ…‡””‡‰‹•–”›

Strategic Objective 5.1: To establish hospital-based and population-based cancer registries in consultant hospitals and regions respectively.

‘’—Žƒ–‹‘Ǧ„ƒ•‡†…ƒ…‡””‡‰‹•–”›ȋȌ…‘ŽŽ‡…–•ƒ†’”‘…‡••‡•†ƒ–ƒ”‡Žƒ–‹‰–‘ƒ†‡Ƥ‡†’‘’—Žƒ–‹‘Ȁ‰‡‘‰”ƒ’Š‹…ƒŽ Priority areas for actions:

‹Ǥ •–ƒ„Ž‹•Š–”ƒ‹‹‰…‡–”‡ƒ†…—””‹…—Žƒˆ‘”…ƒ…‡””‡‰‹•–”ƒ–‹‘‹ƒœƒ‹ƒ

Strategic Objective 5.2: To establish a national cancer data collection and reporting

ƒ–ƒ …‘ŽŽ‡…–‡† ˆ‘” –Š‡ ƒ…‡” ‡‰‹•–”› Šƒ• …‘•‹†‡”ƒ„Ž‡ ’‘–‡–‹ƒŽ ˆ‘” –”ƒ…‹‰ –Š‡ •–ƒ„Ž‹•Š‹‰ ƒ ƒ–‹‘ƒŽŽ›

‘—–‹‡…‘ŽŽ‡…–‹‘ƒ†ƒƒŽ›•‹•‘ˆ‘”‡…‘’”‡Š‡•‹˜‡…ƒ…‡”†ƒ–ƒ…‘—Ž†„‡—•‡†–‘ƒ••‡••Š‘™…—””‡–’‘Ž‹…‹‡•ǡ

•‡”˜‹…‡•ƒ†–”‡ƒ–‡–’”‘‰”ƒ•ƒ”‡‹’ƒ…–‹‰‘…ƒ…‡”ǡƒ†„‡ƒŽ•‘—•‡†–‘‹†‡–‹ˆ›™Š‡”‡…Šƒ‰‡••Š‘—Ž†„‡

ƒ†‡ƒ†–‘‡ƒ•—”‡–Š‡‹’ƒ…–‘ˆ–Š‡•‡…Šƒ‰‡•Ǥ Priority areas for action

‹Ǥ •—”‡‡•–ƒ„Ž‹•Š‡–‘ˆ’‘Ž‹…›ˆ‘”…ƒ…‡”‘–‹Ƥ…ƒ–‹‘‹–Š‡Š‘•’‹–ƒŽ•Ȁ…‘—–”› education and research

Š‡‘™Ž‡†‰‡”‡“—‹”‡†ˆ‘”‡ơ‡…–‹˜‡…ƒ…‡”…‘–”‘Ž‘”‹‰‹ƒ–‡•‹–Š”‡‡„”‘ƒ†–›’‡•‘ˆ‘™Ž‡†‰‡Ǧ‰‡‡”ƒ–‹‰

ˆƒ…‹Ž‹–ƒ–‡•…”‡‡‹‰ǡƒ†‹’”‘˜‡…ƒ”‡ƒ†–Š‡“—ƒŽ‹–›‘ˆŽ‹ˆ‡Ǥ–’”‘˜‹†‡•ƒ•™‡”•–‘–Š‡ˆ‘ŽŽ‘™‹‰ǣWhat population

•—„‰”‘—’•Šƒ˜‡Š‹‰Š‡”…ƒ…‡””‹••ǫŠ‹…Š–›’‡•‘ˆ…ƒ…‡”Šƒ˜‡‰”‡ƒ–‡”‹’ƒ…–ǫ‘™™‡ŽŽƒ”‡™‡’”‡˜‡–‹‰…ƒ…‡”

‹…‹†‡…‡ƒ†…‘–”‘ŽŽ‹‰…ƒ…‡”’”‘‰”‡••‹‘ǫ

Š‡•‡–Š”‡‡ƒ…–‹˜‹–‹‡•ƒ”‡–Š‡‡›‹’—–•–‘‘™Ž‡†‰‡•›–Š‡•‹•ǡƒ†–Š‡’”‘†—…–‹‘‘ˆ–Š‡‡˜‹†‡…‡‡‡†‡†ˆ‘”

‡ơ‡…–‹˜‡’”‡˜‡–‹‘ƒ†…‘–”‘Ž‘ˆ…ƒ…‡”Ǥ‘™Ž‡†‰‡•›–Š‡•‹•Š‡Ž’•–‘ƒ•™‡”ǣŠƒ–ƒ…–‹‘•ƒ”‡‡‡†‡†‘™ǫ

Š—•ǡ”‡•‡ƒ”…ŠƒŽŽ‘™•–Š‡†‡˜‡Ž‘’‡–‘ˆ‡˜‹†‡…‡Ǧ„ƒ•‡†’”‹‘”‹–‹‡•ˆ‘”…ƒ…‡”…‘–”‘ŽǤ Key strategies:

…‘”’‘”ƒ–‡…ƒ…‡””‡•‡ƒ”…Š‹ˆ‘”ƒ–‹‘‹–‘Š‡ƒŽ–Š…ƒ”‡’”‘ˆ‡••‹‘ƒŽ–”ƒ‹‹‰’”‘‰”ƒ•Ǥ

Strategic Objective 6.1: Extend and enhance research across the continuum of cancer control

Š‡”‡‹•ƒ’ƒ”–‹…—Žƒ”‡‡†ˆ‘”‹…”‡ƒ•‡†•‘…‹ƒŽǡ„‡Šƒ˜‹‘”ƒŽǡ‡˜‹”‘‡–ƒŽǡƒ†’•›…Š‘Ž‘‰‹…ƒŽƒ†Š‡ƒŽ–Š•‡”˜‹…‡•

–’”‡•‡––Š‡”‡‹•‘•‹‰Ž‡„‘†›”‡•’‘•‹„Ž‡ˆ‘”‹†‡–‹ˆ›‹‰ƒ†”‡‡†›‹‰‰ƒ’•‹–Š‡•’‡…–”—‘ˆ…ƒ…‡””‡•‡ƒ”…Š

‹ƒœƒ‹ƒǤŠ—•ǡ–Š‡”‡‹•ƒ‡‡†–‘‡•–ƒ„Ž‹•Šƒ•–”ƒ–‡‰‹…ƒ†…‘–‹—‹‰’”‘…‡••ˆ‘”‘˜‡”•‡‡‹‰ƒ†ˆƒ…‹Ž‹–ƒ–‹‰

…ƒ…‡””‡•‡ƒ”…Šǡ–‘’”‘˜‹†‡ƒǮˆ”‘”‡•‡ƒ”…Š–‘’‘Ž‹…›’”ƒ…–‹…‡ǯ’‡”•’‡…–‹˜‡ˆ‘”ƒȋƒƒ†‹ƒ–”ƒ–‡‰›ˆ‘”

ƒ…‡”‘–”‘Ž͖͔͔͕ȌǤ Priority areas for action

͕Ǥ Š‡†‡˜‡Ž‘’‡–‘ˆƒ•–”ƒ–‡‰‹…ƒ†”‡‰—Žƒ”’”‘…‡••ˆ‘”ˆƒ…‹Ž‹–ƒ–‹‰”‡•‡ƒ”…Š”‡Ž‡˜ƒ––‘…ƒ…‡”…‘–”‘Ž‹

ƒœƒ‹ƒ

͖Ǥ •—”‡‰‘˜‡”‡–ˆ—†‹‰ˆ‘”…ƒ…‡””‡•‡ƒ”…Šǡ–”ƒ‹‹‰ƒ†‡†—…ƒ–‹‘

Strategic Objective 6.2: To establish cancer education and training programs

ƒœƒ‹ƒŠƒ•ƒ•Š‘”–ƒ‰‡‘ˆ…ƒ…‡”‡š’‡”–•‹Ǥ‡Ǥ‘…‘Ž‘‰‹•–•ȋ™Š‘–”‡ƒ–…ƒ…‡”’ƒ–‹‡–•Ȍƒ†’ƒ–Š‘Ž‘‰‹•–•ȋ™Š‘

†‹ƒ‰‘•‡…ƒ…‡”Ȍƒ†‘…‘Ž‘‰›—”•‡•™Š‘‰‹˜‡—”•‹‰…ƒ”‡Ǥ”ƒ‹‹‰‹‘…‘Ž‘‰›‹••–‹ŽŽ„‡‹‰”‡‰ƒ”†‡†ƒ•ƒ

•—’‡”•’‡…‹ƒŽ–›‹‘•–Ƥ‡Ž†•‹‡†‹…‹‡Ȃ•—…Šƒ•‰›‡…‘Ž‘‰‹…ƒŽ‘…‘Ž‘‰›ǡ‡†‹…ƒŽ‘…‘Ž‘‰›ǡ’‡†‹ƒ–”‹…‘…‘Ž‘‰›ǡ

‡‡†‹‰•‘‡‘‡–‘•’‡…‹ƒŽ‹œ‡‹‘–Š‡”†‹•…‹’Ž‹‡•Ƥ”•–„‡ˆ‘”‡•—’‡”Ǧ•’‡…‹ƒŽ‹œ‹‰‹‘…‘Ž‘‰›Ǥ Priority areas for action

‹Ǥ ƒ…‹Ž‹–ƒ–‡–”ƒ‹‹‰•ˆ‘”…ƒ†‹†ƒ–‡•‹–‡”‡•–‡†‹–Š‡Ƥ‡Ž†•‘ˆ‘…‘Ž‘‰›‹‘˜‡”•‡ƒ•—‹˜‡”•‹–‹‡•ƒ†…‘ŽŽ‡‰‡•

areas of cancer control in Tanzania

Š‡”‡‹•ƒ’”‡••‹‰‡‡†–‘†‡˜‡Ž‘’ƒ†‹’Ž‡‡–ƒƒ–‹‘ƒŽŽ›…‘‘”†‹ƒ–‡†…ƒ…‡”…‘–”‘ŽŠ—ƒ”‡•‘—”…‡•’Žƒ

‹–Š”ƒ‹•‹‰ƒ™ƒ”‡‡••ƒ†•‡•‹–‹œƒ–‹‘ǡ†‡ƒ†ˆ‘”…ƒ…‡”ƒƒ‰‡‡–™‹ŽŽ‹…”‡ƒ•‡Ǥ–‹•‹’‡”ƒ–‹˜‡–Šƒ–ƒ

…‘‘”†‹ƒ–‡† ƒ† …‘’”‡Š‡•‹˜‡ •–”ƒ–‡‰‹… ƒ’’”‘ƒ…Š ‹• –ƒ‡ –‘ “—ƒ–‹ˆ› ‰ƒ’• ‹ Š—ƒ ”‡•‘—”…‡ ”‡“—‹”‡‡–

ƒ…”‘•• –Š‡ „‘ƒ”† –‘ …ƒ–‡” ˆ‘” …ƒ…‡” …‘–”‘Ž •‡”˜‹…‡•ǡ †‡–‡”‹‡ ˆ—–—”‡ •–ƒƥ‰ ”‡“—‹”‡‡–• ƒ† ‡•—”‡ –Šƒ–

‡†—…ƒ–‹‘ƒ†–”ƒ‹‹‰”‡•‘—”…‡•ƒ”‡ƒ˜ƒ‹Žƒ„Ž‡–‘ƒ–…Š–Š‘•‡‡‡†•Ǥ Priority areas for action

‹Ǥ ‡•‹–‹œ‹‰‘ˆŠ‡ƒŽ–Š™‘”ˆ‘”…‡ƒ–ƒŽŽŽ‡˜‡Ž•‘–Š‡ƒ‰‹–—†‡‘ˆ…ƒ…‡”

‹‹Ǥ –”‘†—…‹‰‹Ǧ•‡”˜‹…‡–”ƒ‹‹‰ƒ–‡ƒ…ŠŽ‘…ƒŽ‹–›

‹‹‹Ǥ ”‘‘–‹‰ƒ†•–”‡‰–Š‡‹‰…ƒ…‡”–”ƒ‹‹‰…—””‹…—Ž—‹ƒŽŽŠ‡ƒŽ–Š…ƒ”‡–”ƒ‹‹‰‹•–‹–—–‹‘•

‹˜Ǥ ‡˜‹•‹‰‡…Šƒ‹•ˆ‘””‡–‡–‹‘‘ˆ•’‡…‹ƒŽ‹•–…ƒ†”‡•

–”ƒ–‡‰‹…„Œ‡…–‹˜‡͛Ǥ͕ǣ†‡–‹Ƥ…ƒ–‹‘ƒ†ƒ–‹‘ƒŽ‹œƒ–‹‘‘ˆ…ƒ…‡”…‘–”‘Žƒ…–‹˜‹–‹‡•ƒ–†‹ơ‡”‡–Ž‡˜‡Ž•‘ˆ‡ƒŽ–Š

system in Tanzania.

Priority areas for action

‹Ǥ ‰”‡‡‘™Š‹…Š–ƒ••‘ˆ…ƒ…‡”…‘–”‘Ž…ƒ„‡…ƒ””‹‡†‘—–ƒ–™Šƒ–Ž‡˜‡Ž‘ˆƒœƒ‹ƒŠ‡ƒŽ–Š•›•–‡Ǥ

‹‹Ǥ ‡–‡”‹‡–Š‡ƒ’‘™‡”…ƒ’ƒ…‹–›ƒ†”‡“—‹”‡‡–•ƒ–‡ƒ…ŠŽ‡˜‡ŽǤ

–”ƒ–‡‰‹…„Œ‡…–‹˜‡͛Ǥ͖ǣ†‡–‹Ƥ…ƒ–‹‘‘ˆ–Š‡–”ƒ‹‹‰…ƒ’ƒ…‹–›ȋ…—””‹…—Ž—ƒ†Š—ƒ”‡•‘—”…‡Ȍ‘ˆƒŽŽŠ‡ƒŽ–Š

training Institutions.

Priority areas for action

‹Ǥ ‘†—…–•—”˜‡›‘ˆ–Š‡†‹ơ‡”‡–Š‡ƒŽ–Š”ƒ‹‹‰•–‹–—–‹‘•‹–Š‡…‘—–”›Ǥ

‹‹Ǥ ˜ƒŽ—ƒ–‡–Š‡‹”•›ŽŽƒ„—•‡•ƒ†•–ƒƥ‰ƒ‰ƒ‹•–ƒ…‡”…‘–”‘Žƒƒ‰‡‡––”ƒ‹‹‰‡‡†•Ǥ

‹‹‹Ǥ ’†ƒ–‹‰–Š‡›ŽŽƒ„—•‡•ƒ†Š—ƒ”‡•‘—”…‡•”‡“—‹”‡‡–•–‘…ƒ–‡”ˆ‘”

‹˜Ǥ Š‡‡‡†•‘ˆ–Š‡…ƒ†”‡•‹˜‘Ž˜‡†‹…ƒ…‡”…‘–”‘Žƒ†ƒƒ‰‡‡–Ǥ

Strategic Objective 7.3 Training and posting of the required workforce at each level Priority areas for action

‹Ǥ ‘†—…–”ƒ‹‹‰‡‡†•••‡••‡–Ǥ

Strategic Objective 7.4 Ensuring Recruitment and Retention of most of the trained personnel Priority areas for action

‹Ǥ ƒ–‹‘ƒŽ‹œ‡•…Š‡‡‘ˆ•‡”˜‹…‡ˆ‘”‡ƒŽ–Š‡”•‘‡Ž–‘‹…Ž—†‡ƒŽŽ…ƒ†”‡••’‡…‹Ƥ…ˆ‘”ƒ…‡”…‘–”‘Žƒ†

‘ƒŽ͜ȏƒœƒ‹ƒƒ…‡”‘…‹‡–›Ȑǣ•–ƒ„Ž‹•Š…ƒ…‡”•‘…‹‡–›–Šƒ–™‹ŽŽƒ†˜‘…ƒ–‡ˆ‘”ƒ†‡ơ‡…–‹˜‡Ž›’ƒ”–‹…‹’ƒ–‡‹

sustainable cancer control initiatives

ƒœƒ‹ƒ ƒ…‡” ••‘…‹ƒ–‹‘ ™ƒ• ‡•–ƒ„Ž‹•Š‡† ‹ ͕͕͝͝ ™‹–Š –Š‡ ’”‹‘”‹–› ‘ˆ ƒ†˜ƒ…‡‡– ƒ† †‹••‡‹ƒ–‹‘ ‘ˆ Key strategies:

”‘‘–‡ƒŽŽ‹ƒ…‡„‡–™‡‡•–Šƒ–™‘”‘…ƒ…‡”…‘–”‘Ž

”‘‘–‡ˆ—†Ǧ”ƒ‹•‹‰–‘•—’’‘”–…ƒ…‡”…‘–”‘Ž‹‹–‹ƒ–‹˜‡•

”‘‘–‹‘‘ˆ…ƒ…‡”ƒ™ƒ”‡‡••…ƒ’ƒ‹‰•

Priority areas for action

‹Ǥ ‘ŽŽƒ„‘”ƒ–‡™‹–Š–Š‡‹‹•–”›‘ˆ‡ƒŽ–Šƒ†‘…‹ƒŽ‡Žˆƒ”‡‹…‘†—…–‹‰…ƒ…‡”•‹–—ƒ–‹‘ƒƒŽ›•‹•‹ƒœƒ‹ƒ Strategic Objective 8.1 Mobilize resources

Priority areas for action

‹Ǥ ‘ ‘„‹Ž‹œ‡ ”‡•‘—”…‡• ‹ ’ƒ”–‡”•Š‹’ ™‹–Š ‡”‹…ƒ ƒ…‡” ‘…‹‡–› ȋȌ ˆ‘” ”‡Ǧ„—‹Ž†‹‰ –Š‡ ƒœƒ‹ƒ

ƒ…‡” ••‘…‹ƒ–‹‘ǡ ƒ ‘Ǧ‰‘˜‡”‡–ƒŽ ‘”‰ƒ‹œƒ–‹‘ †‡†‹…ƒ–‡† –‘ …‘—‹–› „ƒ•‡† …ƒ…‡” …‘–”‘Žǡ

‹…Ž—†‹‰’”‡˜‡–‹‘ƒ†‡ƒ”Ž›†‡–‡…–‹‘–‘ƒ……‡••–”‡ƒ–‡–ƒ†’ƒŽŽ‹ƒ–‹˜‡…ƒ”‡Ǥ Strategic Objective 8.2 Community participation

Priority areas for action

‹Ǥ ‘ ’”‘‘–‡ ‰‘‘† Š‡ƒŽ–Š ’”ƒ…–‹…‡• ƒ‘‰ ƒœƒ‹ƒ …‘—‹–‹‡• –Š”‘—‰Š …‘—‹–› •‡•‹–‹œƒ–‹‘ ƒ†

‘„‹Ž‹œƒ–‹‘

Strategic Objective 8.3 Provide seed grants Priority areas for action

‹Ǥ ‘’”‘˜‹†‡ƒ…‘’‡–‹–‹˜‡•‡‡†‰”ƒ––‘‡„‡”•‘ˆ–Š‡ƒœƒ‹ƒƒ…‡”••‘…‹ƒ–‹‘–‘Žƒ—…Šƒ…–‹˜‹–‹‡•

ƒ‹‡†ƒ–‘„‹Ž‹œ‹‰‹’”‘˜‡†…‘‘”†‹ƒ–‹‘‹…ƒ…‡”…‘–”‘Žƒ†„—‹Ž†‹‰–Š‡‰”ƒ••”‘‘–•ƒ†…‘—‹–›Ǧ

„ƒ•‡†”‡•’‘•‡–‘–Š‡Ƥ‰Š–ƒ‰ƒ‹•–…ƒ…‡”Ǥ

GOAL 9: INTEGRATION OF CANCER CONTROL INTO EXISTING HEALTH SYSTEM: Integrate cancer control interventions and services at all levels of the existing healthcare delivery system.

‘”†‡”–‘‡•—”‡‡ơ‡…–‹˜‡‹’Ž‡‡–ƒ–‹‘‘ˆ…ƒ…‡”…‘–”‘Ž’”‘‰”ƒ•ǡ‹–‡‰”ƒ–‹‘‹–‘–Š‡‡š‹•–‹‰Š‡ƒŽ–Š…ƒ”‡ Key strategies:

‹Ǥ †‡–‹ˆ›’ƒ…ƒ‰‡‘ˆ‹–‡”˜‡–‹‘•ƒ†•‡”˜‹…‡•–‘„‡‹–‡‰”ƒ–‡†ƒ–‡ƒ…ŠŽ‡˜‡Ž‹Ǥ‡Ǥƒ™ƒ”‡‡••…”‡ƒ–‹‘ǡ‡ƒ”Ž›

Strategic Objective 9.1: Revise and upgrade national level policies that reduce inequalities in respect to access to cancer care

Š‡™‹ŽŽ•‡–‘—––‘”‡†—…‡‹‡“—ƒŽ‹–‹‡•‹ƒ……‡••–‘…ƒ…‡”…ƒ”‡‹–Š‡Ƥ”•–‹•–ƒ…‡Ǥ‡‘ˆ–Š‡‘˜‡”‡–ǯ•

Strategic Objective 9.2: Integrate cancer control services into all levels of health care delivery

–‹•‹’‘”–ƒ––Šƒ–…ƒ…‡”…ƒ”‡•‡”˜‹…‡•–Šƒ–…ƒ„‡‹–‡‰”ƒ–‡†‹–‘ƒŽŽŽ‡˜‡Ž•‘ˆŠ‡ƒŽ–Š…ƒ”‡–Š”‘—‰Šƒ‹‹ƒŽ

’ƒ…ƒ‰‡ƒ”‡‹†‡–‹Ƥ‡†ƒ†‹’Ž‡‡–‡†ǤŠ‡•‡”˜‹…‡•–Šƒ–…ƒ„‡‹–‡‰”ƒ–‡†ƒ”‡–Š‘•‡–Šƒ–…ƒ—–‹Ž‹œ‡–Š‡Š—ƒ

”‡•‘—”…‡…ƒ’ƒ…‹–›ƒ†ˆƒ…‹Ž‹–‹‡•–Šƒ–ƒ”‡ƒ˜ƒ‹Žƒ„Ž‡ƒ––Š‡ƒ’’”‘’”‹ƒ–‡Ž‡˜‡Ž•Ǥ

Š‡•‡”˜‹…‡•–Šƒ–•Š‘—Ž†„‡‹–‡‰”ƒ–‡†‹–‘–Š‡Š‡ƒŽ–Š†‡Ž‹˜‡”›•›•–‡‹…Ž—†‡’”‹ƒ”›’”‡˜‡–‹‘ǡ‡ƒ”Ž›†‡–‡…–‹‘

ƒ††‹ƒ‰‘•‹•ǡ’ƒŽŽ‹ƒ–‹˜‡…ƒ”‡ƒ†…Š‡‘–Š‡”ƒ’›ˆ‘”…‡”–ƒ‹…ƒ…‡”–›’‡•

Strategic Objective 9.3: Integrate cancer services into other health care services

Š‡ƒƒ‰‡‡–‘ˆ…‡”–ƒ‹…ƒ…‡”–›’‡•…ƒ„‡‹–‡‰”ƒ–‡†‹–‘‘–Š‡”•‡”˜‹…‡•ƒŽ”‡ƒ†›‡•–ƒ„Ž‹•Š‡†‹–Š‡Š‡ƒŽ–Š

•›•–‡Ǥ ‘”‡šƒ’Ž‡ǡ–Š‡ƒƒ‰‡‡–‘ˆƒ’‘•‹ǯ••ƒ”…‘ƒ…ƒ„‡‹–‡‰”ƒ–‡†‹–‘…ƒ”‡ƒ†–”‡ƒ–‡–…‡–”‡•

™Š‹…Šƒ”‡Ž‘…ƒ–‡†‹‘•–ˆƒ…‹Ž‹–‹‡•…ƒ”‹‰ˆ‘”ȀǤ

͕͜ƒ–‹‘ƒŽ–”ƒ–‡‰›ˆ‘””‘™–Šƒ†‡†—…–‹‘‘ˆ‘˜‡”–›ǡ‹…‡”‡•‹†‡–ǯ•ƥ…‡ǡ͖͔͔͙

CHAPTER 3: INSTITUTIONAL AND MANAGEMENT FRAMEWORK

Coordination and Management Principles

Š‡ ‹•–‹–—–‹‘ƒŽ ƒ† ƒƒ‰‡‡– ˆ”ƒ‡™‘” ’”‘˜‹†‡• ‰—‹†ƒ…‡ ‘ Š‘™ ‹’Ž‡‡–ƒ–‹‘ ‘ˆ –Š‹• •–”ƒ–‡‰› ™‹ŽŽ

Coordination Framework

Š‡‰‘˜‡”‡––Š”‘—‰Š–Š‡”‹‡‹‹•–‡”ǯ•ƥ…‡ǡƒ†™‘—Ž††‘ƒŽŽ‹–…ƒ–‘…‘„ƒ––Š‡‹…”‡ƒ•‹‰

‘Ž‡•ƒ† —…–‹‘•‘ˆ–Š‡”‹‡‹‹•–‡”ǯ•ƥ…‡

Roles and Functions of the MoHSW

- ’‡ƒ”Š‡ƒ†‡•–ƒ„Ž‹•Š‡–‘ˆƒ–‹‘ƒŽƒ…‡”‘–”‘Ž”‘‰”ƒ

- •—”‹‰‘Ž‹–‹…ƒŽƒ†–‡…Š‹…ƒŽŽ‡ƒ†‡”•Š‹’ˆ‘”‹‹•–‡”‹ƒŽ”‡•’‘•‡Ǥ - ‡˜‡Ž‘’‹‰ƒ†”‡Ƥ‹‰–Š‡•–”ƒ–‡‰‹‡•ˆ‘”…ƒ…‡”…‘–”‘ŽǤ

- †˜‘…ƒ–‹‰ˆ‘”–Š‡’”‘˜‹•‹‘•‘ˆ’—„Ž‹…Ȁ’”‹˜ƒ–‡”‡•‘—”…‡•Ǥ - †˜‘…ƒ–‹‰ˆ‘”‹’Ž‡‡–ƒ–‹‘‘ˆ–Š‡•–”ƒ–‡‰‹‡•

Roles and Functions of ORCI

- •–ƒ„Ž‹•Š‘ˆƒ–‹‘ƒŽƒ…‡”•–‹–—–‡ˆ‘”ƒœƒ‹ƒƒ–Ž‘‰ƒœ‹Žƒ‘’Ž‡š

- ”‘˜‹†‡‡ƒ†‡”•Š‹’ƒ†…‘‘”†‹ƒ–‹‘ˆ‘”–Š‡‹’Ž‡‡–ƒ–‹‘‘ˆ–Š‡•–”ƒ–‡‰‹‡•Ǥ - ”‘˜‹†‡–‡…Š‹…ƒŽ•—’’‘”––‘‘–Š‡”•‡…–‘”•ƒ•–Š‡›†‡˜‡Ž‘’…ƒ…‡”…‘–”‘Žƒ…–‹˜‹–‹‡•Ǥ

- ‘‘”†‹ƒ–‡ƒ†’”‘˜‹†‡ƒ’’”‘’”‹ƒ–‡Š‡ƒŽ–ŠǦˆƒ…‹Ž‹–›„ƒ•‡†ƒ†Š‘‡Ǧ„ƒ•‡†•’‡…‹ƒŽ‹œ‡†…ƒ”‡ˆ‘”…ƒ…‡”

’ƒ–‹‡–•Ǥ

Roles and Functions of the Zonal Referral Level

- ‘‘”†‹ƒ–‡ƒ†’”‘˜‹†‡ƒ’’”‘’”‹ƒ–‡Š‡ƒŽ–ŠǦˆƒ…‹Ž‹–›„ƒ•‡†…ƒ”‡ˆ‘”…ƒ…‡”’ƒ–‹‡–•Ǥ - ••‹•–‹‡•–ƒ„Ž‹•Š‡–‘ˆ…ƒ…‡”–”‡ƒ–‡–…‡–‡”•‹–Š‡”‡ˆ‡””ƒŽŠ‘•’‹–ƒŽ•

- ”‘˜‹†‡ƒ’’”‘’”‹ƒ–‡‹ˆ”ƒ•–”—…–—”‡ˆ‘”…ƒ…‡””‡•‡ƒ”…Šƒ†–”ƒ‹‹‰

Roles and Functions of the Regional and District Level

- ’Ž‡‡– •—•–ƒ‹ƒ„Ž‡ ‹‘˜ƒ–‹˜‡ …ƒ…‡” …‘–”‘Ž ’”‘Œ‡…–• ƒ† ƒ…–‹˜‹–‹‡•ǡ ‹ Ž‹‡ ™‹–Š –Š‡ ’”‹‘”‹–‹‡• ‘ˆ –Š‡

…ƒ…‡”…‘–”‘Ž•–”ƒ–‡‰›Ǥ

- •—”‡‹–‡‰”ƒ–‹‘‘ˆ–Š‡…ƒ…‡”…‘–”‘Žƒ…–‹˜‹–‹‡•‹–‘–Š‡‡š‹•–‹‰Š‡ƒŽ–Š…ƒ”‡’ƒ…ƒ‰‡ƒ–”‡‰‹‘ƒŽƒ††‹•–”‹…–

Š‘•’‹–ƒŽ•

Roles and Functions of the Community Level

- ‘„‹Ž‹œ‡–Š‡…‘—‹–‹‡•ˆ‘”…ƒ…‡”…‘–”‘Žƒ…–‹˜‹–‹‡•™Š‹…Šƒ”‡ƒơ‘”†ƒ„Ž‡ƒ†•—•–ƒ‹ƒ„Ž‡Ǥ

Civil society Organizations, Private Sector, and Associations of People Living with Cancer

- ‘‘”†‹ƒ–‡ƒ‘‰–Š‡•‡Ž˜‡•ƒ•™‡ŽŽƒ•’ƒ”–‹…‹’ƒ–‹‰‹…‘‘”†‹ƒ–‡†ƒ…–‹˜‹–‹‡•–‘‹‹‹œ‡†—’Ž‹…ƒ–‹‘ƒ† Development Partners

- ‘„‹Ž‹œ‡”‡•‘—”…‡•ˆ‘”‹’Ž‡‡–ƒ–‹‘‘ˆ…ƒ…‡”…‘–”‘Ž’”‘‰”ƒ•ˆ‘”–Š‡…‘—–”›

- ••‹•–‹•—’’‘”–‹‰–”ƒ‹‹‰’”‘‰”ƒ•ˆ‘”…ƒ…‡”…‘–”‘ŽŠ‡ƒŽ–Š’‡”•‘‡Ž

- ”‘˜‹†‡–‡…Š‹…ƒŽ•—’’‘”–ˆ‘”…ƒ…‡”…‘–”‘Ž’”‘‰”ƒ•

From the National Cancer Control Strategy to its Implementation

Š‡‡š–•–‡’™‹ŽŽ„‡–Š‡†‡˜‡Ž‘’‡–‘ˆƒ‹’Ž‡‡–ƒ–‹‘’Žƒǡ™Š‹…Š™‹ŽŽ–”ƒ•Žƒ–‡–Š‡‰‘ƒŽ•ƒ†‘„Œ‡…–‹˜‡•

‘ˆ–Š‡•–”ƒ–‡‰›‹–‘ƒ…–‹‘•ǤŠ‡‹’Ž‡‡–ƒ–‹‘’Žƒ™‹ŽŽ‹†‡–‹ˆ›–Š‡ƒ…–‹‘•‡‡†‡†„›‰‘˜‡”‡–ƒ†‘Ǧ

‰‘˜‡”‡–•‡”˜‹…‡ˆ—†‡”•ǡ’Žƒ‡”•ƒ†’”‘˜‹†‡”•–‘ƒ…Š‹‡˜‡–Š‡‘˜‡”ƒ”…Š‹‰‰‘ƒŽ•‘ˆ–Š‡•–”ƒ–‡‰›Ǥ

–™‹ŽŽ‘–„‡’‘••‹„Ž‡–‘†‘‡˜‡”›–Š‹‰ƒ–‘…‡ƒ†ƒ’Šƒ•‡†‹–”‘†—…–‹‘‘ˆ–Š‡‹’Ž‡‡–ƒ–‹‘’Žƒƒ›„‡

”‡“—‹”‡†Ǥ–ƒ›„‡’‘••‹„Ž‡–‘‹’Ž‡‡–•‘‡ƒ…–‹‘•˜‡”›‡ƒ”Ž›ǡ™Š‡”‡ƒ•‘–Š‡”•™‹ŽŽ–ƒ‡Ž‘‰‡”–‘’Žƒƒ†

…ƒ””›‘—–ǤŠ‡‹’Ž‡‡–ƒ–‹‘’Žƒ™‹ŽŽ„‡†‡˜‡Ž‘’‡†™‹–Š‰‘˜‡”‡–ƒ†‘Ǧ‰‘˜‡”‡–ƒ‰‡…‹‡•ǡŠ‡ƒŽ–Š

’”‘ˆ‡••‹‘ƒŽ•ƒ†…‘•—‡”•‹˜‘Ž˜‡†‹ƒŽŽƒ•’‡…–•‘ˆ…ƒ…‡”…‘–”‘ŽǤ

– ‹• ƒ–‹…‹’ƒ–‡† –Šƒ– ƒ ƒœƒ‹ƒ ƒ…‡” ‘‹••‹‘ ȋȌ ƒ† ƒ–‹‘ƒŽ ƒ…‡” ‘–”‘Ž ”‘‰”ƒ ȋȌ ™‹ŽŽ

„‡‡•–ƒ„Ž‹•Š‡†ƒ†™‹ŽŽ‘˜‡”•‡‡–Š‡‹’Ž‡‡–ƒ–‹‘‘ˆ–Š‡’ŽƒǤŠ‡™‹ŽŽ„‡—†‡”–Š‡Ž‡ƒ†‡”•Š‹’‘ˆ”‹‡

‹‹•–‡”ǯ•ƥ…‡ƒ†™‹ŽŽ„‡—†‡”–Š‡Ž‡ƒ†‡”•Š‹’‘ˆ–Š‡ǤŠ‡”‡™‹ŽŽ„‡•‡˜‡”ƒŽ’”‘‰”ƒ•–Šƒ–™‹ŽŽ

„‡‹’Ž‡‡–‡†„ƒ•‡†‘–Š‡‰‘ƒŽ•ƒ†‘„Œ‡…–‹˜‡•‘ˆ–Š‡•–”ƒ–‡‰‹‡•‹†‡–‹Ƥ‡†„›–Š‹•†‘…—‡–ǤŠ‡ˆ—†‹‰‘ˆ

–Š‡ƒ…–‹˜‹–‹‡•™‹ŽŽ„‡ƒ‹Ž›ˆ”‘ƒ‘˜‡”‡–Ž‘ƒˆ”‘ˆ—†‹‰ƒ‰‡…‹‡•Ǥ

CHAPTER 4: NATIONAL HEALTH FINANCING OF CANCER

Š‡‹‹•–”›‘ˆ ‹ƒ…‡ƒ†…‘‘‹…ơƒ‹”••Š‘—Ž†‡•—”‡–Š‡›‘„–ƒ‹Ž‘ƒ•ˆ”‘‹–‡”ƒ–‹‘ƒŽ‘”Ž‘…ƒŽˆ—†‹‰

‘”‰ƒ‹œƒ–‹‘•–‘‹’Ž‡‡––Š‡ƒ–‹‘ƒŽ…ƒ…‡”…‘–”‘Ž’”‘‰”ƒƒ…–‹˜‹–‹‡•Ǥ

—”–Š‡”‘”‡ǡ–Š‡”‹‡‹‹•–‡”ǯ•ƥ…‡ƒ†‹‹•–”›‘ˆ‡ƒŽ–Šƒ†‘…‹ƒŽ‡Žˆƒ”‡•Š‘—Ž†‡•—”‡ƒ†‡“—ƒ–‡ˆ—†‹‰

–‘†‹•–”‹…–ǡ”‡‰‹‘ƒŽǡ”‡ˆ‡””ƒŽƒ†•’‡…‹ƒŽ‹•‡†Š‘•’‹–ƒŽ•ˆ‘””‡…—””‡–‡š’‡†‹–—”‡•‘…ƒ…‡”…‘–”‘Žƒ…–‹˜‹–‹‡•Ǥ

–‡”ƒ–‹‘ƒŽ†‘‘”•ƒ†ƒ‰‡…‹‡•’ƒ”–‹…—Žƒ”Ž›‘”Ž†‡ƒŽ–Š”‰ƒ‹•ƒ–‹‘ƒ†”‘‰”ƒƒ…–‹‘ˆ‘”…ƒ…‡”

–Š‡”ƒ’›ȋǦȌ™‘—Ž†„‡‡š’‡…–‡†–‘’Žƒ›ƒ†‹’‘”–ƒ–”‘Ž‡ƒ•’ƒ”–‡”•‹–Š‡ƒ–‹‘ƒŽ”‡•’‘•‡‹‹–‹ƒ–‹˜‡

–‘…‘„ƒ–…ƒ…‡”ǤŠ‡‰‘˜‡”‡–‘ˆƒœƒ‹ƒǡ†‘‘”•ƒ†•™‹ŽŽ–Š‡”‡ˆ‘”‡„‡–Š‡ƒŒ‘”ƒ…–‘”•‹’”‘˜‹†‹‰

”‡•‘—”…‡•ˆ‘”ƒ–‹‘ƒŽ…ƒ…‡”…‘–”‘Žƒ…–‹˜‹–‹‡•Ǥ Government Budgetary Allocation

ƒ…Š›‡ƒ”ǡƒ„—†‰‡–ƒ”›ƒŽŽ‘…ƒ–‹‘–‘ƒœƒ‹ƒƒ…‡”‘‹••‹‘ƒ†ƒ–‹‘ƒŽƒ…‡”‘–”‘Ž”‘‰”ƒ•Š‘—Ž†

„‡ ’”‘˜‹†‡† „› –Š‡ ‰‘˜‡”‡– –Š”‘—‰Š –Š‡ ”‹‡ ‹‹•–‡”ǯ• ƥ…‡ ƒ† ǡ ”‡•’‡…–‹˜‡Ž›Ǥ  ƒ††‹–‹‘ǡ

‰‘˜‡”‡–ƒ‰‡…‹‡•ƒ†‹•–‹–—–‹‘••Š‘—Ž†‡•—”‡‹…”‡ƒ•‡†…‘ŽŽƒ„‘”ƒ–‹‘‹•‘—”…‹‰”‡•‘—”…‡•ƒ†–‡…Š‹…ƒŽ

ƒ••‹•–ƒ…‡‡…‡••ƒ”›ˆ‘”–Š‡‹’Ž‡‡–ƒ–‹‘‘ˆ’”‘‰”ƒ•ƒ†‹–‡”˜‡–‹‘•–Š”‘—‰Š‘—––Š‡…‘—–”›Ǥ‡‰‹‘ƒŽ

ƒ•™‡ŽŽƒ•†‹•–”‹…–Š‡ƒŽ–Šƒƒ‰‡‡––‡ƒ••Š‘—Ž†„‡ƒ†ƒ–‡†–‘•—’’‘”–ƒ’’”‘’”‹ƒ–‡Ž‡˜‡Ž…ƒ…‡”…‘–”‘Ž

ƒ…–‹˜‹–‹‡•Ǥ

National Fund for Cancer

ƒ–‹‘ƒŽ…ƒ…‡”ˆ—†•Š‘—Ž†„‡‡•–ƒ„Ž‹•Š‡†™‹–Š–Š‡ƒ‹‹••‹‘‘ˆ”ƒ‹•‹‰ˆ—†•–‘•—’’‘”–…ƒ…‡”…‘–”‘Ž

’”‘‰”ƒ•‹ƒœƒ‹ƒǤŠ‡ˆ—†‹‰•Š‘—Ž†…‘‡ˆ”‘†‹ơ‡”‡–•‘—”…‡•‹…Ž—†‹‰Ž‘…ƒŽƒ•™‡ŽŽƒ•‹–‡”ƒ–‹‘ƒŽ

’ƒ”–‡”•Ǥ

CHAPTER 5: MONITORING AND EVALUATION FRAMEWORK

‘‹–‘”‹‰ƒ†‡˜ƒŽ—ƒ–‹‘ȋƬȌ™‹ŽŽˆ‘”ƒ‡••‡–‹ƒŽ…‘’‘‡–‘ˆ–Š‡ƒ†™‹ŽŽ•‡‡–‘„—‹Ž†‘‡š‹•–‹‰

•›•–‡•Ǥ‘˜‡”ƒŽŽƬ’Žƒ™‹ŽŽ„‡†‡˜‡Ž‘’‡†ǤŠ‡”‡™‹ŽŽ„‡ƒ†‡†‹…ƒ–‡†—‹–™‹–Š‹–Š‡…ƒ…‡”…‘–”‘Ž’”‘‰”ƒ

™Š‹…Š™‹ŽŽ„‡”‡•’‘•‹„Ž‡ˆ‘”ƬǤŠ‹•—‹–™‹ŽŽ…‘‘”†‹ƒ–‡ƒŽŽƬƒ…–‹˜‹–‹‡•‹–Š‡…‘—–”›ƒ†”‡‰—Žƒ”Ž›’”‘†—…‡

ƒ†™‹†‡Ž›†‹••‡‹ƒ–‡ƒ—ƒŽ•—ƒ”›”‡’‘”–•Ǥ

Š‡‡˜ƒŽ—ƒ–‹‘—‹–™‹ŽŽ‡•–ƒ„Ž‹•Šƒ‘˜‡”ƒŽŽ‡˜ƒŽ—ƒ–‹‘’”‘–‘…‘Žǡƒ•™‡ŽŽƒ•†‡˜‡Ž‘’ƒ†‘˜‡”•‡‡‹’Ž‡‡–ƒ–‹‘

‘ˆƒ‡˜ƒŽ—ƒ–‹‘’ŽƒǤ–™‹ŽŽ†‡–‡”‹‡–Š‡‡‡†•ǡ“—‡•–‹‘•ǡ‡–Š‘†•ǡ‡ƒ•—”‡•‘ˆ‡ơ‡…–‹˜‡‡••ǡƒ†ˆ”ƒ‡™‘”

ˆ‘”‡˜ƒŽ—ƒ–‹‘‘ˆ–Š‡ƒ…–‹˜‹–‹‡•ƒ†‘—–…‘‡•ǤŠ‡—‹–™‹ŽŽƒŽ•‘ƒ••‡••’”‘‰”‡••–‘™ƒ”†•–ƒ–‡†‘„Œ‡…–‹˜‡•ƒ†

‘—–…‘‡•ǡƒ†–‘™ƒ”†•ƒ…Š‹‡˜‹‰–Š‡‰‘ƒŽ•Ǥ

Š‡—‹–™‹ŽŽƒƒŽ›œ‡–Š‡—–‹Ž‹œƒ–‹‘ƒ†ƒ˜ƒ‹Žƒ„‹Ž‹–›‘ˆ”‡•‘—”…‡•ǡ‹–‡”ƒŽƒ†‡š–‡”ƒŽ‹ˆ”ƒ•–”—…–—”‡•ǤŠ‡‡˜ƒŽ—ƒ–‹‘

”‡’‘”–™‹ŽŽ„‡—•‡†–‘‹’”‘˜‡•–”—…–—”‡ƒ†ˆ—…–‹‘ǡ–Š‡‹’Ž‡‡–ƒ–‹‘’”‘…‡••ƒ†‹’”‘˜‡†’”‘‰”‡••

–‘™ƒ”†•†‡•‹”‡†‘—–…‘‡•Ǥ

Š‡ˆ‘ŽŽ‘™‹‰ƒ”‡ƒ•™‹ŽŽˆ‘”’ƒ”–‘ˆ–Š‡‡˜ƒŽ—ƒ–‹‘•–”ƒ–‡‰›ˆ‘”–Š‡ˆ‘”ƒœƒ‹ƒǣ Ȉ”‹ƒ”›’”‡˜‡–‹‘

Ȉƒ”Ž›†‡–‡…–‹‘ǡ•…”‡‡‹‰ƒ††‹ƒ‰‘•‹•

Ȉ”‡ƒ–‡–

ȈƒŽŽ‹ƒ–‹˜‡ƒ”‡

Ȉƒ…‡””‡‰‹•–”ƒ–‹‘ǡ‘‹–‘”‹‰ƒ†•—”˜‡‹ŽŽƒ…‡ Ȉ”ƒ‹‹‰ƒ†‡•‡ƒ”…Š

Ȉ‘•–‡ơ‡…–‹˜‡‡••‘ˆ†‹ơ‡”‡–•–”ƒ–‡‰‹‡•

Ȉ—ƒ”‡•‘—”…‡•†‡˜‡Ž‘’‡–

Ȉƒœƒ‹ƒ…ƒ…‡”•‘…‹‡–›

Š‡‡˜ƒŽ—ƒ–‹‘•–”ƒ–‡‰›•Š‘—Ž†Ž‡ƒ†–‘–Š‡†‡˜‡Ž‘’‡–‘ˆ‡ơ‡…–‹˜‡•–”ƒ–‡‰‹‡•–‘™ƒ”†•…ƒ…‡”…‘–”‘ŽǤ—ƒŽ

‡˜ƒŽ—ƒ–‹‘ ƒ† †ƒ–ƒ ƒƒ‰‡‡– •ŠƒŽŽ „‡ ƒ†‡ ƒ– †‹•–”‹…–ǡ ”‡‰‹‘ƒŽǡ œ‘ƒŽȀ”‡ˆ‡””ƒŽ ƒ† ƒ–‹‘ƒŽ Ž‡˜‡ŽǤ —ƒŽ

”‡’‘”–•™‘—Ž†„‡—•‡†–‘”‡ƪ‡…–ƒ…Š‹‡˜‡‡–•ǡˆƒ‹Ž—”‡–‘‡‡–‘„Œ‡…–‹˜‡•ǡ…‘•–”ƒ‹–•ƒ†ˆ—–—”‡’Žƒ•Ǥ‡‰—Žƒ”

‹’Ž‡‡–‡”•‡‡–‹‰•™‹ŽŽ„‡—•‡†ƒ•ƒ’Žƒ–ˆ‘”ˆ‘””‡˜‹‡™‹‰•–”ƒ–‡‰‹‡•ƒ†…‘‹‰—’™‹–Š”‡…‘‡†ƒ–‹‘•

ˆ‘”ˆ—–—”‡ƒ…–‹˜‹–‹‡•Ǥ

CHAPTER 6: ACTION PLAN

Purpose of Action Plan

Š‡ ƒ–‹‘ƒŽ ƒ…‡” ‘–”‘Ž –”ƒ–‡‰› ’”‘˜‹†‡• ƒ Š‹‰ŠǦŽ‡˜‡Ž ˆ”ƒ‡™‘” ˆ‘” ”‡†—…‹‰ –Š‡

Implementing the Action Plan

Š‡…‘’Ž‡šƤ‡Ž†‘ˆ…ƒ…‡”…‘–”‘Ž…‘˜‡”•–Š‡™‘”‘ˆƒ™‹†‡”ƒ‰‡‘ˆ‘”‰ƒ‹œƒ–‹‘•ƒ†Š‡ƒŽ–Š’”‘ˆ‡••‹‘ƒŽ•Ǥ Leadership for Implementation

Š‡‹’Ž‡‡–ƒ–‹‘‘ˆ–Š‡–‡Ǧ›‡ƒ”ƒ…–‹‘’Žƒ™‹ŽŽ„‡–Š”‘—‰Š–Š‡ƒ–‹‘ƒŽƒ…‡”‘–”‘Ž”‘‰”ƒǤŠ‡ƒ–‹‘ƒŽ

…ƒ…‡”…‘–”‘Ž’”‘‰”ƒ–‡ƒ™‹ŽŽ‡‡–‡˜‡”›•‹š‘–Š•ƒ†™‹ŽŽŠƒ˜‡–‡…Š‹…ƒŽ™‘”‹‰‰”‘—’•Ȁ•—„…‘‹––‡‡

™Š‹…Š™‹ŽŽ‡‡–‘–ŠŽ›Ǥ Working in Partnership

ƒ…‡”…‘–”‘Ž‹•ƒ—Ž–‹Ǧ•‡…–‘”ƒŽˆ—…–‹‘™Š‹…Š•Š‘—Ž†‘–„‡…‘Ƥ‡†–‘–Š‡Š‡ƒŽ–Š•‡…–‘”ƒŽ‘‡ǤŠ—•ǡƒœƒ‹ƒ

–‡”ƒŽ‹•–‹–—–‹‘•‹…Ž—†‡Ȃǡǡǡ•ǡ‘–Š‡”‡†‹…ƒŽ•…Š‘‘Ž‹•–‹–—–‹‘•ǡ‡ƒŽ–Š‡†—…ƒ–‹‘Ǥ

Š‡ƒ…‡”…‘–”‘Ž’”‘‰”ƒ™‹ŽŽ…‘ŽŽƒ„‘”ƒ–‡™‹–Š–Š‡‹•—…ŠƤ‡Ž†•ƒ•–”ƒ‹‹‰ǡ”‡•‡ƒ”…Šǡƒ™ƒ”‡‡••ǡ–”‡ƒ–‡–ǡ

•…”‡‡‹‰ƒ†‡ƒ”Ž›†‡–‡…–‹‘ǡ•—’‡”˜‹•‹‘ǡ‘‹–‘”‹‰ƒ†–‡…Š‹…ƒŽƒ†˜‹…‡Ǥ

š–‡”ƒŽ‹•–‹–—–‹‘•‹…Ž—†‡Ȃ‡”‹…ƒƒ…‡”‘…‹‡–›ǡ…ƒ…‡”•‘…‹‡–›ȋƒƒ†ƒȌǡǦ…Šƒ‰‡ǡǡǡǡ ǦǡǦ ”ƒ…‡ǡ‘”†‹‘ǡ’‡‘…‹‡–›•–‹–—–‡ǡ‡‘”‹ƒŽ‘•’‹–ƒŽǡǤŠ‡•‡‹–‡”ƒ–‹‘ƒŽ

ƒ‰‡…‹‡• ƒ”‡ ‡š’‡…–‡† –‘ •—’’‘”– –Š‡ …ƒ…‡” …‘–”‘Ž ’”‘‰”ƒ ‹ •‘Ž‹…‹–‹‰ ƒ† ƒ…“—‹”‹‰ ˆ—†• ˆ‘” ’”‘‰”ƒ

‹’Ž‡‡–ƒ–‹‘ǡ’”‘˜‹†‹‰–‡…Š‹…ƒŽƒ••‹•–ƒ…‡ǡ–”ƒ‹‹‰‘ˆƒ’‘™‡”ƒ–ƒŽŽŽ‡˜‡Ž•ǡ•—’’‘”––‘ƒ…“—‹”‡ƒ–‡”‹ƒŽ•

ƒ†‡“—‹’‡–•ǡ•—’’‘”–‹–”ƒ•’‘”–ǡ•—’’‘”–‹’”‘‰”ƒ‡˜ƒŽ—ƒ–‹‘ƒ†ƒ›‘–Š‡”ƒ••‹•–ƒ…‡™Š‡‡‡†ƒ”‹•‡•Ǥ The Action Plan

Š‡ƒ…–‹‘•‹–Š‡ˆ‘ŽŽ‘™‹‰’Žƒƒ”‡†‹”‡…–‡†–‘™ƒ”†•ƒ…Š‹‡˜‹‰–Š‡‰‘ƒŽ•ƒ†‘„Œ‡…–‹˜‡•‘ˆ–Š‡ƒ–‹‘ƒŽƒ…‡”

‘–”‘Ž–”ƒ–‡‰›ǤŠ‡‘„Œ‡…–‹˜‡•ƒ”‡‰”‘—’‡†—†‡”–Š‡‰‘ƒŽ•‘ˆ–Š‡ƒ…‡”‘–”‘Ž–”ƒ–‡‰›™Š‹…Š…‘˜‡”–Š‡

…ƒ…‡”…‘–‹——•–ƒ”–‹‰™‹–Š’”‹ƒ”›’”‡˜‡–‹‘ƒ†‡†‹‰™‹–Š”‡•‡ƒ”…Šƒ†•—”˜‡‹ŽŽƒ…‡Ǥ ‘”‡ƒ…Š‘„Œ‡…–‹˜‡

ȋ‘”‰”‘—’‘ˆ‘„Œ‡…–‹˜‡•ǡ™Š‡”‡–Š‡•‡ƒ”‡…Ž‘•‡Ž›”‡Žƒ–‡†Ȍ–Š‡”‡‹•ƒ–‡’Žƒ–‡™Š‹…Š‹†‡–‹Ƥ‡•†‡•‹”‡†‘—–…‘‡•Ȁ

”‡•—Ž–•ǡ•’‡…‹Ƥ…ƒ…–‹‘•ǡ†‹…ƒ–‘”•ǡ‡›•–ƒ‡Š‘Ž†‡”•ǡ‹’—–•ƒ†–‹‡ˆ”ƒ‡•Ǥ

ŽŽ‘ˆ–Š‡ƒ…–‹‘•‹–Š‡…–‹‘Žƒƒ”‡™‘”–Š™Š‹Ž‡…‘–”‹„—–‹‘•–‘…ƒ…‡”…‘–”‘ŽǤ–‹•ƒ…‘™Ž‡†‰‡†–Šƒ–‘–

‡˜‡”›ƒ…–‹‘™‹–Š‹–Š‡…–‹‘Žƒ™‹ŽŽ„‡ƒ„Ž‡–‘„‡–ƒ…Ž‡†ƒ–‘…‡Ǥ‘‡…ƒ„‡‹’Ž‡‡–‡†‹–Š‡•Š‘”––‘

‡†‹—–‡”Ǥ–Š‡”ƒ…–‹‘•ǡ’‡”Šƒ’•‘ˆ‰”‡ƒ–‡”‹’ƒ…–ǡ™‹ŽŽ–ƒ‡Ž‘‰‡”–‘‹‹–‹ƒ–‡Ǥ

Š‡–‡‡”‹‰‘‹––‡‡Šƒ•…‘•‹†‡”‡†ƒŽŽ‘ˆ–Š‡ƒ…–‹‘•‹–Š‡…–‹‘Žƒƒ††‡–‡”‹‡†–Šƒ––Š‡–Š‡‡•ƒ†

ƒ…–‹‘•ƒ‡š‡†ƒ––Š‡‡†ƒ”‡Š‹‰Š’”‹‘”‹–›‹–‡†‡†ˆ‘”‹‡†‹ƒ–‡‹’Ž‡‡–ƒ–‹‘Ǥ

dĂďůĞϭ͗EĂƟŽŶĂůĂŶĐĞƌŽŶƚƌŽů^ƚƌĂƚĞŐLJ'ŽĂůƐ͕dĂƌŐĞƚƐĂŶĚŝŶĚŝĐĂƚŽƌƐ ^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22 WZ/DZzWZsEd/KE͗ZĞĚƵĐĞƚŚĞŝŶĐŝĚĞŶĐĞŽĨĐĂŶĐĞƌƚŚƌŽƵŐŚƉƌŝŵĂƌLJƉƌĞǀĞŶƟŽŶ͘ KďũĞĐƟǀĞ͗ZĞĚƵĐƟŽŶďLJϮϬйŽĨĐĂŶĐĞƌŝŶĐŝĚĞŶĐĞďLJϮϬϮϮ ƐƚĂďůŝƐŚŵĞŶƚŽĨ ĐĂŶĐĞƌĐŽŶƚƌŽů ƉŽůŝĐŝĞƐĂŶĚ ŝŶĐƌ

ĞĂƐĞŝŶƉƵďůŝĐ ĞĚƵĐĂƟŽŶ

ŝ͘ĚǀŽĐĂƚĞĨŽƌƉŽůŝĐŝĞƐƚŚĂƚƉƌŽŵŽƚĞĂŶĚŝŶĐƌĞĂƐĞ ƉŚLJƐŝĐĂůĂĐƟǀŝƚLJĂŶĚŚĞĂůƚŚLJĨŽŽĚĐŚŽŝĐĞƐŝŶ ƐĐŚŽŽůƐĂŶĚĂƚŚŽŵĞƐ DŽ,^t

EƵŵďĞƌŽĨdĂŶnjĂŶŝĂŶƐ

ƐŵŽŬŝŶŐŽƌŐŝǀŝŶŐ ƵƉƐŵŽŬŝŶŐ

KǀĞƌǁĞŝŐŚƚĂŶĚ ŽďĞƐŝƚLJƌĂƚĞ ǀĞƌĂŐĞƋƵĂŶƟƚLJŽĨ ǀĞŐĞƚĂďůĞƐĂŶĚ ĨƌƵŝƚƐĐŽŶƐƵŵĞĚ ďLJŝŶĚŝǀŝĚƵĂů ǀĞƌĂŐĞĂŵŽƵŶƚŽĨ ĂůĐŽŚŽůĐŽŶƐƵŵĞĚ ďLJŝŶĚŝǀŝĚƵĂů ,sĂŶĚ,Ws ǀĂĐĐŝŶĂƟŽŶƌĂƚĞ ĂŶĐĞƌŝŶĐŝĚĞŶĐĞĚĂƚĂ

ŝŝ͘ZĂŝƐĞƐĐŚŽŽůĂǁĂƌĞŶĞƐƐĂďŽƵƚƚŚĞŝƌƌŽůĞŝŶ ƉƌŝŵĂƌLJƉƌĞǀĞŶƟŽŶĂŶĚĞŶŐĂŐĞƐĐŚŽŽůƐŝŶƉƌŝŵĂƌLJ ƉƌĞǀĞŶƟŽŶĞĚƵĐĂƟŽŶĞīŽƌƚƐďLJŵĂŬŝŶŐŵĂƚĞƌŝĂůƐ ĂŶĚƌĞƐŽƵƌĐĞƐĂǀĂŝůĂďůĞĨŽƌƚĞĂĐŚĞƌƐ ŝŝŝ͘ŽŶĚƵĐƚƚĂƌŐĞƚĞĚ͕ƉůĂŶŶĞĚŽƵƚƌĞĂĐŚĂĐƟǀŝƟĞƐƚŽ ĞĚƵĐĂƚĞŚĞĂůƚŚĐĂƌĞƉƌŽĨĞƐƐŝŽŶĂůƐ͕ƚŚĞŵĞĚŝĂ͕ƚŚĞ ƉƵďůŝĐĂŶĚƉŽůŝĐLJŵĂŬĞƌƐĂďŽƵƚĐĂŶĐĞƌƌŝƐŬĨĂĐƚŽƌƐ ŶĐŽƵƌĂŐĞĚĞǀĞůŽƉŵĞŶƚĂŶĚŝŵƉůĞŵĞŶƚĂƟŽŶ ŽĨŵŽĚĞůĐƵƌƌŝĐƵůĂĨŽƌŵĞĚŝĐĂůƐĐŚŽŽůƐ͕ŶƵƌƐŝŶŐ ƉƌŽŐƌĂŵƐĂŶĚŽƚŚĞƌŚĞĂůƚŚƉƌŽĨĞƐƐŝŽŶƐĐŚŽŽůƐ ŝǀ͘ĚǀŽĐĂĐLJĨŽƌƉƌŽǀŝƐŝŽŶŽĨǀĂĐĐŝŶĞƐƚŚĂƚƉƌĞǀĞŶƚ ŝŶĨĞĐƟŽŶƐƚŚĂƚŵĂLJůĞĂĚƚŽĐĂŶĐĞƌƐ ZĞĚƵĐƟŽŶŽĨ

ŶƵŵďĞƌŽĨƉĞŽƉůĞ ǁŚŽĚĞ

ǀĞůŽƉ ĐĂŶĐĞƌƐĚƵĞƚŽ ƚŽďĂĐĐŽƵƐĞ͘

ŝ͘ZĞĚƵĐĞĞdžƉŽƐƵƌĞƚŽƚŽďĂĐĐŽƐŵŽŬĞĂŶĚƉƌĞǀĞŶƚ ƚŚĞƵƉƚĂŬĞŽĨƐŵŽŬŝŶŐƚŚƌŽƵŐŚĂĐŽŵƉƌĞŚĞŶƐŝǀĞ ƚŽďĂĐĐŽĐŽŶƚƌŽůƉƌŽŐƌĂŵƚŚĂƚŝŶĐůƵĚĞƐŝŶĐƌĞĂƐĞĚ ŚĞĂůƚŚƉƌŽŵŽƟŽŶ͕ĂĚǀŽĐĂĐLJ͕ĐĞƐƐĂƟŽŶƐĞƌǀŝĐĞƐ͕ ůĞŐŝƐůĂƟŽŶ͕ĂŶĚƐƵƉƉŽƌƚĨŽƌŝŶƚĞƌŶĂƟŽŶĂůƚŽďĂĐĐŽ ĐŽŶƚƌŽůĞīŽƌƚƐ͘ ŝŝ͘/ŶĐƌĞĂƐĞĂŶĚŶŽƌŵĂůŝnjĞƐŵŽŬĞͲĨƌĞĞĞŶǀŝƌŽŶŵĞŶƚƐ ;ƚŚŝƐƌĞƋƵŝƌĞƐƐƚƌŽŶŐĞƌůĞŐŝƐůĂƟŽŶ͕ĚŝƐƉůĂLJĂŶĚ ƐĂůĞƐƌĞƐƚƌŝĐƟŽŶƐ͕ĂŶĚƌĞƐƚƌŝĐƟŽŶƐŽŶƉƌŽŵŽƟŽŶŽĨ ƚŽďĂĐĐŽͿ͘ ŝŝŝ͘^ƵƉƉŽƌƚĨƵƌƚŚĞƌĚĞǀĞůŽƉŵĞŶƚĂŶĚŝŵƉůĞŵĞŶƚĂƟŽŶ ŽĨƐƚƌĂƚĞŐŝĞƐĂŶĚĂĐƟǀŝƟĞƐĚŝƌĞĐƚĞĚƚŽǁĂƌĚƐ ůŽǁĞƌŝŶŐƚŽďĂĐĐŽĐŽŶƐƵŵƉƟŽŶĂŵŽŶŐdĂŶnjĂŶŝĂŶƐ͘ ŝǀ͘DŽŶŝƚŽƌŝŶŐĞīĞĐƟǀĞŶĞƐƐŽĨƉƌŽŐƌĂŵƐĂŶĚĨƵƌƚŚĞƌ ƚŽďĂĐĐŽƌĞƐĞĂƌĐŚ͘

ZĞĚƵĐƟŽŶŽĨ

ŶƵŵďĞƌŽĨƉĞŽƉůĞ ĚĞǀĞůŽƉŝŶŐƉŚLJƐŝĐĂů

ŝŶĂĐƟǀŝƚLJĂŶĚ ŽďĞƐŝƚLJ

ͲƌĞůĂƚĞĚ ĐĂŶĐĞƌƐ

ŝ͘&ŽƐƚĞƌŝŶĐƌĞĂƐĞĚƉŚLJƐŝĐĂůĂĐƟǀŝƚLJƚŚƌŽƵŐŚƐĂĨĞ ĂŶĚĂĐĐĞƐƐŝďůĞĞŶǀŝƌŽŶŵĞŶƚƐ͕ĂĐƟǀĞƚƌĂŶƐƉŽƌƚ͕ ǁŽƌŬƉůĂĐĞƐ͕ƐĐŚŽŽůƐ͕ĐŽŵŵƵŶŝƟĞƐĂŶĚƚŚĞŵĂƐƐ ŵĞĚŝĂ͕ĂŶĚĚĞǀĞůŽƉĞǀŝĚĞŶĐĞĂŶĚĂƌĂƟŽŶĂůĞĨŽƌ ŝŶƚĞƌǀĞŶƟŽŶƐƚŽĂĚĚƌĞƐƐŽďĞƐŝƚLJĂƐĂƌŝƐŬĨĂĐƚŽƌĨŽƌ ĐĂŶĐĞƌ͘ ŝŝ͘WƌŽǀŝĚĞĂŶĚƐƵƉƉŽƌƚĐŽŵƉƌĞŚĞŶƐŝǀĞŵĂƐƐŵĞĚŝĂ ĐĂŵƉĂŝŐŶƐƚŚĂƚƉƌŽŵŽƚĞĂŶĚƐƵƉƉŽƌƚůŝĨĞƐƚLJůĞ ĐŚĂŶŐĞ͕ƉŚLJƐŝĐĂůĂĐƟǀŝƚLJ͕ƚŚĞĚĞǀĞůŽƉŵĞŶƚŽĨ ƐĂĨĞĂŶĚĂĐĐĞƐƐŝďůĞƉƵďůŝĐĞŶǀŝƌŽŶŵĞŶƚƐƚŚĂƚ ĞŶĐŽƵƌĂŐĞƉĞŽƉůĞƚŽƵƐĞŵŽƌĞƉŚLJƐŝĐĂůůLJĂĐƟǀĞ ŵĞĂŶƐŽĨƚƌĂŶƐƉŽƌƚĂƟŽŶ͕ƐƵĐŚĂƐǁĂůŬŝŶŐ͕ĂŶĚ ĂĚǀŽĐĂƚĞĨŽƌĂŶĚƐƵƉƉŽƌƚǁŽƌŬƉůĂĐĞƐƚŚĂƚ ĞŶĐŽƵƌĂŐĞĞŵƉůŽLJĞĞƐƚŽďĞƉŚLJƐŝĐĂůůLJĂĐƟǀĞ͘

DŽ,^t ŝŝŝ͘&ƵƌƚŚĞƌďƵŝůĚƚŚĞĞǀŝĚĞŶĐĞďĂƐĞĨŽƌŝŶƚĞƌǀĞŶƟŽŶƐ ĂĚĚƌĞƐƐŝŶŐŽďĞƐŝƚLJĂƐĂƌŝƐŬĨĂĐƚŽƌĂŶĚĞŶĐŽƵƌĂŐĞ ĂĐƟŽŶƚŽƉƌĞǀĞŶƚƚŚĞĚĞǀĞůŽƉŵĞŶƚŽĨŽďĞƐŝƚLJŝŶ ĐŚŝůĚƌĞŶ͘ ŝǀ͘^ƵƉƉŽƌƚĂƉƉƌŽƉƌŝĂƚĞŝŶƚĞƌǀĞŶƟŽŶƐĨŽƌƚŚĞ ƉƌĞǀĞŶƟŽŶŽĨŽďĞƐŝƚLJ͕ĂŶĚƚŽŝŶĐƌĞĂƐĞƌĂƚĞƐŽĨ ƉŚLJƐŝĐĂůĂĐƟǀŝƚLJĨŽƌĂůůdĂŶnjĂŶŝĂŶƐ

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22

ZĞĚƵĐƟŽŶŽĨ

ŶƵŵďĞƌŽĨƉĞŽƉůĞ ĚĞǀĞůŽƉŝŶŐ ŶƵƚƌŝƟŽŶͲƌĞůĂƚĞĚ ĐĂŶĐĞƌƐ

ŝ͘DĂŬĞƚŚĞŚĞĂůƚŚLJĨŽŽĚĐŚŽŝĐĞƚŚĞĞĂƐLJĐŚŽŝĐĞďLJ ŝŵƉƌŽǀŝŶŐĂĐĐĞƐƐƚŽĂŶĚĂǀĂŝůĂďŝůŝƚLJŽĨŚĞĂůƚŚLJ ĨŽŽĚƐ͘ ŝŝ͘ZĞĚƵĐĞƚŚĞƉƌŽŵŽƟŽŶŽĨƵŶŚĞĂůƚŚLJĨŽŽĚĐŚŽŝĐĞƐ ƚŽĐŚŝůĚƌĞŶ;ĨŽƌĞdžĂŵƉůĞ͕ƚŚƌŽƵŐŚĂĚǀĞƌƟƐŝŶŐͿ͘ ŝŝŝ͘^ƵƉƉŽƌƚĂĐŽŵƉƌĞŚĞŶƐŝǀĞĐĂŵƉĂŝŐŶƚŽƌĂŝƐĞ ĂǁĂƌĞŶĞƐƐŽĨŚĞĂůƚŚLJĨŽŽĚĐŚŽŝĐĞƐ͘ ŝǀ͘ZĞƐĞĂƌĐŚŝŶƚŽĞŵĞƌŐŝŶŐŶƵƚƌŝƟŽŶŝƐƐƵĞƐ͘ ZĞĚƵĐƟŽŶŽĨ

ŶƵŵďĞƌŽĨƉĞŽƉůĞ ĚĞǀĞůŽƉŝŶŐ ŝŶĨĞĐƟŽƵƐĚŝƐĞĂƐĞͲ ƌĞůĂƚĞĚĐĂŶĐĞƌƐ

ŝ͘ŽŶƟŶƵĞƚŽƉƌŽŵŽƚĞƐĂĨĞƐĞdžƉƌĂĐƟĐĞƐ͘ DŽ,^t ŝŝ͘WƌŽŵŽƚĞ,ĞƉĂƟƟƐĂŶĚ,WsǀĂĐĐŝŶĂƟŽŶ͕ ƉĂƌƟĐƵůĂƌůLJĨŽƌŚŝŐŚͲƌŝƐŬƉŽƉƵůĂƟŽŶƐ ŝŝŝ͘WƌŽƚĞĐƚďůŽŽĚƉƌŽĚƵĐƚƐƵƉƉůŝĞƐĨƌŽŵĂůůƉŽƐƐŝďůĞ ŝŶĨĞĐƟŽƵƐĚŝƐĞĂƐĞĐŽŶƚĂŵŝŶĂƟŽŶ͘ ŝǀ͘/ŶĐƌĞĂƐŝŶŐŚĞĂůƚŚƉƌŽŵŽƟŽŶĂƌŽƵŶĚŝŶĨĞĐƟŽƵƐ ĚŝƐĞĂƐĞͲƌĞůĂƚĞĚĐĂŶĐĞƌƐ ZĞĚƵĐƟŽŶŽĨ

ŶƵŵďĞƌŽĨƉĞŽƉůĞ ĚĞǀĞůŽƉŝŶŐĂůĐŽŚŽůͲ ƌĞůĂƚĞĚĐĂŶĐĞƌƐ

ŝ͘ZĂŝƐĞĂǁĂƌĞŶĞƐƐŽŶŚĂƌŵĨƵůĞīĞĐƚƐŽĨĂůĐŽŚŽů ĂŶĚŝƚƐƌĞůĂƟŽŶƐŚŝƉǁŝƚŚĐĂŶĐĞƌ͘ DŽ,^tŝŝ͘ZĞĚƵĐĞĞdžƉŽƐƵƌĞƚŽĂůĐŽŚŽůĂĚǀĞƌƟƐŝŶŐ͘ ŝŝŝ͘WƌŽŵŽƚĞŚĞĂůƚŚǁĂƌŶŝŶŐƐŽŶĂůĐŽŚŽůďĞǀĞƌĂŐĞƐ ĂďŽƵƚƚŚĞƌĞůĂƟŽŶƐŚŝƉďĞƚǁĞĞŶĂůĐŽŚŽůĂŶĚ ĐĂŶĐĞƌ͘ ŝǀ͘/ŶĐƌĞĂƐĞƚĂdžĂƟŽŶŽŶĂůĐŽŚŽůƉƌŽĚƵĐƚƐ͘

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22

ZĞĚƵĐƟŽŶŽĨ

ŶƵŵďĞƌŽĨƉĞŽƉůĞ ĚĞǀĞůŽƉŝŶŐ ŽĐĐƵƉĂƟŽŶĂůͲ ƌĞůĂƚĞĚĐĂŶĐĞƌƐ

ŝ͘^ƚƌĞŶŐƚŚĞŶĂŶĚĞŶĨŽƌĐĞƚŚĞůĞŐĂůĨƌĂŵĞǁŽƌŬ ĚĞƐŝŐŶĞĚƚŽƉƌŽƚĞĐƚǁŽƌŬĞƌƐĂŐĂŝŶƐƚĐĂƌĐŝŶŽŐĞŶŝĐ ĐŽŵƉŽƵŶĚƐŝŶŽĐĐƵƉĂƟŽŶĂůƐĞƫŶŐƐĂŶĚ ƌĂŝƐĞĂǁĂƌĞŶĞƐƐŽĨ͕ĂŶĚƌĞĚƵĐĞĞdžƉŽƐƵƌĞƚŽ͕ ĐĂƌĐŝŶŽŐĞŶŝĐĐŽŵƉŽƵŶĚƐŝŶƚŚĞǁŽƌŬƉůĂĐĞ͘dŚŝƐ ǁŝůůŝŶĐůƵĚĞƉƌŽŵŽƟŶŐƐŵŽŬĞͲĨƌĞĞǁŽƌŬƉůĂŶƐ ĂŶĚĂĐƟŽŶƐ͕ĂŶĚƉƌŽŵŽƟŶŐƉŚLJƐŝĐĂůĂĐƟǀŝƚLJŝŶƚŚĞ ǁŽƌŬƉůĂĐĞ͘ ŝŝ͘^ƵƉƉŽƌƟŶŐŽĐĐƵƉĂƟŽŶĂůƐĂĨĞƚLJĂŶĚŚĞĂůƚŚ ƌĞƐĞĂƌĐŚŝŶƚŽŽĐĐƵƉĂƟŽŶĂůĞdžƉŽƐƵƌĞƐĂŶĚ ŝŵƉƌŽǀŝŶŐƚŚĞƌĞƉŽƌƟŶŐŽĨŽĐĐƵƉĂƟŽŶĂůĐĂŶĐĞƌƐ͘

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22

Z>zdd/KE;^ĐƌĞĞŶŝŶŐŶĚŝĂŐŶŽƐŝƐͿ͗ŶƐƵƌĞĞīĞĐƟǀĞƐĐƌĞĞŶŝŶŐ͕ĞĂƌůLJĚĞƚĞĐƟŽŶĂŶĚĚŝĂŐŶŽƐŝƐƚŽƌĞĚƵĐĞĐĂŶĐĞƌŝŶĐŝĚĞŶĐĞĂŶĚŵŽƌƚĂůŝƚLJ͘ KďũĞĐƟǀĞ͗ůůnjŽŶĂůĂŶĚƌĞŐŝŽŶĂůŚŽƐƉŝƚĂůƐǁŝƚŚĞīĞĐƟǀĞƐĐƌĞĞŶŝŶŐ͕ĞĂƌůLJĚĞƚĞĐƟŽŶĂŶĚĚŝĂŐŶŽƐƟĐƐĞƌǀŝĐĞƐďLJϮϬϮϮ WƌŽǀŝĚĞĂƚĂ ŶĂƟŽŶĂůůĞǀĞůĂ ƐLJƐƚĞŵĂƟĐĂƉƉƌŽĂĐŚ ƚŽĐĂŶĐĞƌƐĐƌĞĞŶŝŶŐ ĂŶĚĞĂƌůLJĚĞƚĞĐƟŽŶ ƚŽĞŶƐƵƌĞƋƵĂůŝƚLJ͕ ĂĐĐĞƉƚĂďŝůŝƚLJĂŶĚ ĞīĞĐƟǀĞŶĞƐƐ ŝ͘ƐƚĂďůŝƐŚĂĐĂŶĐĞƌƐĐƌĞĞŶŝŶŐĐŽŵŵŝƩĞĞ ĂƚƚŚĞŶĂƟŽŶĂůůĞǀĞůƚŽƉƌŽǀŝĚĞŚŝŐŚͲůĞǀĞů ƐƚƌĂƚĞŐŝĐŽǀĞƌƐŝŐŚƚŽĨĞdžŝƐƟŶŐĂŶĚƉŽƚĞŶƟĂů ĐĂŶĐĞƌƐĐƌĞĞŶŝŶŐ͘

DŽ,^tEƵŵďĞƌŽĨdĂŶnjĂŶŝĂŶƐĂǁĂƌĞ ŽĨĐĂŶĐĞƌƐĐƌĞĞŶŝŶŐ EƵŵďĞƌŽĨĐĂŶĐĞƌͲƐƉĞĐŝĮĐ ƐĐƌĞĞŶŝŶŐŐƵŝĚĞůŝŶĞƐ ƐƚĂďůŝƐŚĂƉƌŽĐĞƐƐ ƚŽĂƐƐĞƐƐƚŚĞǀĂůƵĞ ŽĨĞĂƌůLJĚĞƚĞĐƟŽŶ ŽĨĐĂŶĐĞƌŽƚŚĞƌ ƚŚĂŶƚŚĂƚŽďƚĂŝŶĞĚ ƚŚƌŽƵŐŚŽƌŐĂŶŝnjĞĚ ƐĐƌĞĞŶŝŶŐ

ŝ͘/ĚĞŶƟĨLJĂŶĚŝŵƉůĞŵĞŶƚƐƚƌĂƚĞŐŝĞƐƚŽƌĞĚƵĐĞ ĚĞůĂLJƐŝŶĚŝĂŐŶŽƐŝƐĂŶĚƚƌĞĂƚŵĞŶƚǁŚĞƌĞ ƚŚĞƐĞĂƌĞƐŚŽǁŶƚŽďĞĞīĞĐƟǀĞŝŶƌĞĚƵĐŝŶŐ ŵŽƌƚĂůŝƚLJĂŶĚŵŽƌďŝĚŝƚLJĨƌŽŵƐĞůĞĐƚĞĚ ĐĂŶĐĞƌƐ͘

DŽ,^t

EƵŵďĞƌŽĨĐĂŶĐĞƌƐĐƌĞĞŶŝŶŐ ƚƌĂŝŶŝŶŐĐŽƵƌƐĞƐʹĐĞƌǀŝĐĂů͕ ďƌĞĂƐƚ͕ƉƌŽƐƚĂƚĞĂŶĚ ĐŚŝůĚŚŽŽĚĐĂŶĐĞƌƐ ĚƵĐĂƚĞŚĞĂůƚŚ ĐĂƌĞƉƌŽǀŝĚĞƌƐ ĂďŽƵƚƐƚƌĂƚĞŐŝĞƐ ƚŽĞŶĐŽƵƌĂŐĞ ƉĂƟĞŶƚƐĂďŽƵƚ ƚŚĞŝŵƉŽƌƚĂŶĐĞ ŽĨLJĞĂƌůLJƉŚLJƐŝĐĂů ĞdžĂŵŝŶĂƟŽŶ͘

ŝ͘ĞǀĞůŽƉƐŝŵƉůĞŵĂŶƵĂůƐƚŽƚƌĂŝŶŚĞĂůƚŚĐĂƌĞ ƉƌŽǀŝĚĞƌƐ DŽ,^t EƵŵďĞƌŽĨŚĞĂůƚŚǁŽƌŬĞƌƐ ǁŝƚŚƚƌĂŝŶĞĚͬǁŝƚŚƐŬŝůůƐŽŶ ĞĂƌůLJĚĞƚĞĐƟŽŶŽĨĐĞƌǀŝĐĂů͕ ďƌĞĂƐƚĂŶĚƉƌŽƐƚĂƚĞĐĂŶĐĞƌ ŝŶƌĞŐŝŽŶĂůŚŽƐƉŝƚĂůƐ

ŝŝ͘ŝƐƐĞŵŝŶĂƚĞŵĂŶƵĂůƐƚŽƚĂƌŐĞƚĞĚƉĞƌƐŽŶƐ ŝŝŝ͘&ĂĐŝůŝƚĂƚĞƉƌŽǀŝĚĞƌƐƚŽĂĚǀŽĐĂƚĞƚŚĞ ƐƚƌĂƚĞŐŝĞƐ

ĞǀĞůŽƉĂŶĚ ĚŝƐƐĞŵŝŶĂƚĞ ĞĚƵĐĂƟŽŶĂůŵĂƚĞƌŝĂů ŽŶƚŚĞŝŵƉŽƌƚĂŶĐĞ ŽĨƐĐƌĞĞŶŝŶŐĂŶĚ ĞĂƌůLJĚĞƚĞĐƟŽŶ ƚĂƌŐĞƚĞĚĂƚĞŶƟƌĞ ƉŽƉƵůĂƟŽŶǁŝƚŚ ŵŽƌĞĞŵƉŚĂƐŝƐƚŽ ƌƵƌĂůĂŶĚǀƵůŶĞƌĂďůĞ ŐƌŽƵƉƐ͘

ŝ͘ĞǀĞůŽƉƐŝŵƉůĞƉŽƐƚĞƌƐͬůĞĂŇĞƚƐƚŽ ĂĚǀŽĐĂƚĞƚŚĞŝŵƉŽƌƚĂŶĐĞŽĨƐĐƌĞĞŶŝŶŐ ĂŶĚĞĂƌůLJĚĞƚĞĐƟŽŶŽĨĐĂŶĐĞƌƐDŽ,^t

EƵŵďĞƌŽĨŚŽƐƉŝƚĂůƐǁŝƚŚ ƚĞĂŵƐĨŽƌďĂƐŝĐĐĂŶĐĞƌ ƐĐƌĞĞŶŝŶŐ͕ĚĞƚĞĐƟŽŶĂŶĚ ĚŝĂŐŶŽƐƟĐƐĞƌǀŝĐĞƐ EƵŵďĞƌŽĨdĂŶnjĂŶŝĂŶƐ ƐĐƌĞĞŶĞĚĨŽƌĐĞƌǀŝĐĂů͕ ďƌĞĂƐƚ͕ƉƌŽƐƚĂƚĞĂŶĚ ĐŚŝůĚŚŽŽĚĐĂŶĐĞƌƐ /ŶĐŝĚĞŶĐĞŽĨĐĂŶĐĞƌͲĐĞƌǀŝĐĂů͕ ďƌĞĂƐƚ͕ĐŚŝůĚŚŽŽĚĂŶĚ ƉƌŽƐƚĂƚĞ WĞƌĐĞŶƚĂŐĞŽĨƉĂƟĞŶƚƐǁŝƚŚ ĞĂƌůLJƐƚĂŐĞƉƌĞƐĞŶƚĂƟŽŶ EƵŵďĞƌŽĨƌĞŐŝŽŶĂůŚŽƐƉŝƚĂůƐ ǁŝƚŚŚŝƐƚŽƉĂƚŚŽůŽŐLJ ƐĞƌǀŝĐĞƐ

ŝŝ͘ŝƐƐĞŵŝŶĂƚĞŵĂƚĞƌŝĂůƐƚŽƚĂƌŐĞƚĞĚ ƉŽƉƵůĂƟŽŶ ŝŝŝ͘&ĂĐŝůŝƚĂƚĞĂĚǀŽĐĂĐLJŽĨĐĂŶĐĞƌƐĐƌĞĞŶŝŶŐ ĚŽƉƚĂǀĂŝůĂďůĞ ůŽĐĂůͬŝŶƚĞƌŶĂƟŽŶĂů ĂŶĐĞƌ^ĐƌĞĞŶŝŶŐ WƌŽŐƌĂŵƐƚŽĐƌĞĂƚĞ ĂEĂƟŽŶĂůĂŶĐĞƌ ^ĐƌĞĞŶŝŶŐWƌŽŐƌĂŵ ĨŽƌĞĂƌůLJĚĞƚĞĐƟŽŶ ŽĨĐĂŶĐĞƌƐĨŽƌǁŚŝĐŚ ƚƌĞĂƚŵĞŶƚĞdžŝƐƚƐ͘

ŝ͘ĞǀĞůŽƉĂEĂƟŽŶĂů^ĐƌĞĞŶŝŶŐŵŽĚĞů ĨŽƌĞĂƌůLJĚĞƚĞĐƟŽŶŽĨĐĂŶĐĞƌƐ ŝŝ͘ĞǀĞůŽƉĂEĂƟŽŶĂů^ĐƌĞĞŶŝŶŐWƌŽŐƌĂŵ ĨŽƌĞĂƌůLJĚĞƚĞĐƟŽŶŽĨĚŝīĞƌĞŶƚĐĂŶĐĞƌƐ ŝŝŝ͘&ĂĐŝůŝƚĂƚĞƉƌŽĐĞƐƐŽĨƉƌŽŐƌĂŵĂƉƉƌŽǀĂů ŝǀ͘ŝƐƐĞŵŝŶĂƚĞŵĂƚĞƌŝĂůƐƚŽƚĂƌŐĞƚĞĚ /ŶƐƟƚƵƟŽŶƐ

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22 ŽůůĂďŽƌĂƚĞǁŝƚŚ ĞŵƉůŽLJĞƌƐƚŽ ƉƌŽŵŽƚĞĐĂŶĐĞƌ ĞĂƌůLJĚĞƚĞĐƟŽŶ͕ ƐĐƌĞĞŶŝŶŐĂŶĚ ƚƌĞĂƚŵĞŶƚĂŵŽŶŐ ƚŚĞŝƌĞŵƉůŽLJĞĞƐ͘

ŝ͘ŶĨŽƌĐĞEĂƟŽŶĂů^ĐƌĞĞŶŝŶŐƉƌŽŐƌĂŵĂƚ ǁŽƌŬƉůĂĐĞ ŝŝ͘DŽŶŝƚŽƌĂŶĚĞǀĂůƵĂƚĞƚŚĞĞīĞĐƟǀĞŶĞƐƐ ŽĨƚŚĞƉƌŽŐƌĂŵĂƚƚŚĞƐĞĐƚŽƌĂůůĞǀĞů /ŵƉůĞŵĞŶƚƉĂƟĞŶƚ ĂŶĚƉƌŽǀŝĚĞƌ ƌĞŵŝŶĚĞƌƐĂŶĚ ƉƌŽŵƉƚƐƚŽŝŶĐƌĞĂƐĞ ďƌĞĂƐƚĂŶĚĐĞƌǀŝĐĂů ĐĂŶĐĞƌƐĐƌĞĞŶŝŶŐ ƌĂƚĞƐ ŝ͘ĞǀĞůŽƉĐŽŵƉƌĞŚĞŶƐŝǀĞŐƵŝĚĞůŝŶĞƐĨŽƌ ƉĂƟĞŶƚĂŶĚƉƌŽǀŝĚĞƌƌĞŵŝŶĚĞƌƐ ŝŝ͘ŝƐƐĞŵŝŶĂƚĞŐƵŝĚĞůŝŶĞƐƚŽƚĂƌŐĞƚĞĚ ƉĞƌƐŽŶ ŝŝŝ͘&ĂĐŝůŝƚĂƚĞƉƌŽǀŝĚĞƌƐƚŽŝŵƉůĞŵĞŶƚƚŚĞ ŐƵŝĚĞůŝŶĞƐ ŝǀ͘&ĂĐŝůŝƚĂƚĞĞĂƐLJĂĐĐĞƐƐŝďŝůŝƚLJŽĨ ŐƵŝĚĞůŝŶĞƐĂŶĚƌĞŵŝŶĚĞƌƐƚŽƚŚĞ ƉĂƟĞŶƚƐ

dZdDEd͗ŶƐƵƌĞĞīĞĐƟǀĞƚƌĞĂƚŵĞŶƚŽĨĐĂŶĐĞƌƚŽƌĞĚƵĐĞŵŽƌďŝĚŝƚLJĂŶĚŵŽƌƚĂůŝƚLJ KďũĞĐƟǀĞ͗ůůnjŽŶĂůĂŶĚƌĞŐŝŽŶĂůŚŽƐƉŝƚĂůƐǁŝƚŚĞīĞĐƟǀĞƚƌĞĂƚŵĞŶƚƐĞƌǀŝĐĞƐďLJϮϬϮϮ WƌŽǀŝĚĞŽƉƟŵĂů ƚƌĞĂƚŵĞŶƚĨŽƌƚŚŽƐĞ ǁŝƚŚĐĂŶĐĞƌ ŝ͘ŶƐƵƌŝŶŐĂǀĂŝůĂďŝůŝƚLJŽĨƚƌĞĂƚŵĞŶƚĨĂĐŝůŝƟĞƐŝŶ njŽŶĂůĐŽŶƐƵůƚĂŶƚŚŽƐƉŝƚĂůƐ

EƵŵďĞƌŽĨĐĂŶĐĞƌͲ ƐƉĞĐŝĮĐƚƌĞĂƚŵĞŶƚ ŐƵŝĚĞůŝŶĞƐ EƵŵďĞƌŽĨnjŽŶĂů ŚŽƐƉŝƚĂůƐŽīĞƌŝŶŐ ƌĂĚŝŽƚŚĞƌĂƉLJ͕ ƐƵƌŐŝĐĂůĂŶĚ ŵĞĚŝĐĂůŽŶĐŽůŽŐLJ ƐĞƌǀŝĐĞƐ͕

ŝŝ͘džƉĂŶĚŝŶŐƚŚĞƵƐĞŽĨŵƵůƟĚŝƐĐŝƉůŝŶĂƌLJ ŵĂŶĂŐĞŵĞŶƚ;ƚƵŵŽƵƌďŽĂƌĚƐͿ ŝŝŝ͘ŶƐƵƌŝŶŐƟŵĞůLJĂĐĐĞƐƐƚŽƚƌĞĂƚŵĞŶƚĐƵƌƌĞŶƚůLJ ƌĞĐŽŐŶŝnjĞĚĂƐƉƌŽǀŝĚŝŶŐŽƉƟŵĂůŽƵƚĐŽŵĞƐ ŝǀ͘ŶƐƵƌŝŶŐĞƐƚĂďůŝƐŚŵĞŶƚŽĨƉĞĚŝĂƚƌŝĐŽŶĐŽůŽŐLJ ƐĞƌǀŝĐĞƐ ǀ͘^LJƐƚĞŵĂƟĐĂůůLJĂƐƐĞƐƐŝŶŐŶĞǁƚƌĞĂƚŵĞŶƚ ĂƉƉƌŽĂĐŚĞƐ͘ ĞǀĞůŽƉĚĞĮŶĞĚ ƐƚĂŶĚĂƌĚƐĨŽƌ ƚƌĞĂƚŵĞŶƚĂŶĚ ĐĂƌĞĨŽƌƚŚŽƐĞǁŝƚŚ ĐĂŶĐĞƌ

ŝ͘ĞǀĞůŽƉ͕ŝŵƉůĞŵĞŶƚĂŶĚĐŽŶƟŶƵŽƵƐůLJƌĞĮŶĞ ƌĞŐŝŽŶĂůĂŶĚŶĂƟŽŶĂůƐƚĂŶĚĂƌĚƐ͕ŐƵŝĚĞůŝŶĞƐ ĂŶĚƉƌŽƚŽĐŽůƐ EƵŵďĞƌŽĨƋƵĂůŝĮĞĚ ĐĂŶĐĞƌƐƉĞĐŝĂůŝƐƚƐ ĂƚnjŽŶĂůĂŶĚ ƌĞŐŝŽŶĂůůĞǀĞů EƵŵďĞƌŽĨƉĂƟĞŶƚƐ ƚƌĞĂƚĞĚĂƚnjŽŶĂů ĂŶĚƌĞŐŝŽŶĂů ůĞǀĞůƐ ŝŝ͘DƵůƟĚŝƐĐŝƉůŝŶĂƌLJĂƉƉƌŽĂĐŚĞƐƚŽƚƌĞĂƚŵĞŶƚ ĂŶĚĐĂƌĞ ŝŝŝ͘ĞǀĞůŽƉŵĞŶƚŽĨĂŵŝŶŝŵĂůĚĂƚĂƐĞƚƚŽ ŵĞĂƐƵƌĞƉĞƌĨŽƌŵĂŶĐĞĂŶĚŽƵƚĐŽŵĞ͘

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22 WƌŽǀŝĚĞƉĞŽƉůĞ ĞdžƉĞƌŝĞŶĐŝŶŐ ĐĂŶĐĞƌƐĂĐĐĞƐƐƚŽ ƚŚĞďĞƐƚĂǀĂŝůĂďůĞ ĚƌƵŐƐ͕ƐƵƌŐĞƌLJ ĂŶĚƚƌĞĂƚŵĞŶƚ ƉƌŽĐĞĚƵƌĞƐ ŝ͘ĞǀĞůŽƉĂŶĂƟŽŶĂůůLJĐŽŽƌĚŝŶĂƚĞĚĂŶĚ ĐŽŶƐŝƐƚĞŶƚƉƌŽĐĞƐƐĨŽƌŝŶƚƌŽĚƵĐŝŶŐŶĞǁ ƚƌĞĂƚŵĞŶƚƚĞĐŚŶŽůŽŐŝĞƐĂŶĚĚƌƵŐƐĨŽƌĐĂŶĐĞƌ ƚƌĞĂƚŵĞŶƚ͘

YƵĂŶƟƚLJŽĨĐĂŶĐĞƌ ŵĞĚŝĐŝŶĞƐƵƐĞĚ &ƌĞƋƵĞŶĐLJŽĨĐĂŶĐĞƌ ŵĞĚŝĐŝŶĞƐƐƚŽĐŬͲ ŽƵƚƐ

ŝŝ͘ĞǀĞůŽƉĂƉƌŽĐĞƐƐƚŽƉƌŝŽƌŝƟnjĞŵĂŶĂŐĞŵĞŶƚ ŽĨƐƉĞĐŝĮĐĐĂŶĐĞƌƐǁŝƚŚŶĞǁƚƌĞĂƚŵĞŶƚ ĂƉƉƌŽĂĐŚĞƐ͘ ŝŝŝ͘ŽŶƟŶƵĞƚŽĚĞǀĞůŽƉƐƚĂŶĚĂƌĚƐĨŽƌƚŚĞ ƵƟůŝnjĂƟŽŶ͕ƌĞƉůĂĐĞŵĞŶƚĂŶĚĂĚĚŝƟŽŶŽĨ ƌĂĚŝĂƟŽŶŽŶĐŽůŽŐLJĞƋƵŝƉŵĞŶƚ͘ ŝǀ͘ƐƚĂďůŝƐŚĂŶĞdžƉĞƌƚǁŽƌŬŝŶŐŐƌŽƵƉŽĨ ƐƵƌŐĞŽŶƐ͕ŝŶĐůƵĚŝŶŐŐLJŶĞĐŽůŽŐŝƐƚƐ͕ƚŽŝĚĞŶƟĨLJ ŵĂũŽƌĂƌĞĂƐŽĨƐƵƌŐŝĐĂůŵĂŶĂŐĞŵĞŶƚǁŚŝĐŚ ƌĞƋƵŝƌĞĚŝƐĐƵƐƐŝŽŶǁŝƚŚĂǀŝĞǁƚŽƉƌŽĚƵĐŝŶŐ ƌĞĐŽŵŵĞŶĚĂƟŽŶƐĨŽƌƐƵƌŐŝĐĂůŵĂŶĂŐĞŵĞŶƚ͘

EƵŵďĞƌŽĨƚƌĞĂƚŵĞŶƚ

ŵĂĐŚŝŶĞƐ ŝŶƐƚĂůůĞĚĂƚ KZ/ĂŶĚnjŽŶĂů ŚŽƐƉŝƚĂůƐ /ŵƉƌŽǀĞƋƵĂůŝƚLJŽĨ ůŝĨĞĨŽƌƚŚŽƐĞůŝǀŝŶŐ ǁŝƚŚ͕ƌĞĐŽǀĞƌŝŶŐ ĨƌŽŵĂŶĚĚLJŝŶŐ ŽĨĐĂŶĐĞƌĂŶĚ ƚŚĞŝƌĨĂŵŝůŝĞƐ ƚŚƌŽƵŐŚƐƵƉƉŽƌƚ͕ ƌĞŚĂďŝůŝƚĂƟŽŶĂŶĚ ƉĂůůŝĂƟǀĞĐĂƌĞ

ŝ͘ŶƐƵƌĞƉŽůŝĐLJĨŽƌŵƵůĂƟŽŶĨŽƌƉĂůůŝĂƟǀĞĐĂƌĞ ƐĞƌǀŝĐĞƐŝŶƚŚĞĐŽƵŶƚƌLJ ŝŝ͘ŶƐƵƌĞĂǀĂŝůĂďŝůŝƚLJŽĨƚƌĂŝŶŝŶŐƉƌŽŐƌĂŵĨŽƌ ƉĂůůŝĂƟǀĞĐĂƌĞĨŽƌŚĞĂůƚŚǁŽƌŬĞƌƐ ŝŝŝ͘ŶƐƵƌĞĂǀĂŝůĂďŝůŝƚLJŽĨƉĂůůŝĂƟǀĞĐĂƌĞƚĞĂŵƐĂŶĚ ƐĞƌǀŝĐĞƐŝŶĂůůƌĞŐŝŽŶĂůĂŶĚĚŝƐƚƌŝĐƚŚŽƐƉŝƚĂůƐ ŝǀ͘ŶƐƵƌĞĂǀĂŝůĂďŝůŝƚLJŽĨŚŽŵĞͲďĂƐĞĚƉĂůůŝĂƟǀĞ ĐĂƌĞƐĞƌǀŝĐĞƐ ŶƐƵƌĞĂǀĂŝůĂďŝůŝƚLJ ŽĨŽƌĂůŵŽƌƉŚŝŶĞ ĂŶĚŽƚŚĞƌƐLJŵƉƚŽŵƐ ĐŽŶƚƌŽůŵĞĚŝĐŝŶĞƐ ĨŽƌƉĂƟĞŶƚƐǁŝƚŚ ĐĂƌĞŝŶĂůůƌĞŐŝŽŶĂů ĂŶĚĚŝƐƚƌŝĐƚŚŽƐƉŝƚĂůƐ ŝ͘ŶƐƵƌĞƉŽůŝĐLJĨŽƌŵƵůĂƟŽŶĨŽƌŽƌĂůŵŽƌƉŚŝŶĞ ĂǀĂŝůĂďŝůŝƚLJŝŶƚŚĞĐŽƵŶƚƌLJ ŝŝ͘ŶƐƵƌĞƚƌĂŝŶŝŶŐŽŶƚŚĞƵƐĞŽĨŽƌĂůŵŽƌƉŚŝŶĞ ĂŵŽŶŐƉƌŝŵĂƌLJŚĞĂůƚŚĐĂƌĞǁŽƌŬĞƌƐ ŝŝŝ͘ŶƐƵƌĞŽƌĂůŵŽƌƉŚŝŶĞŝƐĂĐĐĞƐƐĞĚďLJĂůů ƉĂƟĞŶƚƐŝŶŶĞĞĚ

/ŵƉƌŽǀĞƌĞƚƵƌŶ ƚŽǁŽƌŬĂŶĚ ƋƵĂůŝƚLJŽĨůŝĨĞŽĨ ĐĂŶĐĞƌƉĂƟĞŶƚƐ ƚŚƌŽƵŐŚƐLJƐƚĞŵĂƟĐ ĂƐƐĞƐƐŵĞŶƚĂŶĚ ĂƉƉƌŽƉƌŝĂƚĞ

ŵƵůƟĚŝƐĐŝƉůŝŶĂƌLJ ŝŶƚĞƌǀĞŶƟŽŶĨŽƌ

ƚŚĞŝƌƐŽĐŝĂůĂŶĚ ǀŽĐĂƟŽŶĂůŶĞĞĚƐ

ŝ͘ĞǀĞůŽƉŝŶŝƟĂůƐĐƌĞĞŶŝŶŐƚŽŽůǁŝƚŚ͚ƚƌŝŐŐĞƌƐ͛ ƚŽĂƐƐĞƐƐƚŚĞǀŽĐĂƟŽŶĂůƌĞŚĂďŝůŝƚĂƟŽŶŶĞĞĚƐ ŽĨĐĂŶĐĞƌƉĂƟĞŶƚƐ͘ ŝŝ͘ĞǀĞůŽƉĂǀŽĐĂƟŽŶĂůƉůĂŶƚŚĂƚŝŶĐůƵĚĞƐ ƌĞĂůŝƐƟĐŐŽĂůƐ͕ƟŵĞůŝŶĞƐĂŶĚŽƵƚĐŽŵĞƐĨŽƌĂůů ƉĂƌƟĐŝƉĂŶƚƐ͘ ŝŝŝ͘hŶĚĞƌƚĂŬĞĂĐĂŵƉĂŝŐŶŽĨƉƵďůŝĐĞĚƵĐĂƟŽŶ ĂŶĚĚŝƐƐĞŵŝŶĂƟŽŶŽĨŝŶĨŽƌŵĂƟŽŶƚŽĂĚĚƌĞƐƐ ŝƐƐƵĞƐƌĞůĂƟŶŐƚŽĚŝƐĐƌŝŵŝŶĂƟŽŶĂŶĚŽƚŚĞƌ ƉŽƚĞŶƟĂůďĂƌƌŝĞƌƐƚŽƌĞƚƵƌŶŝŶŐƚŽǁŽƌŬ͘ ŶƐƵƌĞĂůůƐƵƌǀŝǀŽƌƐ ŽĨĐŚŝůĚŚŽŽĚĐĂŶĐĞƌ ƌĞĐĞŝǀĞƟŵĞůLJĂŶĚ ŽŶŐŽŝŶŐƐƵƉƉŽƌƚ ĂŶĚƌĞŚĂďŝůŝƚĂƟŽŶ͕

ŝŶĐůƵĚŝŶŐĞĂƌůLJ ŝĚĞŶ

ƟĮĐĂƟŽŶŽĨĂŶĚ ŝŶƚĞƌǀĞŶƟŽŶŝŶůĂƚĞ ĞīĞĐƚƐ

ŝ͘KǀĞƌƐĞĞƚŚĞĚĞǀĞůŽƉŵĞŶƚŽĨŶĂƟŽŶĂůŐƵŝĚĞůŝŶĞƐ ĨŽƌƚŚĞƐƵƉƉŽƌƚĂŶĚƌĞŚĂďŝůŝƚĂƟŽŶŽĨĐŚŝůĚƌĞŶĂŶĚ ĂĚŽůĞƐĐĞŶƚƐǁŝƚŚĐĂŶĐĞƌ͘

DŽ,^t͕ DŽsd ŝŝ͘ƉƉƌŽƉƌŝĂƚĞĞĚƵĐĂƟŽŶĂůĂŶĚŶŽŶͲŐŽǀĞƌŶŵĞŶƚ ƐĞƌǀŝĐĞƐƐŚŽƵůĚŝŵƉůĞŵĞŶƚƚŚĞƐĞŐƵŝĚĞůŝŶĞƐ͘

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22 dĂƌŐĞƚ͗ ŝ͘/ŶƐƟƚƵƚĞŚŽƐƉŝƚĂůͲďĂƐĞĚĐĂŶĐĞƌƌĞŐŝƐƚƌLJĂƚĂůůĐŽŶƐƵůƚĂŶƚŚŽƐƉŝƚĂůƐĂŶĚƉŽƉƵůĂƟŽŶͲďĂƐĞĚĐĂŶĐĞƌƌĞŐŝƐƚƌLJĂƚĂůůnjŽŶĞƐďLJϮϬϮϮ ŝŝ͘ZŽƵƟŶĞĂŶŶƵĂůŶĂƟŽŶĂůĐĂŶĐĞƌƌĞƉŽƌƟŶŐ ƐƚĂďůŝƐŚŚŽƐƉŝƚĂůͲ ďĂƐĞĚĂŶĚ ƉŽƉƵůĂ

ƟŽŶͲďĂƐĞĚ ĐĂŶĐĞƌƌĞŐŝƐƚƌŝĞƐ ŝŶĐŽŶƐƵůƚĂŶƚ ŚŽƐƉŝƚĂůƐ ĂŶĚƌĞŐŝŽŶƐ ƌĞƐƉĞĐƟǀĞůLJ͘

ŝ͘ƐƚĂďůŝƐŚƚƌĂŝŶŝŶŐĐĞŶƚĞƌĂŶĚĐƵƌƌŝĐƵůĂ ĨŽƌĐĂŶĐĞƌƌĞŐŝƐƚƌĂƟŽŶŝŶdĂŶnjĂŶŝĂEƵŵďĞƌŽĨnjŽŶĂůŚŽƐƉŝƚĂůͲ ďĂƐĞĚĐĂŶĐĞƌƌĞŐŝƐƚƌŝĞƐ EƵŵďĞƌŽĨƉŽƉƵůĂƟŽŶͲďĂƐĞĚ ĐĂŶĐĞƌƌĞŐŝƐƚƌŝĞƐ dĂŶnjĂŶŝĂĚĂƚĂŝŶƚŚĞ/Z ĚŽĐƵŵĞŶƚŽŶĂŶŶƵĂůĐĂŶĐĞƌ ŝŶĐŝĚĞŶĐĞŝŶĮǀĞĐŽŶƟŶĞŶƚƐ

ŝŝ͘ĞǀĞůŽƉƉƌŽƚŽĐŽůĨŽƌĞƐƚĂďůŝƐŚŵĞŶƚ ŽĨŚŽƐƉŝƚĂůͲďĂƐĞĚĐĂŶĐĞƌƌĞŐŝƐƚƌŝĞƐŝŶ ĐŽŶƐƵůƚĂŶƚŚŽƐƉŝƚĂůƐĂŶĚƌĞŐŝŽŶƐ ŝŝŝ͘ƐƚĂďůŝƐŚĂĐŽŵŵŝƩĞĞƚŽŽǀĞƌƐĞĞƚŚĞ ŝŵƉůĞŵĞŶƚĂƟŽŶŽĨĂƉŝůŽƚŵŽĚĞůƉƌŽũĞĐƚ ĨŽƌWZĨŽƌĂƌĞƐ^ĂůĂĂŵƌĞŐŝŽŶ ŝǀ͘ƐƐĞƐƐŵĞŶƚĂŶĚŵŽďŝůŝnjĂƟŽŶŽĨ ƌĞƐŽƵƌĐĞƐŶĞĞĚĞĚƚŽŝŵƉƌŽǀĞĚĂƚĂ ĐŽůůĞĐƟŽŶĨŽƌ<ŝůŝŵĂŶũĂƌŽWZ ƐƚĂďůŝƐŚĂŶĂƟŽŶĂů ĐĂŶĐĞƌĚĂƚĂ

ĐŽůůĞĐƟŽŶĂŶĚ ƌĞƉŽƌƟŶŐ

ŝ͘ŶƐƵƌĞĞƐƚĂďůŝƐŚŵĞŶƚŽĨƉŽůŝĐLJĨŽƌ ĐĂŶĐĞƌŶŽƟĮĐĂƟŽŶŝŶƚŚĞŚŽƐƉŝƚĂůƐͬ ĐŽƵŶƚƌLJ

EƵŵďĞƌŽĨƌĞƉŽƌƚƐĂŶĚ ĚŝƐƐĞŵŝŶĂƟŽŶǁŽƌŬƐŚŽƉƐ ŝŝ͘ĞǀĞůŽƉĂŶĂƟŽŶĂůůLJĐŽŽƌĚŝŶĂƚĞĚ ŵŝŶŝŵƵŵĐůŝŶŝĐĂůĚĂƚĂƐĞƚƚŚĂƚůŝŶŬƐ ǁŝƚŚĐĂŶĐĞƌƌĞŐŝƐƚƌŝĞƐ͘ ŝŝŝ͘/ŵƉƌŽǀĞĂŶĐĞƌZĞŐŝƐƚƌLJƉƌŽĐĞƐƐĞƐĨŽƌ ĚĂƚĂĐŽůůĞĐƟŽŶ͕ĂŶĂůLJƐŝƐĂŶĚƌĞƉŽƌƟŶŐ͘ ŝǀ͘ƐƚĂďůŝƐŚŵŽŶŝƚŽƌŝŶŐĂŶĚƌĞƉŽƌƟŶŐŽĨ ĐĂŶĐĞƌŝŶĐŝĚĞŶĐĞĂŶĚŵŽƌƚĂůŝƚLJ͘ ǀ͘ĞǀĞůŽƉƐLJƐƚĞŵƐĨŽƌĞŶƐƵƌŝŶŐƚŚĞ ƋƵĂůŝƚLJĂŶĚĂĐĐƵƌĂĐLJŽĨĚĂƚĂ͘ ǀŝ͘ĞǀĞůŽƉĂĚĚŝƟŽŶĂůƉĞƌĨŽƌŵĂŶĐĞ ŝŶĚŝĐĂƚŽƌƐƚŽŵŽŶŝƚŽƌĐĂŶĐĞƌĐĂƌĞ ƐĞƌǀŝĐĞƐ͘

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22 dĂƌŐĞƚ ŶĂďůĞKZ/ƚŽĨƵůĮůůŝƚƐƌŽůĞĂƐĂŶĂƟŽŶĂůĐĂŶĐĞƌŝŶƐƟƚƵƚĞŝŶƚƌĂŝŶŝŶŐ͕ĞĚƵĐĂƟŽŶĂŶĚƌĞƐĞĂƌĐŚďLJϮϬϮϮ WƵďůŝĐŚĞĂůƚŚĞĚƵĐĂƟŽŶƉƌŽŐƌĂŵƐŽŶĐĂŶĐĞƌĐŽŶƚƌŽůĚĞǀĞůŽƉĞĚĂŶĚŝŵƉůĞŵĞŶƚĞĚ ĂŶĐĞƌĂǁĂƌĞŶĞƐƐĂŶĚƐĞŶƐŝƟǀŝƚLJƌĂŝƐĞĚĂŵŽŶŐŚĞĂůƚŚƉƌŽĨĞƐƐŝŽŶĂůƐďLJϮϬϮϮ džƚĞŶĚĂŶĚĞŶŚĂŶĐĞ ƌĞƐĞĂƌĐŚĂĐƌŽƐƐƚŚĞ ĐŽŶƟŶƵƵŵŽĨĐĂŶĐĞƌ ĐŽŶƚƌŽů ŝ͘ĞǀĞůŽƉĂƐƚƌĂƚĞŐŝĐĂŶĚƌĞŐƵůĂƌƉƌŽĐĞƐƐĨŽƌ ĨĂĐŝůŝƚĂƟŶŐƌĞƐĞĂƌĐŚƌĞůĞǀĂŶƚƚŽĐĂŶĐĞƌĐŽŶƚƌŽů ŝŶdĂŶnjĂŶŝĂ

EƵŵďĞƌŽĨĐĂŶĐĞƌ ƌĞƐĞĂƌĐŚƉƌŽũĞĐƚƐ ĐŽŶĚƵĐƚĞĚŝŶ dĂŶnjĂŶŝĂ EƵŵďĞƌŽĨĐĂŶĐĞƌ ƌĞƐĞĂƌĐŚŽƵƚƉƵƚƐ ĨƌŽŵdĂŶnjĂŶŝĂ ƉƵďůŝƐŚĞĚ &ƵŶĚƐĂůůŽĐĂƚĞĚĨŽƌ ĐĂŶĐĞƌƌĞƐĞĂƌĐŚŝŶ dĂŶnjĂŶŝĂ EƵŵďĞƌŽĨĐĂŶĐĞƌ ĐŽŶƚƌŽůŝŶƚĞƌǀĞŶƟŽŶ ŝŵƉƌŽǀĞŵĞŶƚƐͬ ŝŶŶŽǀĂƟŽŶƐďĂƐĞĚ ŽŶŶĂƟŽŶĂůƌĞƐĞĂƌĐŚ ĮŶĚŝŶŐƐ EƵŵďĞƌŽĨƉƵďůŝĐŚĞĂůƚŚ ƉƌŽŐƌĂŵƐĚĞǀĞůŽƉĞĚ ĂŶĚĚĞůŝǀĞƌĞĚ >ĞǀĞůŽĨĐĂŶĐĞƌ ĂǁĂƌĞŶĞƐƐŝŶƚŚĞ ĐŽŵŵƵŶŝƚLJ EƵŵďĞƌŽĨŚĞĂůƚŚ ƉƌŽĨĞƐƐŝŽŶĂůƐ ƐĞŶƐŝƟnjĞĚŽŶĐĂŶĐĞƌ ĐŽŶƚƌŽůĞĂĐŚLJĞĂƌ EƵŵďĞƌŽĨĐĂŶĐĞƌ ƉĂƟĞŶƚƐƉƌĞƐĞŶƟŶŐ ǁŝƚŚĞĂƌůLJƐƚĂŐĞ ĚŝƐĞĂƐĞ

ŝŝ͘ŶƐƵƌĞŐŽǀĞƌŶŵĞŶƚĨƵŶĚŝŶŐĨŽƌĐĂŶĐĞƌ ƌĞƐĞĂƌĐŚ͕ƚƌĂŝŶŝŶŐĂŶĚĞĚƵĐĂƟŽŶ

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22 ƐƚĂďůŝƐŚĐĂŶĐĞƌ ĞĚƵĐĂƟŽŶĂŶĚ ƚƌĂŝŶŝŶŐƉƌŽŐƌĂŵƐ

ŝ͘&ĂĐŝůŝƚĂƚĞƚƌĂŝŶŝŶŐƐĨŽƌĐĂŶĚŝĚĂƚĞƐŝŶƚĞƌĞƐƚĞĚŝŶ ƚŚĞĮĞůĚƐŽĨŽŶĐŽůŽŐLJŝŶŽǀĞƌƐĞĂƐƵŶŝǀĞƌƐŝƟĞƐĂŶĚ ĐŽůůĞŐĞƐ ŝŝ͘dŽĚĞǀĞůŽƉƚƌĂŝŶŝŶŐĐƵƌƌŝĐƵůƵŵĨŽƌŽŶĐŽůŽŐLJŝŶ dĂŶnjĂŶŝĂŶĐŽůůĞŐĞƐĂŶĚƵŶŝǀĞƌƐŝƟĞƐ ŝŝŝ͘dŽĞƐƚĂďůŝƐŚŽŶĐŽůŽŐLJĚĞƉĂƌƚŵĞŶƚƐŝŶdĂŶnjĂŶŝĂŶ ĐŽůůĞŐĞƐĂŶĚƵŶŝǀĞƌƐŝƟĞƐ ŝǀ͘dŽĞdžƉĂŶĚĐĂŶĐĞƌĮĞůĚƉƌĂĐƟĐĂůǁŽƌŬƐŝŶƚŚĞ ƚƌĂŝŶŝŶŐͬůĞĂƌŶŝŶŐŝŶƐƟƚƵƟŽŶƐĂŶĚƚŽŝŶĐůƵĚĞ ŝŶƚĞƌŶƐŚŝƉƌŽƚĂƟŽŶŝŶĐĂŶĐĞƌŝŶƐƟƚƵƚĞ ǀ͘dŽĚĞǀĞůŽƉĞĚƵĐĂƟŽŶĂůƉĂĐŬĂŐĞƐĨŽƌŵĞĚŝĂ ƉĞƌƐŽŶŶĞůĂŶĚƚŚĞŐĞŶĞƌĂůƉƵďůŝĐ ǀŝ͘dŽĚĞǀĞůŽƉďĂƐŝĐĐĂŶĐĞƌĞĚƵĐĂƟŽŶŵĂƚĞƌŝĂůĨŽƌ ƐĐŚŽŽůƐ ,hDEZ^KhZ^s>KWDEd͗/ŶƐƟůůĂƉƉƌŽƉƌŝĂƚĞŬŶŽǁůĞĚŐĞĂŶĚƐŬŝůůƐƚŽƐƚƌĂƚĞŐŝĐƐƚĂīŝŶĂůůĂƌĞĂƐŽĨĐĂŶĐĞƌĐŽŶƚƌŽůŝŶdĂŶnjĂŶŝĂ dĂƌŐĞƚ ,ĂǀĞŵƵůƟͲĚŝƐĐŝƉůŝŶĂƌLJĐĂŶĐĞƌŵĂŶĂŐĞŵĞŶƚƚĞĂŵƐĂƚĂůůĐŽŶƐƵůƚĂŶƚŚŽƐƉŝƚĂůƐďLJϮϬϮϮ dĂŶnjĂŶŝĂŶŝŶƐƟƚƵƟŽŶƐǁŝƚŚĂĐĐƌĞĚŝƚĞĚƉŽƐƚŐƌĂĚƵĂƚĞƉƌŽŐƌĂŵƐŝŶŽŶĐŽůŽŐLJĂŶĚŽŶĐŽůŽŐLJͲƌĞůĂƚĞĚĮĞůĚƐ /ĚĞŶƟĮĐĂƟŽŶĂŶĚ ZĂƚŝŽŶĂůŝnjĂƚŝŽŶ ŽĨĐĂŶĐĞƌĐŽŶƚƌŽů ĂĐƟǀŝƟĞƐĂƚĚŝīĞƌĞŶƚ ůĞǀĞůƐŽĨ,ĞĂůƚŚ ƐLJƐƚĞŵŝŶdĂŶnjĂŶŝĂ͘

ŝ͘ŐƌĞĞŽŶǁŚŝĐŚƚĂƐŬƐŽĨĐĂŶĐĞƌĐŽŶƚƌŽů ĐĂŶďĞĐĂƌƌŝĞĚŽƵƚĂƚǁŚĂƚ ůĞǀĞůŽĨdĂŶnjĂŶŝĂŶŚĞĂůƚŚƐLJƐƚĞŵ͘

EƵŵďĞƌŽĨƚƌĂŝŶĞĚƐƚĂī ƐŬŝůůĞĚƚŽƉƌŽǀŝĚĞ ĐĂŶĐĞƌŵĂŶĂŐĞŵĞŶƚ EƵŵďĞƌŽĨƵŶŝǀĞƌƐŝƚLJ ĂĐĐƌĞĚŝƚĞĚŽŶĐŽůŽŐLJ ƚƌĂŝŶŝŶŐƉƌŽŐƌĂŵƐ ĐŽŶĚƵĐƚĞĚŝŶdĂŶnjĂŶŝĂ

ŝŝ͘ĞƚĞƌŵŝŶĞƚŚĞŵĂŶƉŽǁĞƌĐĂƉĂĐŝƚLJ ĂŶĚƌĞƋƵŝƌĞŵĞŶƚƐĂƚĞĂĐŚůĞǀĞů͘

/ĚĞŶƟĮĐĂƟŽŶŽĨƚŚĞ ƚƌĂŝŶŝŶŐĐĂƉĂĐŝƚLJ ;ĐƵƌƌŝĐƵůƵŵĂŶĚ ŚƵŵĂŶƌĞƐŽƵƌĐĞͿŽĨ ĂůůŚĞĂůƚŚƚƌĂŝŶŝŶŐ /ŶƐƟƚƵƟŽŶƐ͘

ŝ͘ŽŶĚƵĐƚƐƵƌǀĞLJŽĨƚŚĞĚŝīĞƌĞŶƚ ŚĞĂůƚŚdƌĂŝŶŝŶŐ/ŶƐƟƚƵƟŽŶƐŝŶƚŚĞ ĐŽƵŶƚƌLJ͘

EƵŵďĞƌŽĨŽŶĐŽůŽŐŝƐƚƐ ƚƌĂŝŶĞĚ EƵŵďĞƌŽĨĂƉƉƌŽǀĞĚ ĐƵƌƌŝĐƵůĂĂŶĚƚƌĂŝŶŝŶŐ ƉƌŽŐƌĂŵƐĨŽƌĐĂŶĐĞƌ ĐŽŶƚƌŽů

ŝŝ͘ǀĂůƵĂƚĞƚŚĞŝƌƐLJůůĂďƵƐĞƐĂŶĚƐƚĂĸŶŐ ĂŐĂŝŶƐƚĂŶĐĞƌĐŽŶƚƌŽůDĂŶĂŐĞŵĞŶƚ ƚƌĂŝŶŝŶŐŶĞĞĚƐ͘ ŝŝŝ͘hƉĚĂƟŶŐƚŚĞ^LJůůĂďƵƐĞƐĂŶĚŚƵŵĂŶ ƌĞƐŽƵƌĐĞƐƌĞƋƵŝƌĞŵĞŶƚƐƚŽĐĂƚĞƌĨŽƌ ƚŚĞŶĞĞĚƐŽĨƚŚĞĐĂĚƌĞƐŝŶǀŽůǀĞĚŝŶ ĐĂŶĐĞƌĐŽŶƚƌŽůĂŶĚŵĂŶĂŐĞŵĞŶƚ͘ dƌĂŝŶŝŶŐĂŶĚƉŽƐƟŶŐ ŽĨƚŚĞƌĞƋƵŝƌĞĚ ǁŽƌŬĨŽƌĐĞĂƚĞĂĐŚ ůĞǀĞů

ŝ͘ŽŶĚƵĐƚdƌĂŝŶŝŶŐEĞĞĚƐ ƐƐĞƐƐŵĞŶƚ͘ƉƉƌŽǀĞĚƐĐŚĞŵĞŽĨ ƐĞƌǀŝĐĞĨŽƌŚĞĂůƚŚ ĐĂƌĞƐƚĂīŝŶĐůƵĚŝŶŐ ĐĂĚƌĞƐŝŶĐĂŶĐĞƌ ĐŽŶƚƌŽů ŝŝ͘ĞǀĞůŽƉƐŚŽƌƚĂŶĚůŽŶŐƚĞƌŵ ƚƌĂŝŶŝŶŐĂƉƉƌŽĂĐŚĂŶĚďƵĚŐĞƚĨŽƌ ĞĂĐŚĐĂĚƌĞ͘ ŝŝŝ͘ĂƌƌLJŽƵƚĐĂƉĂĐŝƚLJĂŶĚ ĐŽŵƉĞƚĞŶĐĞďƵŝůĚŝŶŐĨŽƌ ƚƌĂŝŶŝŶŐŝŶƐƟƚƵƟŽŶƐ͕ĂŶĚƌĞĨĞƌƌĂů ,ŽƐƉŝƚĂůƐ͘ ŝǀ͘:ŽŝŶƚůLJďĞƚǁĞĞŶƚƌĂŝŶŝŶŐ ŝŶƐƟƚƵƟŽŶƐĂŶĚƌĞĨĞƌƌĂů ŝŶƐƟƚƵƟŽŶƐĐĂƌƌLJŽƵƚƉŚĂƐĞĚŝŶ ƐĞƌǀŝĐĞƚƌĂŝŶŝŶŐĨŽƌĞĂĐŚĐĂĚƌĞ͘ ǀ͘ĞǀĞůŽƉŝŶĐĞŶƟǀĞƐĨŽƌLJŽƵŶŐ ĚŽĐƚŽƌƐĂŶĚŽƚŚĞƌĐĂŶĐĞƌĐĂƌĞ ƉĞƌƐŽŶŶĞůƚŽďĞŵŽƟǀĂƚĞĚƚŽŐŽ ĨŽƌĨƵƌƚŚĞƌƚƌĂŝŶŝŶŐ͘

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22

^dZd'zd/s/dzdŝŵĞĨƌĂŵĞZĞƐƉŽŶƐŝďůĞ/E/dKZ^ ‘13‘14‘15‘16‘17‘’18‘19‘20‘21‘22 ŶƐƵƌŝŶŐ ZĞĐƌƵŝƚŵĞŶƚĂŶĚ ZĞƚĞŶƟŽŶŽĨŵŽƐƚ ŽĨƚŚĞƚƌĂŝŶĞĚ ƉĞƌƐŽŶŶĞů

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WƌŽǀŝĚĞƐĞĞĚŐƌĂŶƚƐWƌŽǀŝĚĞĂĐŽŵƉĞƟƟǀĞƐĞĞĚŐƌĂŶƚƚŽŵĞŵďĞƌƐ ŽĨƚŚĞdĂŶnjĂŶŝĂĂŶĐĞƌƐƐŽĐŝĂƟŽŶƚŽůĂƵŶĐŚ ĂĐƟǀŝƟĞƐĂŝŵĞĚĂƚŵŽďŝůŝnjŝŶŐŝŵƉƌŽǀĞĚ ĐŽŽƌĚŝŶĂƟŽŶŝŶĐĂŶĐĞƌĐŽŶƚƌŽůĂŶĚďƵŝůĚŝŶŐ ƚŚĞŐƌĂƐƐƌŽŽƚƐĂŶĚĐŽŵŵƵŶŝƚLJͲďĂƐĞĚ ƌĞƐƉŽŶƐĞƚŽƚŚĞĮŐŚƚĂŐĂŝŶƐƚĐĂŶĐĞƌ͘

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ƉŽůŝĐŝĞƐĂŶĚ ŚĞĂůƚŚƐĞƌ

ǀŝĐĞƐ

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EĂƟŽŶĂů ĐĂŶĐĞƌ

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EƵŵďĞƌŽĨĐĂŶĐĞƌĐ ŽŶƚ ƌŽůĂĐƟǀŝƟĞƐĂŶĚƉƌ ŽũĞĐƚƐŝŶĐŽƌƉŽƌ

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ĂƚĂů ůůĞǀ

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ϱ͘ DŽŶŝƚŽƌŝŶŐĂŶĚǀĂůƵĂƟŽŶhŶŝƚ͘

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EĂŵĞ WŽƐŝƟŽŶ͕/ŶƐƟƚƵƟŽŶ

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^ĞƌǀŝĐĞƐ͕DK,^tʹE/Z

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EĂŵĞ WŽƐŝƟŽŶ͕/ŶƐƟƚƵƟŽŶ

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ƉƉĞŶĚŝdžϯ͗dŚĞEĂƟŽŶĂůĂŶĐĞƌŽŶƚƌŽů^ƚƌĂƚĞŐLJtŽƌŬŝŶŐ'ƌŽƵƉƐ

'ƌŽƵƉ DĞŵďĞƌƐ

WƌŝŵĂƌLJWƌĞǀĞŶƟŽŶ ƌ'ŽĚĨƌĞLJ<ŝĂŶŐŝ ƌDŽŚĂŵĞĚŵƌŝ

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ĂŶĐĞƌƌĞŐŝƐƚƌĂƟŽŶ ƌWĞƚĞƌDŵďƵũŝ

dƌĞĂƚŵĞŶƚ WƌŽĨ>ĞŽŶĂƌĚ>ĞŵĂ DƌďƌĂŚĂŵELJĂŶĚĂ

ŽͲŽƉƚĞĚŵĞŵďĞƌƐʹƌŝǁĂŶŝDƐĞŵŽ

WĂůůŝĂƟǀĞĂƌĞ ƌdǁĂůŝďEŐŽŵĂ

ŽͲŽƉƚĞĚŵĞŵďĞƌƐʹƌŝǁĂŶŝDƐĞŵŽ dƌĂŝŶŝŶŐ͕ĞĚƵĐĂƟŽŶĂŶĚƌĞƐĞĂƌĐŚ ƌ:ŽƐĞƉŚDďĂƟĂ

,ƵŵĂŶƌĞƐŽƵƌĐĞĚĞǀĞůŽƉŵĞŶƚ WƌŽĨDĂŶŽƌŝƐDĞƐŚĂĐŬ

ŽͲŽƉƚĞĚŵĞŵďĞƌʹDƐDĞůĂŶŝĞ^ǁĂŝ dĂŶnjĂŶŝĂĂŶĐĞƌƐƐŽĐŝĂƟŽŶ ƌDĂƌŝŶĂEũĞůĞŬĞůĂ

ŽͲŽƉƚĞĚŵĞŵďĞƌƐʹDƌƌĂƐƚƵƐDǁŝůŝŬĞ͕ƌ&ůŽƌĞŶĐĞdĞŵƵ͕ƌŽŵŝŶŝƐƚĂ

<ŽŵďĞ

ƉƉĞŶĚŝdžϰ͗^ƚĂŬĞŚŽůĚĞƌƐ͛tŽƌŬƐŚŽƉWĂƌƟĐŝƉĂƟŶŐ/ŶƐƟƚƵƟŽŶƐ

/ŶƐƟƚƵƟŽŶ dŽǁŶ

DK,Θ^tͲDĂŝŶůĂŶĚ ĂƌĞƐ^ĂůĂĂŵ

DĞǁĂƚĂ ĂƌĞƐ^ĂůĂĂŵ

Dh,^ͬDE, ĂƌĞƐ^ĂůĂĂŵ

MNH ĂƌĞƐ^ĂůĂĂŵ

ŽĚŽŵĂhŶŝǀĞƌƐŝƚLJ ŽĚŽŵĂ

t,KdĂŶnjĂŶŝĂ ĂƌĞƐ^ĂůĂĂŵ

DK,Θ^tͲĂŶnjŝďĂƌ ĂŶnjŝďĂƌ

DǁĂŶŐĂŝƐƚƌŝƐƚ DǁĂŶŐĂ

DďĞLJĂZĞĨĞƌƌĂů,ŽƐƉŝƚĂů DďĞLJĂ

ĂŶĐĞƌ^ƵƌǀŝǀŽƌƐ ĂƌĞƐ^ĂůĂĂŵ

>ŝŶĚŝZĞŐŝŽŶĂů,ŽƐƉ >ŝŶĚŝ

ZDKŽĸĐĞʹƌƵƐŚĂ ƌƵƐŚĂ

ZDKŽĸĐĞͲDďĞLJĂ DďĞLJĂ

WĞƌĂŵŝŚŽ,ŽƐƉ ^ŽŶŐĞĂ

dW ĂƌĞƐ^ĂůĂĂŵ

/ŶƐƟƚƵƟŽŶ dŽǁŶ

CDC ĂƌĞƐ^ĂůĂĂŵ

ZDKŽĸĐĞͲDŽƌŽŐŽƌŽ DŽƌŽŐŽƌŽ

džŝŽƐ ĂƌĞƐ^ĂůĂĂŵ

ZDKŽĸĐĞͲ^ŽŶŐĞĂ ^ŽŶŐĞĂ

DKŽĸĐĞͲ^ƵŵďĂǁĂŶŐĂ ^ƵŵďĂǁĂŶŐĂ

ORCI ĂƌĞƐ^ĂůĂĂŵ

dd& ĂƌĞƐ^ĂůĂĂŵ

DKͲdĞŵĞŬĞ ĂƌĞƐ^ĂůĂĂŵ

d& ĂƌĞƐ^ĂůĂĂŵ

,<Dh ĂƌĞƐ^ĂůĂĂŵ

d&E ĂƌĞƐ^ĂůĂĂŵ

W,&d ĂƌĞƐ^ĂůĂĂŵ

/Ddh ĂƌĞƐ^ĂůĂĂŵ

ZDKKĸĐĞ ĂƌĞƐ^ĂůĂĂŵ

DKŽĸĐĞ DƵŚĞnjĂ

ZDKŽĸĐĞͲŽĚŽŵĂ ŽĚŽŵĂ

NHIF ĂƌĞƐ^ĂůĂĂŵ

/W ĂƌĞƐ^ĂůĂĂŵ

ƉƉĞŶĚŝdžϱ͗^ƚƌĂƚĞŐLJĞǀĞůŽƉŵĞŶƚWƌŽĐĞƐƐ WƌĞůŝŵŝŶĂƌLJWůĂŶŶŝŶŐWŚĂƐĞ

dŚĞE^ǁĂƐĚĞǀĞůŽƉĞĚďLJĂďƌŽĂĚƉĂƌƚŶĞƌƐŚŝƉŽĨƉƵďůŝĐĂŶĚƉƌŝǀĂƚĞƐƚĂŬĞŚŽůĚĞƌƐǁŚŽƐĞĐŽŵŵŽŶŵŝƐƐŝŽŶǁĂƐƚŽ ĚĞǀĞůŽƉĂŶĂƟŽŶĂůƐƚƌĂƚĞŐLJƚŽƌĞĚƵĐĞƚŚĞďƵƌĚĞŶŽĨĐĂŶĐĞƌŝŶdĂŶnjĂŶŝĂ͘ƐƚĞĞƌŝŶŐĐŽŵŵŝƩĞĞŵĂĚĞƵƉŽĨϭϱŝŶĚŝǀŝĚƵĂůƐ ŐƵŝĚĞĚƚŚĞǁŽƌŬŽĨƉƌĞƉĂƌŝŶŐƚŚŝƐƐƚƌĂƚĞŐLJĚŽĐƵŵĞŶƚ͘dŚĞƌĞƐƵůƚŽĨƚŚŝƐƉƌŽĐĞƐƐǁĂƐƚŽĞƐƚĂďůŝƐŚĂƐƚƌĂƚĞŐLJĚŽĐƵŵĞŶƚ ǁŚŝĐŚǁŝůůĞŶŚĂŶĐĞƚŚĞŝŶĨƌĂƐƚƌƵĐƚƵƌĞĨŽƌĐĂŶĐĞƌĐŽŶƚƌŽůĂĐƟǀŝƟĞƐ͘

dŚĞƐƚƌĂƚĞŐLJŝƐĚĞƐŝŐŶĞĚƚŽƉƌŽŵŽƚĞĂŶĂƟŽŶǁŝĚĞĐŽŽƌĚŝŶĂƟŽŶŽĨƉƵďůŝĐĂŶĚƉƌŝǀĂƚĞĐĂŶĐĞƌĐŽŶƚƌŽůĞīŽƌƚƐ͕ƉƌŽǀŝĚĞĂ ĨƌĂŵĞǁŽƌŬĨŽƌĂĐƟŽŶƚŽƌĞĚƵĐĞƚŚĞďƵƌĚĞŶŽĨĐĂŶĐĞƌ͕ĂŶĚŝŶĐƌĞĂƐĞĐŽŵŵƵŶŝĐĂƟŽŶĂŶĚĐŽůůĂďŽƌĂƟŽŶĂŵŽŶŐĂůůƚŚŽƐĞ ŝŶǀŽůǀĞĚŝŶǁŽƌŬŝŶŐǁŝƚŚĐĂŶĐĞƌĐĂƌĞ͘

&ŽƌŵĂƟŽŶŽĨƚŚĞ^ƚĞĞƌŝŶŐŽŵŵŝƩĞĞĨŽƌEĂƟŽŶĂůĂŶĐĞƌŽŶƚƌŽů^ƚƌĂƚĞŐLJ

&ŽůůŽǁŝŶŐ Ă ĐŽŵŵŝƚŵĞŶƚ ĨƌŽŵ ƚŚĞ DŝŶŝƐƚĞƌ ŽĨ ,ĞĂůƚŚ ĂŶĚ ^ŽĐŝĂů tĞůĨĂƌĞ͕ ƚŚĞ ^ƚĞĞƌŝŶŐ ŽŵŵŝƩĞĞ ĨŽƌ E^͕ ǁŝƚŚ ĞdžƉĞƌƟƐĞŝŶƚŚĞǀĂƌŝŽƵƐĂƐƉĞĐƚƐŽĨĐĂŶĐĞƌĐŽŶƚƌŽů͕ǁĂƐĨŽƌŵĞĚŝŶDĂLJϮϬϬϳƚŽŽǀĞƌƐĞĞĚĞǀĞůŽƉŵĞŶƚŽĨƚŚĞƐƚƌĂƚĞŐLJ͘

dŚĞWdĨƵŶĚĞĚƚŚĞĚĞǀĞůŽƉŵĞŶƚŽĨƚŚĞƐƚƌĂƚĞŐLJ͘tŽƌŬŝŶŐŐƌŽƵƉƐǁĞƌĞĞƐƚĂďůŝƐŚĞĚƚŽĂĚǀŝƐĞƚŚĞ^ƚĞĞƌŝŶŐŽŵŵŝƩĞĞ ĂŶĚƚŽƌĞĐŽŵŵĞŶĚƉƌŝŽƌŝƟĞƐĨŽƌƚŚĞƐƚƌĂƚĞŐLJ͘

ŶŐĂŐŝŶŐĂŽŶƐƵůƚĂŶƚ

,ĞĂůƚŚƐƚĂƚƵƐ ĚĞƐĐƌŝƉƟŽŶĂŶĚͬŽƌŵĞĂƐƵƌĞŵĞŶƚŽĨƚŚĞŚĞĂůƚŚŽĨĂŶŝŶĚŝǀŝĚƵĂůŽƌƉŽƉƵůĂƟŽŶ͘

ZĞĨĞƌĞŶĐĞƐ

ϭ͘ ĂŶĂĚŝĂŶ^ƚƌĂƚĞŐLJĨŽƌĂŶĐĞƌŽŶƚƌŽů͗ŚƩƉ͗ͬͬϮϬϵ͘Ϯϭϳ͘ϭϮϳ͘ϳϮͬŚŽŵĞͺĐƐĐĐ͘Śƚŵů^ĞƉƚĞŵďĞƌϭϰ͕ϮϬϬϳ Ϯ͘ 'ůŽďĂůĂĐƟŽŶĂŐĂŝŶƐƚĐĂŶĐĞƌ͕h/͕ϮϬϬϱ

ϯ͘ DK,ĚŽĐƵŵĞŶƚ͕ŚƩƉ͗ͬͬǁǁǁ͘ŵŽŚ͘ŐŽǀƚ͘ŶnjͬĐĂŶĐĞƌĐŽŶƚƌŽů^ĞƉƚĞŵďĞƌϭϰ͕ϮϬϬϳ ϰ͘ EĂƟŽŶĂůĂŶĐĞƌŽŶƚƌŽůWůĂŶŶŝŶŐZĞƐŽƵƌĐĞƐĨŽƌE'KƐ͕h/͕ϮϬϬϲ

ϱ͘ KƉĞŶŝŶŐƐƉĞĞĐŚďLJĞƉƵƚLJDŝŶŝƐƚĞƌŽĨ,ĞĂůƚŚĂƚƚŚĞϭ^ƐƚƐĐŝĞŶƟĮĐĐŽŶĨĞƌĞŶĐĞŽĨKZ/ʹŶĂƟŽŶĂůĐĂŶĐĞƌĐŽŶƚƌŽů͗ĂĐĂůůĨŽƌ ĂĐƟŽŶ͕ϮϬϬϲ

ϲ͘ KZ/;ϮϬϬϲͿ͕ŽŵƉƌĞŚĞŶƐŝǀĞĂŶĐĞƌŽŶƚƌŽůĂƉĂďŝůŝƟĞƐŝŶĂƌĞƐ^ĂůĂĂŵ͕WƌŽũĞĐƚƉƌŽƉŽƐĂů͘

ϳ͘ KZ/ĂŶŶƵĂůƌĞƉŽƌƚ͕ϮϬϬϲ

ϴ͘ dŚĞEĞǁĞĂůĂŶĚĂŶĐĞƌŽŶƚƌŽů^ƚƌĂƚĞŐLJ͕DŝŶŝƐƚƌLJŽĨ,ĞĂůƚŚĂŶĚƚŚĞEĞǁĞĂůĂŶĚĂŶĐĞƌŽŶƚƌŽůdƌƵƐƚϮϬϬϯ ϵ͘ dĂŶnjĂŶŝĂDDW͕ϮϬϬϯ

ϭϬ͘ t,KĚŽĐƵŵĞŶƚ͘ŚƩƉ͗ͬͬǁǁǁ͘ǁŚŽ͘ŝŶƚͬĐĂŶĐĞƌͬŵĞĚŝĂͬƐƚƌĂƚĞŐLJͬĞŶͬ^ĞƉƚĞŵďĞƌϭϰ͕ϮϬϬϳ ϭϭ͘ t,Kǁǁǁ͘ǁŚŽ͘ŝŶƚͬƐƵďƐƚĂŶĐĞͺĂďƵƐĞͬƉƵďůŝĐĂƟŽŶƐͬĞŶͬƵŶŝƚĞĚƌĞƉƵďůŝĐƚĂŶnjĂŶŝĂ͘ƉĚĨ͕^ĞƉƚϮϬϬϳ

Ministry of Health and Social Welfare National Cancer Control Strategy (NCCS)

(2013-2022)

Dans le document National Cancer Control Strategy (NCCS) (Page 13-0)