Tirana Declaration on Transforming Cancer Care Together in Europe

We, the representatives of governments, national parliaments, European institutions, patient organisations, civil society, and healthcare experts, gathered in Tirana on April 4th, 2025, for the event Transforming Cancer Care Together. This declaration is a follow-up to the declaration made in Bucharest on October 16th, 2024, where critical challenges Europe faces in combating cancer were acknowledged and where the following areas for collaboration and joint action were identified:

• Promoting early detection and screening
• Enhancing education and public awareness
• Improving the oncological patient journey
• Reducing inequalities in access to cancer care
• Recognising the economic impact of cancer

This declaration reaffirms our dedication to improving cancer care at both the national and European levels, with a special focus on mobilising funding and investments to realise accessible, affordable, and sustainable high-quality cancer care and to create both economic and social impact across countries. Cancer incidence and mortality are rising across Europe, accompanied by significant productivity losses and economic strain. Untreated or inadequately managed cancer leads to poor patient outcomes, a lower quality of life, and overall economic losses, underscoring the urgency for strategic interventions.

Investing in cancer care (e.g., early detection, treatment access, prevention) costs far less than the Gross Domestic Product lost to cancer-related productivity declines. The EU’s Cancer Plan estimates that every €1 invested in prevention and better care yields up to €14 in economic returns. Healthier populations contribute longer to the workforce, reducing disability burdens and fostering economic growth: a 10% reduction in cancer mortality could save billions annually in Europe.

Southern, Central, and Eastern European countries face unique challenges, including underfunded healthcare systems, disparities in rural/urban access, higher rates of cancers and their complications (e.g., breast, lung, cervical), as well as workforce shortages. Tailored strategies should address these gaps while leveraging funding, investments, and regional collaboration.

Southern, Central, and Eastern European countries can turn challenges into opportunities by targeting high-impact cancers, leveraging EU funds, and fostering regional collaboration. Prioritising equity, prevention, and workforce development will not only save lives but also boost economic productivity by keeping citizens healthy. Praiseworthy progress in the region has been made during the last decade, but policymakers can make a difference in bringing the quality of cancer care to the next level.

Accordingly, parties undersigning the Tirana Declaration on Transforming Cancer Care Together are dedicated to jointly working on:

1. A regional strategy for prioritising funding, investment mechanisms, reimbursement, and national budget reallocations for sustainable high-quality cancer care
2. Regional collaboration to mobilise funding and investment for leveraging cross-border trials, research, and innovation through existing programmes like Europe’s Beating Cancer Plan and Horizon Europe funding
3. Mobilising funding and investment for modernising infrastructure and data systems, including cancer registries
4. Universal access to early diagnostics and innovative therapies while minimising or eliminating out-of-pocket costs for diagnostics, treatment, and other cancer-related expenses
5. Tackling workforce shortages by mobilising funding and investment for regional training hubs, collaboration, and knowledge exchange, as well as sharing best practices (e.g., health professionals, managers, procurers, HTA, data scientists)
6. Reducing disparities (e.g., rural access, marginalised communities) through equity-focused investments to prevent broader economic drag from untreated populations

We, the undersigned, express our willingness to continue working as described above with national and European institutions, patient communities, healthcare providers, and policymakers to create a future where cancer is detected earlier, treated more effectively, and where every patient has the opportunity for a longer and healthier life.

Signed