2017 is coming to an end and, as always, this is a time to look back on, remember achievements, re-evaluate challenges and set new goals for 2018. It is also an opportunity to show gratitude and to recognize all those who, together with us, have been involved in the fight against breast cancer and in the struggle for health in Brazil. With this in mind, FEMAMA would like to share some of the important milestones of 2017:

> World Cancer Day (02/04) – #DesafioFEMAMA

In February, FEMAMA participated in the World Cancer Day campaign of the Union for International Cancer Control (UICC), with several actions. From 2016 to 2018, under the slogan "We Can, I Can.", the campaign seeks to show how everyone – together or individually – can do their part to fight cancer.

In the 2017 edition, FEMAMA launched the #DesafioFEMAMA action on social networks that stimulated the adoption of healthy habits with an impact on the reduction of cancer risks. Associated NGOs held Public Hearings scheduled in eight Brazilian states to evaluate the access to treatments for patients with metastatic breast cancer in the state.

> Cycles and Hearings – debate for better treatments of metastatic breast cancer in SUS (Unified Health System) in state legislatures

In 2017, FEMAMA held two Cycles of Debates on Breast Cancer for Parliamentarians and eight Public Hearings in Legislative Assemblies, events to discuss the incorporation of new treatments for metastatic breast cancer in the public health network. These hearings were scheduled during World Cancer Day.

– 03/08 – Rio Grande do Sul (Hearing)
– 04/26 – Ceará, Federal District, Mato Grosso do Sul, Paraná, São Paulo, Sergipe (Hearings)
– 05/08 – Pará (Cycle)
– 05/12 – Alagoas (Hearing)
– 05/30 – Piauí (Cycle)

> #PacientesNoControle Part I – award-winning campaign and new treatments for metastatic breast cancer in SUS

In early April, FEMAMA launched the campaign #PacientesNoControle, in which it called upon civil society to give its opinion on two public consultations opened by the National Commission for the Incorporation of Technologies in SUS (CONITEC) for the incorporation of two drugs for metastatic breast cancer in SUS: trastuzumab and pertuzumab.

FEMAMA closely monitored the entire process of incorporating the two drugs – which ended up being included in SUS – and some of the institution's efforts were recognized at an international event in Lisbon in November. FEMAMA and its network have worked hard in recent years to allow patients with metastatic breast cancer to have access to these drugs.

> Access to the diagnosis of cancer – PL of 30 days approved by the CSSF

In August, FEMAMA celebrated the approval of the 30 Day Bill – which establishes a maximum period of 30 days for the conduct of cancer diagnostic exams in SUS – in the Social Security and Family Commission of the Chamber of Deputies. For years, FEMAMA has been working and articulating so that the bill would become law and benefits all SUS patients.

In June, FEMAMA suggested changes to the project text. At the time, the rapporteur withdrew the PL from the voting list of the CSSF to evaluate the recommendations and adjustments that were suggested by the Technical and Scientific Body of the Federation.

After approval by the CSSF, the project will go to the Finance and Taxation Commission (CFT) and the Constitution and Justice Commission (CCJ) of the Chamber of Deputies.

> Compulsory Cancer Registry as a Public Policy

The year 2017 was marked by FEMAMA's strongest role in adopting compulsory cancer registration. Compulsory reporting provides key data for improving the management of public health resources and streamlines the diagnosis and treatment of cancer in the country, facilitating the monitoring and enforcement of the 60 Day Law.

In September, FEMAMA's articulation on the agenda culminated in the creation of two bills in the Chamber of Deputies. In July, the NGO associated with Recomeçar, in partnership with the Federation, led to the regulation of compulsory registration in the Federal District.

> FEMAMA reaches the number of 70 associated NGOs

Throughout the year, FEMAMA celebrated the arrival of eight more NGOs associated with the network, which now brings the total to 70 institutions in 18 states and the Federal District:

– Associação Amigas do Peito do Pará (AAPP), from Belém (PA);
– Grupo de Apoio aos Portadores de Câncer de Cachoeiro de Itapemirim, from Cachoeiro do Itapemirim (ES);
– Associação Beneficente Amigas da Mama do Litoral, from Imbé (RS);
– Associação Buziana de Apoio à Pessoa com Câncer, from Búzios (RJ);
– Associação Laço Rosa de Araras, from Araras (SP);
– Rede Feminina de Combate ao Câncer de Criciúma, from Criciúma (SC);
– Rede Feminina de Combate ao Câncer de Içara, from Içara (SC);
– Grupo de Apoio e Prevenção ao Câncer de Mama de Viamão, from Viamão (RS).

> #PacientesNoControle Parte II – Outubro Rosa (Pink October) and the empowerment of patients

The tenth edition of FEMAMA's national campaign Outubro Rosa, aimed at raising awareness among cancer patients, their families, friends and colleagues about the importance of providing information and actively participating in decision making in regards to coping with the disease. Under the motto #PatientsNoControle – Attitude Requires Courage, it drew attention to the empowerment of patients and the need to know the rights that guarantee them access to diagnosis and treatment.

At the end of September, as part of the actions of Outubro Rosa, FEMAMA launched an online mobilization demanding that several bills in the Chamber of Deputies regarding access to the diagnosis and treatment of cancer become effective rights for thousands of cancer patients in the country.

> Ambassadors

In 2017, FEMAMA launched the project Ambassadors – Women in Defense of Breast Health, in partnership with the Breast Institute of Rio Grande do Sul (IMAMA), an NGO associated with FEMAMA in Porto Alegre (RS). The action sought to empower breast cancer patients, family members and people involved in the cause to assume a leadership and representative role in advocacy for health care rights.

> FEMAMA Forum and National Conference of First Ladies

FEMAMA, in 2017, held two more events to promote the fight against breast cancer in Brazil. In August, at the 1st National Conference of Mayors and Governors and the 7th National Conference of First Ladies, women leaders met to discuss the political, social and economic issues of women's cancer, discussing strategies to tackle the disease, starting with a global overview of the disease for the debate about local actions involving the public powers and the non-profit sector.

For the first time in November, Fortaleza hosted the Forum to Combat Women's Cancer, an annual event sponsored by FEMAMA and was marked by the intense exchange of experiences among members of NGOs, patients and medical specialists, in order to foster strategies and actions at a national level of coping with the disease.

> FEMAMA extends its role in social control

In 2017, FEMAMA took on two vice-coordinator positions at the National Health Council (CNS): the Inter-Sectoral Commission on Health Care for People with Pathologies (CIASPP) and the Inter-Sectoral and Supplementary Health Commission (CISS).

The commissions are advisory bodies to the CNS Plenary and seek to strengthen Social Control and social participation, establish strategies and procedures for the monitoring and supervision of SUS actions and services.

> Advances in the access to mammography

December was also important for access to the diagnosis of cancer. The Senate approved the draft legislative decree (PDS 42/2015) that ensures the access of women between 40 and 49 years to the mammography exam in SUS.

In the same month, Law 13,522/17 was sanctioned. The law states that teams from the social safety network and basic health care workers will seek out women who are struggling to perform preventative medical examinations and uterine and breast cancer screening and help them so that they can perform these examinations.

> Incorporation of trastuzumab and pertuzumab into SUS for metastatic breast cancer

In December, CONITEC announced the inclusion of pertuzumab for metastatic breast cancer in SUS. In August, they announced the use of trastuzumab for the same purpose.

FEMAMA has been working for years to achieve this result, having as one of its focus points the expansion of access to treatments for patients with metastatic breast cancer in SUS. During the public consultation that sought to hear society's opinion about the offering of trastuzumab and pertuzumab in the public health network, the institution launched the campaign #PacientesNoControle, in order to mobilize the population to participate. This was one of the consultations of the Ministry of Health with the largest number of contributions from 2017 until then.

In addition to the aforementioned campaign, FEMAMA, along with its NGO network, promoted Debate Cycles with Parliamentarians and Public Hearings on the theme in 15 Brazilian states, events to strengthen the performance of organized civil society to pursue this goal such as the Forum to Combat Women's Cancer, and projects to stimulate the joint actions of the non-profit sector institutions with regional political leaderships such as the National Conference of Mayors and Governors and the National Conference of First Ladies. Joint ventures took place with NGO partners to analyze and formulate guidance documents, mobilize the executive and legislative areas, acting in the National Health Conference, in addition to campaigns of awareness and mobilization in previous years for the expansion of access to treatments.

In 2018, FEMAMA will continue to provide access to quality information, will continue to demand the fulfillment of the acquired rights and continue in the fight for more achievements. The institution will also support and promote actions that will attract the attention of society and the government. Let's make it an incredible year together!