This was a powerful and ambitious objective, but against the backdrop of COVID-19, the importance of non-communicable diseases is easily forgotten, and these goals left hollow and undelivered. The theme of this meeting would have been Delivering a Common Future: Connecting, Innovating, Transforming. June 22–27, 2020, would have marked the occasion of the biennial Commonwealth Heads of Government Meeting in Kigali, Rwanda, had it not been postponed due to the coronavirus disease 2019 (COVID-19) pandemic. Our experience during the curation of the Cancer Control in Small Island Nations Series highlighted some grave issues: despite considerable proactivity and engagement across the Pacific islands with welcome enthusiasm and assistance from the Pacific Community (a regional intergovernmental agency), engagement in the Caribbean islands was-and continues to be-woefully inadequate, with local agencies unwilling to participate or take the concerns seriously. Indeed, there are only 39 small states in the world, and thus the Commonwealth comprises the majority. The Commonwealth has a key role to play here-32 of its 54 member countries are classified as small states with unique challenges and vulnerabilities. In 2019, The Lancet Oncology published a Series by Diana Sarfati and colleagues outlining the challenges surrounding cancer control in small island nations, along with possible solutions. Unfortunately, progress towards achieving this goal has been lacking in some Commonwealth countries. Among these, the Charter notes, “the necessity of access to affordable health care … for all citizens and … the importance of promoting health and wellbeing in combating communicable and non-communicable diseases”.
The Commonwealth Charter sets out 16 guiding principles towards the shared goals of prosperity, democracy, and peace. Established in 1887 and with its roots in the British Empire, the Commonwealth is one of the world's oldest political associations with a membership representing 2♴ billion people from 54 of the world's “biggest, smallest, richest, and poorest countries”.
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