WHAT IS HINDERING PROVISION OF SUSTAINABLE CANCER CARE IN AFRICAN COUNTRIES?

Cancer is by definition a group of diseases which involve the growth of abnormal cells that have the potential to spread through the body and invade the entire immune system. With more than 100 types of cancer in existence, in accordance with WHO, almost ten million people die from cancer each year and a large percentage of the deaths from cancer worldwide is caused by lung cancer, colorectal cancer, liver cancer, breast cancer and stomach cancer.

Cancer has proved for decades to be a major drawback in the global public health sector affecting both developed and developing countries, besides, it has also contributed to the global economic disparity. On that account, this article particularly highlights the setbacks faced in low-income countries located in Africa as far as the provision of cancer care is concerned.

According to statistics, by the year 2030, there will be at least 21 million new cancer cases globally; this indicates that the cancer rates are continuously rising especially within developing countries. Even though there has been a promising increase in the rates of cancer survival due to advancement in the medical research and technology sector which has significantly contributed to increased chances of early detection and effective treatment, there are still major factors hindering the progress with regard to cancer care. These challenges include;

1. limited access to crucial data and educational resources which highly impacts the progress of research and projects relevant to the discovery of new treatment methods and, furthermore leads to poor documentation of the cancer diagnosis and treatment statistics within low-income countries
2. ineffective sensitization which fuels widespread of misinformation on the nature, causes and signs of cancer hence resulting in significantly low cancer awareness, not to mention it also triggers cancer stigma. This factor is one of the main reasons more than 80% of patients of cancer in African countries are already in later or advanced stages of the disease by the time of diagnosis.
3. insufficiency of financial resources which has affected the governments’ capability to fully fund the training of oncology professionals (physicians, care takers, medical physicists and engineers, radiologists, researchers, etc.), provide up-to-date cancer treatment machinery and support the maintenance of cancer treatment facilities that can provide reliable health care to patients of cancer. For example, in 2016 when the sole radiotherapy machine in Uganda broke down, more than 75% of the cancer patients in the country had no other alternative other than to travel abroad for treatment which would cost them over $5000. As of 2020, there were only 365 radiotherapy machines in the continent, and 60% of these were in Egypt, Morocco and South Africa. This illustrates very clearly the dire state of cancer care within the continent.
4. the lack of expertise to the extent that some countries have less than 10 to zero professional oncologists which has created an imbalance in the ratio of cancer cases to oncology specialists for instance according to a survey by the SA Society of Clinical and Radiation Oncology, as of 2018, in South Africa, there were only 38 oncologists working in the public sector. In addition, as per data collected for the “Global survey of Clinical Oncology Workforce” between 2011 and 2013, the ratio of new cancer cases per clinical oncologist in Angola was 417 with only 24 clinical oncologists, a total of 2 oncologists with 4,500 new cases per clinical oncologist in Mali, total of 6 clinical oncologists in Uganda with 4,833 new cases per clinical oncologist, not to mention, some countries were recorded as having no oncologists.
5. inability to afford the cancer care services; considering that at least 490 million people in Africa live under the poverty line living on less than 1.90$ per day (UNCTAD,2021), it is obvious that majority of the patients are not able to incur the costs of diagnosis and undergoing necessary therapy and surgical procedures required to mitigate the disease and hence this results in increasing rates of mortality due to cancer in these countries. 

In closing, despite the currently daunting state of cancer care in the public health system of African countries, there is hope in the fact that various institutions and organizations across the continent are taking the lead on implementing initiatives relevant to the combating of cancer. This is being achieved through providing funds for the construction of oncology units, grants to aid research, upgrading of cancer treatment equipment, sensitization of the public through facilitation programs and events, to mention but a few. The aforementioned incentives are all significant steps towards a world where cancer care is available and affordable, and most importantly a cancer free world, which is the ultimate goal.

Leon Inksmitten