Featured, Health
Although the bill to establish the National Institute on Cancer Research and Treatment was signed into law on December 29, 2017 by President Muhammadu Buhari, more efforts should be directed at reducing the high cost of treating cancer by establishing more specialized centres for the treatment of cancer across the country.
By Anthony Isibor
CANCER is a disease in which abnormal cells grow and reproduce uncontrollably and invade nearby tissues by spreading to other parts of the body. Generally, it is considered as one of the most dangerous health conditions in the world. The World Health Organization, WHO says that cancer is the second leading cause of death around the globe; it is responsible for 70 percent of deaths in low- and middle-income countries.
This is more than the number of deaths from AIDS, malaria and tuberculosis combined. In Nigeria, about 72,000 Nigerians die yearly from cancer among more than 100,000 cancer diagnoses. The two most common and often treatable forms of cancer in Nigeria are breast and cervical, colorectal, ovarian cancer and non-Hodgkin’s lymphoma, while these are common among women, the men mostly suffer from prostate, colorectal, liver, stomach cancer and non-Hodgkin’s lymphoma.
The three most common cancers in Nigeria are breast cancer, cervical cancer and prostate cancer. Thousands of Nigerians die every year from cancer, according to UN report. The number of new cancer cases per year among Nigerian women is 71,022, and this is higher than the number of new cancer cases per year among Nigerian men which ii put at 44,928.
Prof Sani Abubakar Malami, President of the Nigerian Cancer Society said that 250,000 new cancer cases are recorded in the country each year.
Though deaths are mostly preventable, the lack of infrastructure, equipment and healthcare professionals needed to treat its cancer victims has been considered as the cause for high number of deaths. Furthermore, the high cost of cancer treatment prevents many Nigerians from seeking medical treatments
According to the WHO report of 2019, Nigeria’s population of 170 million requires at least 170 cancer centres and Nigeria only has two. The cancer treatment centre will provide at least 6000 treatments a year in radiation and chemotherapy for cancer patients. Due to the fact that 50% of these patients are indigent they would have received minimal or no treatment at all which would have reduced their chances of survival.
According to the report by St Cyril Foundation on its website http://www.stcyrilfoundation.org, about 80,000 people die from cancer annually in Nigeria and that by 2030, 70% of the 13 million cancer deaths expected globally will be from low-middle income countries like Nigeria.
The current state of cancer treatment in Nigeria might look very discouraging, however, Nigeria is making great efforts to improve the care it provides to Nigeria’s cancer victims with the help of partners like the WHO and the American Cancer Society. On April 13, 2015, the Nigerian federal ministry of health launched the Cancer Control Plan, CCP. This plan sets the course for the ministry of health to improve cancer treatment in Nigeria from 2018 to 2022. The goals included in the CCP that Nigeria intends to reach to improve its response to cancer.
Another major stepping-stone in the advancement of cancer treatment in Nigeria is the construction of the world-class , Nigeria Sovereign Investment Authority, NSIA, and Lagos University Teaching Hospital, LUTH, Advanced Cancer Treatment Centre. This facility emerged to ensure that the prevention, early diagnosis and treatment of cancer are available to many more Nigerians and is equipped with the most innovative cancer therapy solutions from Varian Medical Systems.
These facility can treat 100 patients a day and provide more advanced training for 80 healthcare professionals. Although these efforts are commendable, Nigeria is still a far cry from achieving optimum capacity in cancer treatment. The number of deaths per year continues to grow as more and more cancer patients in Nigeria continue to seek medical care abroad.
The death of Sound Sultan, a popular musician, who recently died of Angioimmunoblastic T-cell Lymphoma; a type of cancer that affects the white blood cells (lymphocytes), in a US hospital, once again goes to show just how ill prepared the country is for the treatment and care for cancer patients.
In February 2020, a report published in Daily Trust to mark the 2020 world cancer day revealed that there were only eight teaching hospitals in Nigeria that have radiotherapy machines for handling cancer cases and that the centers included Lagos University Teaching Hospital, University of Benin Teaching Hospital, Benin; Usman Danfodiyo Teaching Hospital, Sokoto, the Federal Teaching Hospital, Gombe; University College Hospital, Ibadan; National Hospital Abuja, Ahmadu Bello University Teaching Hospital, Zaria; and University of Nigeria Teaching Hospital, Enugu.
It also said that checks by its correspondents revealed that “Out of the eight teaching hospitals that have facilities, only two are working well as others often breakdown from time to time or have packed up completely.
“In the last one year, it was gathered that only the National Hospital Abuja and the Lagos University Teaching Hospital, LUTH, have acquired more radiotherapy machines and improved services,” it said.
Bello Abubakar Mohammed, a Clinical and Radiation Oncologist at the National Hospital Abuja said in an interview with Daily Trust, that with four radiation machines for the treatment of cancer, Nigeria is still short of the 180 machines recommended by the WHO. Mohammed, who is the president of the African Organisation for Reachout and Treatment of Cancer, said out of 3,000 radiation oncologists needed in Nigeria, only 70 are available; and only 20 work in centres that have facilities
Apart of the problems of limited cancer treatment centers and the shortage of medical specialist in the country, another major problem is the huge amount of money required for cancer treatment.
An investigation carried out by PREMIUM TIMES showed that the cost of cancer treatment in the country is high and not affordable to the low or medium income earners.
The report revealed that it costs about N600,000 for a cancer patient to go through the complete sessions of radiotherapy.
A staff at the radiotherapy unit of the National Hospital Abuja, who requested anonymity, said “radiotherapy costs from N350,000 to N600,000 depending on the case presented
“However, this amount is only for radiotherapy sessions. When a patient comes to the hospital, he/she will obtain the hospital card, run some tests before commencing treatment,” she said.
She also said there is no fixed cost for chemotherapy. “Like I said, the case presented will determine the cost at that time,” she explained.
Charles Okwonna, a Senior Registrar, Department of Radiotherapy and Oncology, Usman Danfodiyo University Teaching Hospital, Sokoto has, however, urged the federal government to first invest in free cancer screening and awareness.
“When cancer is detected early, the cost and the burden of treatment is cheaper,” he said. “Just like there is free screening for HIV and Hepatitis B, there should be free screening for the most common cancers in designated government hospitals.
“People should have the opportunity to have free mammogram, free breast scan so when it’s detected early, it makes treatment less difficult,” he said.
Okwonna also added that although it is impossible to make cancer treatment completely free, the government should provide designated fund strictly for treating cancer patients.
“What the government can do is set up a centre per region or per state and say this is a centre of excellence for that region,” he said.
“People with some specific kind of cancer can go there to obtain almost free treatment. These cancer treatments can be for low and middle-income people.”
“Those above the middle-income class can afford to go to either private hospitals or the expensive government hospitals,” he said.
He also added that the government should earmark 10 percent of the annual budget and “ensure people who cannot afford the treatment benefit from it”.
It therefore falls on the government to find a way towards mitigating the cost of cancer treatment as the disease is not limited or exclusive to the high income earners. The poor are also affected and are most likely to die from this due to the huge amount of money required for its treatment.
In 2019, Osagie Ehanire, the minister of health, disclosed in a National health dialogue organised by PREMIUM TIMES that the federal government was planning to roll out a cancer treatment fund to reduce the burden of treating cancer in Nigeria.
“There will be a creation of a fund, either a cancer treatment fund or whatever we decide to call it. It is important and can be driven by investment or donation,” the minister said.
However, two years after, the government is yet to release further information on this.
Another major reason for the high number of cancer death recorded in the country is the late report of cancer cases. Medical experts have observed that though cancer is treatable at the early stages, many seek medical attention very late.
According local media reports, a large number of Nigerian men, who were diagnosed with prostate cancer, presented themselves late at stages III or IV, when the prostate cancer had spread to other vital organs of the body.
Amina Abubakar Bello is spearheading the campaign to improve awareness and treatment of breast and cervical cancers through her Raise Foundation in Niger state. She is also the state’s first lady and has said that what triggered the cancer awareness initiative was the need to ensure that cancer patients get a diagnosis early and then help them through the health system for care.
According to her, most women are screened live in urban or semi-urban areas.
“Those in marginalized areas have little chance of accessing services not unless as an organization, we have an outreach programme in that community. Only then can they be screened.
“The biggest challenge we face here is in as much as women would want to be screened and treated for breast or cervical cancer, some of the healthcare facilities do not have enough equipment and machinery to complete the processes.
“The test might be done at facility A then sent to facility B for analysis. The process to get results might take 3–4 weeks. After getting a diagnosis, most of the facilities will not be able to deliver radiotherapy although they are able to provide chemotherapy.
She also stated that Nigeria has fewer than 12 facilities that can provide radiotherapy and that the cost of radiotherapy makes it difficult for a patient to be treated adequately.
Some stakeholders have continued to harp on the need for the government to be more involved in the treatment of cancer in the country through legislations and by providing more financial assistance and creating special health centers with up to date facilities necessary for its treatment.
Amina Abubakar Bello has raised the need for the government to invest more in cancer care.
“In the budget, there should be an allocation to tackle cancer. Though in Nigeria we have a Cancer Control Plan, it has not been implemented. Incorporating care within the health insurance scheme is another measure that can be used to reduce the costs on patients thereby making things easier for them.
“The government should invest in cancer prevention programmes. We need specific programmes that address cancer awareness and prevention, including the provision of vaccines. Cervical cancer can be prevented from occurring completely by protecting young girls from getting infected by HPV, human papillomavirus, through vaccination. As such, this is an investment that government needs to make.
Government legislation has a very important role to play in curbing wide report of cancer cases in the country. This is because although medical experts differ as to the exact causes of the disease, there seem to be some agreement that the major cause is the habit of the people which is not helped by government policy or the absence of it.
Reports have it that while most countries are making stringent laws against tobacco use, “our government seems to be encouraging it. Also, given the epileptic nature of the power sector, the use of generator has since become a necessity in most homes. Almost every family, particularly in the urban area, has a power generating set. Yet the carbon monoxide emitted from this power source is a serious health hazard and has been identified as a huge contributor to the cancer menace.”
Prof. Malami of the Nigerian Cancer Society said while there was increasing awareness about cancer amongst Nigerians, the country still lacks a framework for and a supportive environment for optimal cancer care despite the fact that President Muhammadu Buhari had signed into law, the bill to establish the National Institute on Cancer Research and Treatment on December 29, 2017.
“He lamented that Nigeria has continued to record more deaths and new cases because there was no national cancer agency and inadequate cancer dedicating centres and registries. While insisting that the treatment of the disease in Nigeria is largely underfunded, he said there is no specific budget line for cancer like that for HIV and some other diseases”
He also said that the “treatment of cancer is not covered by the National Health Insurance Scheme and as such, patients have to pay out-of-pocket, making them suffer untold hardships.
“The expert said the prevention of the disease is not given priority and institutionalized as done in other countries, adding that there is need to address the root problem in order to tackle the disease. “Government needs to do more in the area of screening and prevention.”
It is therefore essential that the bulk of the efforts that will ensure that the Nigerian citizens are protected and saved from the cancer scourge remain with the government. The government must create an environment that will enable quick response to cancer prevention treatments through legislations, especially by collaborating with the private sectors. It must also do more to support the awareness campaigns, and provide a form of medical insurance that covers for the treatment of cancer in the country.
– July 25, 2021 @ 08:55 GMT |
Tags: experts call for more government commitment in taming the scourge of cancer stakeholders
