Nigeria loses 72,000 citizens yearly to cancer and is challenged with an estimated 102,000 fresh cases annually. Yet the country continues its romance with unsustainable fuel subsidy with funds that could have been channelled into efficient control of the life-threatening scourge.
The Federal Government spent no less than N132 billion in the first quarter of 2019 to keep Nigerians hooked on cheap fuel, according Nigerian National Petroleum Corporation (NNPC), but it plans to spend N97.3 billion on tackling the incidence of cancer across the country for the duration of four years (2018-2022).
In 2018, FG spent a total of N730.9 billion on fuel subsidy, leaving critical sectors like health, agriculture, education, works and infrastructure starved of funds.
The N730.9 billion spent on fuel subsidy in 2018 could cater for at least 24,363 cases of breast cancer, while the first-quarter 2019 subsidy sum could cater for 4,400 cases. Women in Nigeria require about N2.1 million to N29.2 million to treat breast cancer depending on the type, according to a report on catastrophic health fund for oncology care. Breast and cervical cancers are the two most prevalent types of cancer responsible for approximately 50.3 percent of all cancer cases in Nigeria.
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Cancer treatment plan typically involves diagnosis, chemotherapy and surgeries, among others. Eight series of diagnosis cost between N232,000 and N311,000, according to a report by International Centre for Investigative Reporting. Three surgeries cost between N670,000 and N3.3 million; 10 sessions of chemotherapy cost about N916,000 to N2.6 million, while 10-23 sessions of radiotherapy range between N138,000 and N360,000. This huge cost of treatment leaves a gaping hole in the pockets of suffering individuals, leading experts to call for government intervention.
“We have 36 states plus Abuja making 37. What is wrong with every state having a cancer centre? We have only seven centres with only two functional machines. We need to train more cancer specialists, we need to train more therapy radiographers, medical physicists. We need all these on ground to battle cancer,” Remi Ajekigbe, a professor of Radiotherapy & Oncology and former consultant radiotherapist and oncologist, Department of Radiation Biology, Radiotherapy, Radioagnosis and Radiography, College of Medicine, University of Lagos and Lagos University Teaching Hospital (LUTH), said.
“We must be ready to fight cancer more than we fought Boko Haram. If you tell government to buy this machine today, they will say there is no money. The government should allocate an oil block to cancer, after all they are allocating oil blocks to individuals, making them billionaires. If the machines, manpower and facilities are there, it will go a long way towards fighting cancer,” Ajekigbe told BusinessDay in a previous interview.
In an auspicious National Cancer Control Plan unveiled in 2018, the government says its goals are to make screening services and early detection of cancer available for all Nigerians.
It hopes to improve access to quality, cost-effective and equitable diagnostic and treatment services, ensure the availability of drugs, consumables and functional equipment for cancer care and achieve best possible quality of life for patients and families facing the life-limiting threat.
The plan is hinged on projections that governments at both federal and state levels will provide 75 percent of the funding required to implement while the donors and development partners will support by bridging the funding gap of 25 percent over the next five years.
But the prospects of translating this commitment from paper to direct impact on Nigerians seem dim on a budget indicating that the government will be allocating only N190,826 to each new case of cancer.
Babatunde Palomeras, managing director, J-Rapha Hospital, said the health sector would continue to grope in the dark if resource allocation is skewed in favour of wasteful ventures and against critical areas such as health, agriculture and education.
“How can you be paying N30 million to an individual in a month? That alone is enough to buy insurance for everybody in that constituency for one year, but our priorities are completely skewed. And it is unfortunate,” the director said.
In 2015-2018, Nigeria allocated N489.5 billion to lawmakers’ salaries and wages, rent subsidies, electricity, telephone and internet charges, office materials and supplies, drugs and medical supplies, maintenance of vehicles, furniture, plants and generators, contingencies and souvenirs for important dignitaries, refreshment and meals, among other things.
“Neighbouring countries like Ghana have better health indices than we have. We have enough to buy health insurance for everybody across the board so that we can have quality health services and quality life,” he said.
There is still a huge gap in diagnostic services. In terms of generational gap between Nigeria and the developed world, there are well over 50 years between where the country stands and where the advanced countries stand in diagnostic medicine.
There are still several medical diagnoses that cannot be carried out currently in Nigeria across all areas of medical practise, said Ayodele Benson, chairman, Echolab Radiology and Laboratory Services. He attributed this to lack of financial investment in technology and dearth of trained personnel even in cases where some technologies are available.
As a result, cancer is largely treated blindly in the absence of Positron Emission Tomography (PET) scan, an imaging technology used to effectively measure the extent to which a cancer cell has spread possibly from the primary origin to other organs or tissue.
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“While you are treating the primary disease, it might have spread to other tissues and you won’t know. But if there were PET CT, you can pick it out anywhere it has gone and this is not available,” Benson told BusinessDay on the sidelines of the launch of diagnostics healthcare business in Lagos.
“Beyond the one that should be available in private centres, every teaching hospital should have one. The fact that it is not there and we are treating cancer blindly is a sin,” he said.
Nigeria’s commitment to health has consistently fallen short of the World Health Organisation’s threshold of 15 percent. While the population continues to expand, the health spend has averaged 3.7 percent of annual budgets in the last five years. The N315.7 billion allocated to health in the 2019 budget, which represents 3.54 percent of the total budget, brings per capital spend to N1,578. Yet, this amount may not be completely released or utilised for implementation for the fund-starved sector.
According to the 2018 fourth quarter capital budget implementation by ministries, departments and agencies, N63.4 billion was released from a total annual appropriation of N86.4 billion as at the end of June.
Eugene Nwosu, chief executive officer, United Heart Hospital and Clinics, said Nigeria’s leadership needs to begin to think of the greater good of its citizens in its priority settings.
“There is no leadership and we don’t have conscience and it’s like everybody is on his own. People are so poor and yet the priorities, where they are spending money, are wrong. The people at the National Assembly are just there for themselves,” said Nwosu, who is also a fellow of America College of Cardiology.
“Most African countries are better than us. I was at a conference in South Africa last year, and I saw Rwanda, Malawi, Kenya, Sudan and Tanzania ahead of us. We are just answering giant of Africa for nothing,” he said.
TEMITAYO AYETOTO
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