Nigeria’s estimated 302,076 populace who battle with cancer are faced with a struggle for remedial treatment under less than 10 radiotherapy machines available country-wide, where at least 200 are required in tandem with the World Health Organisation’s (WHO) recommendation of one machine per one million people.
They equally suffer 96.6 percent deficit of clinical oncologists as less than 100 oncologists practise in Nigeria instead of 3,000, Abubakar Bagudu, president, African Organisation for Research and Training in Cancer (AORTIC) said during the African Cancer CEO’s Forum held virtually.
Despite the disease being preventable and curable, cancer still leads to 13 percent of deaths in Nigeria on the back of late presentation, lack of awareness, poor prognosis and patient’s denial.
By the time they approach hospitals, the malignant disease would often have advanced to a stage where radiotherapy is unavoidable, since access to comprehensive cancer care is so limited.
At that point, some meet with needless and untimely deaths as it takes about four months to get the diagnosis of cancer to the appropriate cancer clinics.
“Most cancer patients are at risk of mortality if infected by Covid-19. The first patient that died of Covid-19 in Nigeria had multiple myeloma, which is a form of cancer. There is always crowding in most of the cancer centres that we have because there are so few,” Bagudu said, speaking during the programme aimed at appraising the situation of cancer management on the African continent.
The scarcity of radiation oncology resources in Africa holds glaring evidence in not only Nigeria’s poor healthcare system, but also an increasingly worsening economy that places the cost of care at few treatment centres beyond the reach of average people.
It is not unusual to find patients abandoning their therapy because they cannot afford treatment.
While cancer treatment is free for nationals in Zambia, for instance, Nigerians are yet to feel the impact of promised government support for cancer patients.
In 2018, Nigeria’s National Cancer Control Plan was launched with a budget of $308 million to control cancer and $192 million for prevention for five years.
Osagie Ehanire, Nigeria’s minister of health, in his speech noted that N729, 861,797 was appropriated in the 2020 budget for the Catastrophic Health Fund, a provision to support the treatment of indigent Nigerians diagnosed with breast, cervical and prostate cancers. However, these plans have remained paperwork.
The Federal Ministry of Health in the last quarter of 2020 is still promising to ensure that the fund is released within this budget cycle.
The largest African economy is outside the circle of three countries including South Africa, Egypt and Morocco, able to meet the International Atomic Energy Agency recommendation of 250 population per 1 radiotherapy machine.
Out of the 385 radiotherapy machines in sub-Saharan Africa, Egypt boasts of almost 100 while Nigerians struggle with two.
The country is yet to develop a fully-fledged cancer institute that can cater to the needs of its sick people.
“We have seven centres of excellence. These are departments not stand-alone cancer centres. There is the national cancer institute that is being talked about. We need to have things like that so that we will be able to move the agenda forward,” Bagudu said.
According to a Lancet publication, sub-Saharan Africa will require about 5,000 radiotherapy machines by 2023, with at least 1,208 domiciled in Nigeria based on the estimate of 1 per 250 people.
The projection is that by the year 2030, cancer death would have decreased by about 30 percent in developed countries, but in developing low-income countries such as Nigeria, mortality will increase by about 70 percent.
Countries including the United States are averting millions of deaths by leveraging advances in cancer treatment and care, leaving Africa with the greatest burden of the disease.
Oncologists now use scientific innovations like immunotherapy to target cancer, stop or slow the growth of cancerous cells. Other innovations like gene therapy, radiomics, thermal ablation of tumours and many others have sprang up across the world.
According to Bagudu, the government can reach out to the manufacturing industry on how more machines can be leased on hire purchase to support more patients.
While prevention remains the most effective for achieving low-cost cancer control, efforts to provide affordable medicines should be intensified, he said.
Africa and Nigeria in particular should really benefit from investing and supporting the development of local biopharmaceutical industries, he said, noting that this approach will help the continent establish a solid biopharmaceutical and research hub while growing the needed talent pool of researchers and clinicians.
For Dina Mired, president, Union for International Cancer Control (UICC), the tools to make progress are available but political leaders must demonstrate the will to use them just like they have done to address Covid-19.
“If $1 is invested in early detection for everyone in a country, it will save the country $7 per person from treatment. The country ends up saving money,” she said.
