If the Federal Government follows through on its fresh plans to slash the cost of 16 priority cancer drugs and chemotherapy treatment by 50 percent, accessing care for the top five cancers of greatest burden to Nigeria might become easier.
The Federal Ministry of Health under its new programme labelled ‘Chemotherapy Access Partnership’ (CAP) has promised to make low-cost and high-quality treatment available in seven teaching hospitals across the country.
In effect, the out-of-pocket burden of treating breast cancer, cervix uteri, prostate, liver and colorectal cancer which have the highest prevalence in both male and female Nigerians will reduce significantly. These types of cancer account for approximately 50.3 percent of identified cancer cases in Nigeria.
Breast cancer has accounted for 34.2 percent of the total of 38,000 deaths in women, with prostate cancer responsible for 31.7 percent of 30,400 deaths in men.
Generally, Nigeria could lower over N72,000 deaths arising from cancer and effectively tackle 102,000 new cases estimated by the World Health Organisation if the announcement by Adeleke Mamora, minister of state for health, does not result in another media jamboree to promise what the government won’t do.
Depending on the cancer type, drug prices vary from N10,000 to N3 million for each cycle of chemotherapy, health analysts say. Chemotherapy deploys drugs to kill cancer cells, by targeting cells that grow and divide quickly, as cancer cells do. The treatment can destroy cancer cells to the point that they would no longer be detected or grow back.
Women battling with cancer, for instance, usually need about 12 to 18 cycles of Herceptin, a prescription for breast cancer which costs at least N300,000, Joseph said.
But breast cancer patients will now need N150,000 for each cycle and N1.8 million under the government’s partnership with the Clinton Health Access Initiative, Inc. (CHAI), the American Center Society (ACS), Pfizer Incorporation, Worldwide Healthcare and EMGE Resources Limited. The programme will run in six African countries which account for 42 percent of the cancer burden in sub-Saharan Africa.
The structure of the partnership is such that immediate payment will be made to participating pharmaceutical companies and drug distributors for sustenance and regular stock replenishment.
Cancer patients can seek this subsidy at the Lagos University Teaching Hospital (LUTH), University College Hospital Ibadan, Obafemi Awolowo University Teaching Hospital, and the National Hospital Abuja. They can equally seek treatment at the University of Nigeria Teaching Hospital Enugu, Aminu Kano Teaching Hospital and the Ahmadu Bello University Teaching Hospital, Zaria.
Health analysts who spoke to BusinessDay agreed that the biggest challenge to fighting cancer is not only access to treatment, but the fact that the effective drugs are expensive, shooting out of reach for many Nigerians who suffer low discretionary income.
Adedayo Joseph, clinical radiation oncologist, applauded the initiative, saying it is a significant improvement from the current situation where cancer patients have to pay 100 percent out of pocket.
“I think the government is doing a very good job. It is up to the industry to also play their own role as well, from the pharmaceutical companies to the doctors,” Joseph said.
Abdulrazzaq Lawal, senior lecturer at the Department of Surgery, College of Medicine of the University of Lagos, said the move is potentially a game-changer towards the fight against breast cancer and all other forms of cancer in Nigeria
“The programme, if properly implemented, will significantly reduce the number of cancer deaths in our environment by increasing the number of our patients that can access care in a manner that is affordable, without inflicting financial toxicity on them,” Lawal said.
Fears over accountability mount
While stakeholders in health applauded the government’s initiative, fears have also been mounting over accountability and transparency in the implementation of the programme.
At a time when external donors are raising concern over diversion of donated vaccines and other materials into the commercial market, analysts see the scheme stumbling if stern monitoring and evaluation fail to follow.
Evelyn Ngige, director of public health, Federal Ministry of Health, in September complained that only 8.1 million of the 16.2 million artemisinin-based combination therapy (ACT) financed by Global Fund was delivered to health facilities in the 13 states identified for collection in 2018.
She confirmed that some of the medical commodities were found in private pharmaceutical companies, while others were displayed on the streets for sale, despite being labelled `not for sale’.
“Having implemented the grant thus far and following examination of grant report for 2018, it became clear that not all malaria commodities distributed to health facilities in the states could be accounted for, particularly ACT,” she groused in a report monitored by BusinessDay. “We don’t know how these commodities that were officially delivered to the states are found on private vendors and Global Fund is aware of it; this put Nigeria in a very bad light.”
Temitayo Ayetoto
