Cancer kills 80,000 Nigerians every year

 Isaac Adewole, Nigeria Health Minister
Eranga Isaac, CNS Correspondent, Nigeria
Nigeria marked World Cancer Day 2016, recording a significant increase in the number of deaths from common cancers during the last few years. As per data of the World Health Organisation, between 2008 and 2012, daily number of deaths increased from (i) 30 to 40 in women due to breast cancer; (ii) 24 to 26 in men due to prostate cancer; and (iii) 24 to 32 due to liver cancer. This significant increase is, to some extent, connected to the lack of quality cancer treatment facilities available in the country.

Oncologist Dr Bello Abubakar disclosed, in a forum to mark the 2016 World Cancer Day in Abuja, that Nigeria’s only cancer treatment machine located at the National Hospital, Abuja had outlived its utility— it was already 16 years old, while its life span is 7 years. Abubakar regretted that the only cancer treatment facility in the country lacked the basic infrastructure to function optimally. He therefore called for more funding and the provision of basic infrastructure to deal with cancer. On his part, the Deputy Chairman of House of Representatives Committee on Healthcare Services, Muhammad Usman regretted the ‘miserable’ amount of funds allocated for the fight against cancer in the 2016 health budget of the country, and called for more government funds for the procurement of equipment needed to diagnose and treat cancer.

According to Dr. Abia Nzelu, the WHO National Co-ordinator of the Committee Encouraging Corporate Philanthropy (CECP-Nigeria), “Over 100,000 Nigerians are diagnosed with cancer yearly, and about 80,000 die (10 deaths every hour) with a dismal survival ratio of 1:5. The situation is worse for some specific cancers— the survival ratio for certain blood cancers in Nigeria is 1:20. This poor survival rate is mainly due to inadequate infrastructure for cancer care and lack of well-organised system of prevention.” Nzelu said Nigerians spend $200 million annually on cancer treatment abroad. “Incidentally, $200 million is also the approximate amount needed to establish three comprehensive cancer centres, or to acquire 300 mobile cancer centres.

Unfortunately, the outcome for Nigerians who embark on cancer-related medical tourism is often poor because of late detection. Nigeria has lost many precious and talented people to cancer. Cancer constitutes a preventable major drain on our human and financial resources,” she said. Meanwhile, the Federal Government of Nigeria has rolled out a new set of policies aimed at strengthening the nation’s cancer management and control. In a speech to commemorate the 2016 World Cancer Day in Abuja, the Nigerian Minister of Health, Prof. Isaac Adewole, while acknowledging that the growing burden of cancer in Nigeria is faught with ‘inadequacy of health systems, poor manpower, poor access to treatment facilities and lack of access to end of life care’, disclosed that the Buhari administration has recognized and prioritized cancer care interventions as a signature project of the health sector. In addition to the planned establishment of the National Agency for Cancer Control [NACC], the Minister also announced new measures for the control and management of the disease in the country.

These include the strengthening of the nation’s Primary Healthcare (PHC) Systems to ensure a strong referral system and a revision of the National Strategic Plan for cervical cancer control that would lead to the inclusion of Human Papilloma virus (HPV) vaccination in the routine immunization programme.  Adele gave an update on the steps taken by the government for cancer care and control. He informed that, “The pivot of the cancer control, starting from primary healthcare level, will be health promotion and cancer prevention. So we are working on strengthening PHCs across the nation, including building a formidable workforce to provide essential outreach services which will include health promotion. Our ‘one PHC per ward’ initiative will also link up with secondary and tertiary care through strong referral systems. Arrangements are also underway to commence a pilot of GAVI-supported demonstration on HPV vaccination in some selected states in Nigeria.”

“HPV immunization of girls for cervical cancer prevention was introduced in Nigeria by the government in 2011. Subsequently, HPV vaccination has been made available in health service outlets in both private and public hospitals. Government is making efforts to include it as part of the routine immunization programme. Furthermore, a National Policy/ Guideline on Prevention, Control and Management of hepatitis has been developed to address the rising incidence of hepatitis in the country. The policy is also targeted at the prevention and control of liver cancer associated hepatitis. The Federal Ministry of Health is committed to pursuing a policy for a waiver of import duties for cancer medication to encourage the pharmaceutical sector to bring in adequate amounts of cancer drugs to cater for our needs,” he said.

“The government is also planning to increase the number of radiation service outlets in the country through private public partnerships (PPP). Currently the Ministry is consulting with some organisations to upgrade 7 of these existing centres to oncology centres of excellence. In the second phase of the upgrade process, 7 more such centres will be created for comprehensive cancer care in Nigeria within the next two years”. “Efforts are also on to develop a palliative care policy for the country. The Ministry has been actively engaged with the African Palliative Care Association and the Nigerian Palliative and Hospice Care Association to design and implement research and training programmes in designated hospitals for palliative care, with focus on pain free management of terminal conditions. A training centre for palliative care, situated at University College Hospital Ibadan, trains healthcare professionals to conduct this service in health centres and to also provide palliative care as a community based service. In addition, the Federal Health Ministry has requested the National Universities Commission to implement curriculum review that will allow for the incorporation of palliative care in the training of nurses and doctors in Nigeria”, he informed.

The Minister called upon all Nigerians to recognize the role they can play in reducing the burden of the disease, ‘so that we can reduce the unnecessary number of premature deaths from cancer and other NCDs to 25% by the year 2025’. In line with the theme for this year’s World Cancer Day: ‘We can, I can,’ Prof. Adewole noted that much could be done at the individual, community and government levels to ‘harness and mobilize solutions and catalyze positive changes’. He pledged that health service delivery improvement, provision for cancer and other disease conditions would continue, especially with the commitment of the Nigerian government to Universal Health Coverage and with the support of the National Health Act.

Eranga Isaac, Citizen News Service - CNS
February 26, 2016