Punch Editorial Board
Cancer is a dreaded disease globally because of its high fatality rate. But for hard-pressed patients of the ailment in Nigeria, it is a race against time, as there are only eight radiotherapy machines to treat them. Worse still, only two of the machines are currently functional. This is most appalling for the health care system of a country with about 170 million people.
The World Cancer Day, marked recently, provided an opportune moment to put this issue on the front burner. A Consultant Radiation Oncologist and Executive Director of the Sebeccly Cancer Care Centre, Lagos, Omolola Salako, has, therefore, urged the Federal Government to tackle the frequent breakdown of these machines, available in seven federal tertiary institutions and a private hospital. “With over 100,000 new cancer cases diagnosed each year, it is impossible to treat all patients that require radiotherapy,” she agonisingly noted in a statement.
Even where treatment is available, the cost is prohibitive for most of the victims. Amid this seemingly hopeless situation, experts say that 80,000 Nigerians die of cancer annually. But cancer is not necessarily a death sentence if detected early and a cocktail of therapies required applied immediately. With the acute shortage of radiotherapy machines, many patients who do not have enough funds to travel abroad, queue for a long time before treatment could start. This invariably reduces their chances of survival. From the less known Nigerian, to popular figures such as Gani Fawehinmi, Dora Akunyili, Sunny Okosuns, Yinka Craig, Maryam Babangida, cancer has painfully and fatally reaped.
Cancer is a malignant tumour that spares neither the young nor the old. The World Health Organisation says, “One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their normal boundaries, and which can invade adjoining parts of the body and spread to other organs.” From 8.2 million deaths and 14 million new cases of the disease in 2012, WHO said 8.8 million people died of it worldwide in 2015. Lung cancer was the deadliest with 1.6 million deaths. Most common in women are breast, cervical, pelvis and ovarian cancers, while men are susceptible to prostrate, lung, and liver cancers. There are also colorectal, stomach and brain cancers.
As one of the three leading causes of death in developing countries, the 100,000 reported new cases should jolt the Federal Government into action. It has no choice but to give cancer treatment a priority attention by ensuring the immediate productive use of the eight radiotherapy machines and equipping more tertiary health centres with the capacity to intervene.
The economy has been haemorrhaged by medical tourism. Annually, Nigeria loses $1 billion to other countries as a result, says Minister of State for Health, Osagie Ehanire. India, the United States and the United Kingdom are the preferred destinations for Nigerians who can afford cancer treatment abroad.
Containing the cancer epidemic, especially among women, can be achieved if new preventive techniques can be adopted. One is the vaccination of adolescent girls, especially those between the ages of nine and 14, using the Human papillomavirus vaccine. It targets the virus that triggers 70 to 90 per cent cases of cervical cancer, according to a former Minister of Finance, Ngozi Okonjo-Iweala, now at Global Alliance Vaccine, Washington DC. With such a measure, she says 1,500 deaths in every 100,000 persons could be prevented.
Health remains a strong social public policy agenda in the world. This is why it is the responsibility of federal and state governments to set up world-class health centres that will address the cancer scourge. Our teaching hospitals should be made to function as centres of excellence, which they purport to be. Government-run health care is still trending in Cuba, Canada, England and France. By adopting a WHO recommendation, Cuba was able to set up a comprehensive cancer plan that encapsulates prevention via diagnosis and treatment, underpinned by a robust primary health care system.
Through this model, doctors detect the disease early and make referrals to specialised centres for treatment. In 2008, the country moved a notch higher in cancer treatment by using biotechnology. Its Ministry of Health issued the first vaccine produced by Havana Centre of Molecular Immunology for therapeutic treatment of advanced lung cancer. A second vaccine was patented in 2013 for the same type of cancer.
Nigeria has to change its damning cancer scorecard. And where to begin is in increasing the annual health budget, aimed at improving our health care facilities and the system generally so that early detection could be targeted. Regrettably, the 2017 federal health budget of N252.87 billion undermines this dream. In fact, it is N51 billion short of the 15 per cent agreed by the African Union in 2001 under the Abuja Health Declaration.
The advantage of early diagnosis is evident in Europe-wide statistics unfurled by Factmint – covering those diagnosed in 2007 – that five-year survival in Sweden was 64.7 per cent, as against 50.2 per cent in the UK where early diagnosis is reportedly poor. France, Italy and Germany all did better than the UK, according to the survey.
While the government must take the lead, it could also sensitise Nigerian experts in this field in the US and Europe to return home, exemplified by the case of Lakeshore Cancer Centre, Lagos that sprang up in 2014. It has a US-trained Thoracic Surgical Oncologist, Chumy Nwogu, as the Chief Executive Officer. The centre is an affiliate of Rosewell Park Cancer Institute, US. Through the linkage, the institute visited Nigeria in 2015 to organise an in-house training for medical staff of two teaching hospitals.
Above all, a massive public awareness campaign in all the states on the risk factors for cancer such as cigarette smoking, excessive intake of alcohol, sedentary lifestyle, ageing, will no doubt help in mitigating the grave situation.
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