Do you know that according to the World Health Organization, deaths due to cancer in developing countries have surpassed the deaths due to HIV, malaria and tuberculosis combined? About 80% of deaths due to cancer worldwide occur in developing countries, and infectious disease related cancers account for about 40% of all cancers in Africa.
There is only one conclusion that can be drawn from these tough facts, the conclusion being that cancer is now a major and growing public health challenge in Africa and other developing countries and something needs to be done fast before this ticking time bomb explodes. Unfortunately, despite the glaring problem cancer poses, cancer has remained at the background of public health discourse in many African countries. The theme of World Cancer Day 2013 is “Cancer – Did you know?” In my opinion this is a perfect tagline for us in Africa.
For many years cancer has been thought to be mainly a Caucasian problem in most parts of Africa. And the concept of the disease has remained abstruse, even among health professionals. However, in the last decade many African countries have seen the influx of better diagnostic equipment such as Magnetic Resonance Imaging (MRI) and Computerized tomography (CT) scans. With the advent of improved diagnostics, it has become evident that cancer has extended its ugly tentacles to Africa.
Furthermore, Africa has seen a lot of her prominent citizens die of cancer. For example, the immediate past president of Nigeria, Alhaji Musa Yar’adua was rumored in the local Nigerian media to have died of lung cancer in a Saudi hospital, the immediate past president of Ghana, Professor Attah Mills died of throat cancer in a Accra hospital in 2012. There are countless other examples of prominent Africans dying in foreign hospitals as a result of cancer. These deaths from cancer in different parts of Africa have heralded a greater awareness of cancer on the continent.
Unfortunately, there is a paucity of cancer specialists and resources to prevent and manage the disease. According to the Indian Ministry of Foreign affairs, India made an estimated $2billion from health tourism in 2012, and it is estimated that 26% of this sum came from Nigerians seeking medical care in India.
A significant percentage of these patients seeking care in India from Nigeria suffered from cancer. It is evident therefore, that a diagnosis of cancer without the means to go “abroad” for treatment is tantamount to a death sentence.
There are many types of cancers known to medical science. However, in the African context we can potentially intervene most effectively on those cancers that are caused by infectious diseases, and according to the World Health organization this makes up an estimated 40% of cancers in Africa.
Cervical cancer for example, has been largely contained in most western countries. Yet, according to the International Agency for Research in Cancer (IARC) 242,000 women in Africa died of cervical cancer in 2008, accounting for almost 90% of deaths due to cervical cancer worldwide! Africa indeed has a great window of opportunity to prevent avoidable deaths due to cancer.
The good news is that global attention has been drawn to Africa once again. In 2011, world leaders met at the United Nations General Assembly Special Session to discuss the burden of non-communicable diseases in developing countries. The outcome of the meeting was an $11 billion pledge by wealthy countries to help African countries fight non-communicable diseases.
It is high time therefore that Africa paid attention to this ticking time bomb. It should start with a strong political will by its leaders to budget more funds to non communicable diseases, train health workers in field of oncology (cancer), develop national policies/guidelines on cancer prevention and treatments, and fund national cancer registries and cancer research and ultimately invest in specialized cancer centers.
The story is not all gloomy. Uganda is one country setting the pace in the cancer fight; The Ugandan Cancer Institute has grown from one oncologist to eleven within a few years. Thanks to the collaborative partnership between the Ugandan Cancer Institute and the Fred Hutchinson Cancer Research Center in Seattle, Washington.
Africa has lost too many precious lives from HIV, malaria and tuberculosis; the last thing Africa needs is another public health “explosion” of many more deaths from a raging cancer epidemic. It is time to disentangle its citizens from the complex web of an epidemic of preventable cancers and infectious diseases. We must turn our lenses to the fight against cancer. Now is the time!
Dr. Kingsley Ikenna Ndoh
MPH Candidate in Global Health,
University of Washington, Seattle, USA