Cancer care in Nigeria after Tinubu’s first year as president

Cancer, one of the deadliest diseases the world has ever encountered, is a large group of diseases that can start in almost any organ or tissue of the body.

According to the World Health Organisation (WHO), it is the second leading cause of death globally.

It also said that in 2022, there were an estimated 20 million new cancer cases and 9.7 million deaths.

In Nigeria, however, an estimated 124,000 new cases were recorded in 2020, which resulted in 78,899 deaths.

The disease exerts tremendous physical, emotional and financial strain on individuals, families, communities and health systems, shrinking resources as it strikes the rich, poor, young, old and now even children.

To ease the burden of cancer treatment in Nigeria, the federal government came up with various interventions that could benefit patients.

The Minister of State for Health, Tunji Alausa, said the country has a cancer continuum that is given necessary priority attention.

He listed cancer prevention, treatment, supply chain management, Hospice and Palliative care, advocacy and social mobilisation, data management and research, as well as governance and finance as areas government focused on to tackle the menace.

These, he added, are priority measures in cancer control efforts contained in the government’s four-point agenda, which also includes improving healthcare governance, improving population health outcomes, unlocking the healthcare value chain, and health security for Nigerians.

Mr Alausa said that the federal government earmarked N200 million for indigent cancer patients’ treatment in the 2024 budget through the Cancer Health Fund (CHF), a demonstration of its commitment to reducing the cancer burden.

According to him, the federal government has put N1.3 billion into the CHF in the last four years.

He, however, added that though the fund would not be enough to do all that is needed to take care of Nigerians, the ministry is mobilising funds through a sector-wide approach and involving private sector participation.

He explained that “the National Health Insurance Authority (NHIA) will ultimately manage funding for cancer care in the future to avoid duplication of roles in terms of purchase of services for patients.

“Recently, guidelines for the NHIA Act was launched to pave the way for full operationalisation of the Act, which also provides funding for vulnerable Nigerians, including cancer patients.’’

Also to enhance oncology care in the country, the federal government and the Nigeria Sovereign Investment Authority (NSIA), signed a Memorandum of Understanding (MoU) to aid the procurement of equipment for cancer management.

The Coordinating Minister of Health and Social Welfare, Ali Pate, also said that upgrading equipment in the six cancer centres, located in teaching hospitals in the six geo-political zones of the country, is an important milestone.

This, he said, is because it would mark the end of tragic stories for thousands of Nigerians who struggle to get care for cancer.

He noted that the government had in the past established an oncology initiative with other hospitals which lasted for years without success.

He explained that an initial appropriation for teaching hospitals about four years ago remained N17.9 billion, while in 2024, the federal government appropriated N20 billion for it, totalling N37.9 billion.

Mr Pate said “So, the NSIA would bring the technical capacity, the experience, and the governance system, following the authority’s relationship with manufacturers of cancer equipment.

“We have seen how the authority ran that of LUTH and it is a very important partner to the government.

“But this is a different path where we’re using government-owned entity (NSIA) to execute, where the entity will go directly to the manufacturers, taking away the middlemen.

“My understanding is that we have almost a 30 per cent discount in the cost of equipment by virtue of going to the manufacturers directly, a clear value of almost N10 billion saved because of the discount.”

Added to that, he said, President Bola Tinubu upgraded six Federal Tertiary Health Institutions with modern Brachytherapy and Nuclear Medicine equipment and other ancillary and complementary facilities.

On his part, Usman Aliyu, the director-general, National Institute for Cancer Research and Treatment (NICRAT), said that though Nigeria has done a lot to improve cancer treatment, more needs to be done.

Mr Aliyu said “We have made significant progress in raising awareness about the causes, symptoms and prevention of cancer by empowering individuals with knowledge, we aim to reduce the incidence of late-stage cancer diagnoses and improve early detection rates across Nigeria.’’

He added that taking the measures beyond the shores of the country and expanding it to the continent, the interventions continued with the First Lady, Oluremi Tinubu’s involvement, where she organised a high-level regional seminar to promote awareness and advocacy programmes in the Organisation of Islamic Cooperation (OIC) African Member States.

During the event, she called for collective action against cancer in Africa, to end it by 2030.

She reiterated her commitment to reducing the prevalence of cancer through effective preventive control.

The first lady said she would continue to lead in advocacy to promote innovative approaches to cancer prevention and early detection, while the federal government took charge of the diagnostic and treatment components of cancer care.

She said “This has led to my stand in championing preventive measures and early detection approaches to preventable and curable cancers in Nigeria.’’

To buttress her belief that prevention is better than cure, she launched the Human Papilloma Virus (HPV) Vaccine for the prevention of cervical cancer in October 2023.

The launch marked the beginning of the inclusion of HPV vaccines into routine immunisation by the National Primary Healthcare Development Agency (NPHCDA).

She said “I am aware that over nine million girls have been fully immunised since the launch of the vaccine in October.’’

Regarding legislation that would help in advancing cancer care, Speaker of the House of Representatives, Tajudeen Abbas, assured that the National Assembly (NASS) would work with the First Lady to enact a law for prevention in Nigeria.

He said that financial barriers, high cost of treatment and lack of health insurance left many unable to afford necessary care.

He noted that low awareness and educational gaps about cancer prevention and early detection for timely intervention were worsening the scourge.

He added that “the combination of these factors result in high mortality rate, while inequality of life underscored the urgent need for comprehensive strategies to address cancer.

“As representatives of the people, we in the House of Representatives and by extension, the National Assembly, recognise our role in the fight against cancer.

“The House will work with the First Lady to enact a National Cancer Act to reduce cancer mortality through comprehensive measures, including the promotion of screening, early diagnosis, treatment advancement and palliative care.”

According to Mr Abbas, the law will also guarantee greater investment in cancer care infrastructure and provide a framework for the establishment and funding of comprehensive treatment centres across the country.

Commending the government’s efforts in the fight against cancer, Gloria Nwajiogu, a survivor and advocate, said there have been improvements compared to what was obtainable some 10 to 15 years ago.

Ms Nwajiogu, the president of the Network of People Impacted by Cancer in Nigeria (NePICiN), said that before now, cancer treatment was not covered by NHIA but now, there are packages for not only those in government employment but also those in private sector.

She added that “there is also the CHF; so to me, there has been an improvement. However, in this journey of cancer, though there are improvements, people are not even aware of these things and when people are not aware of the services, there is no way they can access them.

“I have to celebrate the strides made by government because as of 2020 when I was diagnosed, it was like if you do not have money, you cannot survive cancer, except God decides to work a miracle in your life.

“Chemotherapy alone is not affordable and the drugs are expensive, but we now have options.”

She commended the Chemotherapy Access Programme (CAP) which gives patients access to lower-priced, high-quality medications at a 50 per cent discount at the hospital, adding that it has helped.

She, however, said that the challenge of not having enough funds to go to the hospital persists because citizens are not aware of the packages.

Ms Nwajiogu explained that a lot needs to be done about creating awareness, not just about the treatment of cancer but about prevention too, which has been lacking.

She also said that the facilities, though being upgraded, need to be expanded so patients can access them without having to travel far.

Dozie Akwarandu, another cancer survivor and president of the Nest of Hope Cancer Advocacy and Support Community, said the CHF is a great initiative.

He, however, said that the fund, designed to cater for only Breast, Cervical and Prostate cancers and only for indigent patients, is not sufficient to reduce the cost of cancer treatment.

“The CHF needs to be reviewed, expanded and made to accommodate other cancers, as well as make it accessible and generally let the demographics change.

“I am of the opinion that there should be integration of cancer treatment and care with infectious disease.

“We can borrow ideas from the HIV world and get a programme where cancer patients can get medications all the time,’’ he suggested.

He also said that though the federal government’s initiatives are commendable, “the facilities we have are not sufficient for patients, the available ones are overstretched, the personnel are also overstressed.

“However, I believe that the recent engagements by NICRAT, Federal Ministry of Health and Social Welfare and the most recent by the Office of the First Lady, will beam light at the dark tunnel.”

(NANFeatures)