Developing cancer control plans in Africa: examples from five countries (original) (raw)
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The Lancet Oncology, 2013
Sub-Saharan Africa has a disproportionate burden of disease and faces a major public-health challenge from noncommunicable diseases. Although infectious diseases continue to affl ict Africa, the proportion of the overall disease burden in sub-Saharan Africa attributable to cancer is rising. The region is predicted to have a greater than 85% increase in cancer burden by 2030. Approaches to minimise the burden of cancer in sub-Saharan Africa in the past few years have had little success because of low awareness of the cancer burden and a poor understanding of the potential for cancer prevention. Success will not be easy, and will need partnerships and bridges to be built across countries, economies, and professions. A strategic approach to cancer control in sub-Saharan Africa is needed to build on what works there and what is unique to the region. It should ideally be situated within strong, robust, and sustainable health-care systems that off er quality health care to all people, irrespective of their social or economic standing. However, to achieve this will need new leadership, critical thinking, investment, and understanding. We discuss the present situation in sub-Saharan Africa and propose ideas to advance cancer control in the region, including the areas of cancer awareness, advocacy, research, workforce, care, training, and funding.
2019
Key Message 1: Cancer Burden Has A Broad Social, Economic, And Political Impact. New cancer cases and cancer deaths are anticipated to at least double in Africa by 2030, reaching 1.28 million new cancer cases and 970,000 cancer deaths[1]. Cancer takes a substantial toll on the financial security, quality of life and the future well-being of patients and their families. In African culture, burden on families is particularly great, as family members help pay illness costs. Additionally, mothers of children affected with pediatric cancers carry a disproportionate share of caretaking burden, and face challenges from missing work to transportation costs and marital instability. Key Message 2: Research Is Essential To Effective And Cost-Efficient Cancer Control. Research forms the bedrock of health care policy in many international countries and translating research into health practice has been shown to improve patient safety and treatment outcomes[26]. In international settings, locally relevant cancer research has led to substantial cost savings in care. Allocating cancer research funding with respect to the societal burden each type of cancer imposes leads to high impact clinical and policy interventions[27]. Key Message 3: Collaboration Provides Opportunities to Gain Cutting Edge Knowledge. Collaboration with other African governments and regional or international bodies provides opportunities for mentorship and information exchange. In 2015, 473
Cancer in sub-Saharan Africa: a Lancet Oncology Commission
Lancet Oncology, 2022
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality. Without rapid interventions, data estimates show a major increase in cancer mortality from 520 348 in 2020 to about 1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive, and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial investment is needed in developing cancer registries and cancer diagnostics for core cancer tests. We show that investments in, and increased adoption of, some approaches used during the COVID-19 pandemic, such as hypofractionated radiotherapy and telehealth, can substantially increase access to cancer care in Africa, accelerate cancer prevention and control efforts, increase survival, and save billions of US dollars over the next decade. The involvement of African First Ladies in cancer prevention efforts represents one practical approach that should be amplified across SSA. Moreover, investments in workforce training are crucial to prevent millions of avoidable deaths by 2030. We present a framework that can be used to strategically plan cancer research enhancement in SSA, with investments in research that can produce a return on investment and help drive policy and effective collaborations. Expansion of universal health coverage to incorporate cancer into essential benefits packages is also vital. Implementation of the recommended actions in this Commission will be crucial for reducing the growing cancer crises in SSA and achieving political commitments to the UN Sustainable Development Goals to reduce premature mortality from non-communicable diseases by a third by 2030.
Cancer in Sub-Saharan Africa: The need for new paradigms in global health
2015
Cancer now ranks as the leading cause of death globally, outpacing mortality rates for HIV/AIDS, malaria, and tuberculosis combined. Cancers and other noncommunicable diseases (NCDs), in particular, are quietly taking center stage in many lowand middle-income countries in sub-Saharan Africa and worldwide, and these countries are projected to carry as much as 80 percent or more of the global cancer burden by 2030. Yet, there are severe inequities in the response to this burden, and many patients diagnosed with cancer are unable to access comprehensive cancer care simply because of where they live. In policy and advocacy circles, cancer is often seen as too challenging and expensive to treat in low resource settings, and funding and priority-setting for cancer has fallen substantially behind the current disease burden in sub-Saharan Africa. This is an often repeated narrative in global health, with the HIV/AIDS epidemic serving as an especially telling example of how inaction can fuel...
Cancer in Africa: the way forward
ecancer, 2019
While progress in oncology has been remarkable in recent decades, not every cancer patient is benefitting from the advances made in treating their disease. The contrast in diagnosis, treatment and its outcome between high-resource and low-resource countries is dramatic. Africa presents an enormous challenge with population growth and life expectancy increasing in many countries as the toll of AIDS and other communicable diseases declines. However, there has been little investment in capacity of any sort to deal with the current cancer problem, never mind the rapid increase in incidence which is underway. This is a critical area for investment and not only of a purely financial nature. It is bad to have cancer and worse to have cancer if you are poor. The gap between rich and poor, highly educated and less educated and the North-South divide is substantial and continuing to grow. Radical solutions are urgently needed: the status quo is not an appropriate response to the current situation. Recognising that no single government or source of philanthropy has the means to solve this problem, new models are needed to cope with and improve this situation.
Cancer in Africa: a preventable public health crisis
Journal Africain du Cancer / African Journal of Cancer, 2012
Cancer in sub-Saharan Africa is a latent public health crisis. Its burden is expected to increase, as people in this region live longer with reduced risk of death from infectious diseases and increasingly adopt lifestyles that include tobacco use, unhealthy diet, the harmful use of alcohol and reduced physical activity. Promotion of healthy lifestyles including anti-tobacco and alcohol legislation, immunization, early diagnosis by screening target populations and surveillance and monitoring are available to stem this tide. Alarm must be raised now, before it is too late. Africa can avoid a significant proportion of the cancer scourge that lies ahead. This requires the development and implementation of proactive national cancer prevention and control programmes, which are guided by sound scientific evidence. Governments and partners need to grasp the importance of the growing cancer burden in the region and reflect this awareness in their budget and funding policies as recommended in the African Regional Strategy for Cancer Prevention and Control.
Journal Africain du Cancer / African Journal of Cancer, 2014
Introduction: In most low and middle income countries (LMICs), including the majority of African countries, cancer burden is increasing rapidly and poses enormous challenges to the health systems. This foresees the need for urgent action and the establishment of strategic partnerships, as well as mobilizing resources and coordinating efforts among counterparts for the development and strengthening of cancer control interventions. Methods: Here below we describe the collaborative activities between the International Atomic Energy Agency (IAEA) and the World Health Organization African regional office (WHO AFRO) and other partners regarding the major projects of the IAEA's Programme of Action for Cancer Therapy (PACT) since its creation until the end of 2013. Results: National cancer control capacity has been assessed in 24 Member States within the WHO Africa region through integrated missions of PACT (imPACT Reviews); in addition, two countries have been elevated to PACT Model Demonstration Site (PMDS) status and are receiving the relevant expansion of needed radiotherapy; an e-learning project, the Virtual University Cancer Control network (VUCCnet), has been established and African health professionals have been sponsored in various educational activities and three regional and one sub-regional coordination meetings have taken place. Conclusions: The collaboration between IAEA/PACT and WHO AFRO stands out as a model for United Nations agencies as an effective collaboration for programmatic delivery to Member States.
Cancer control in Africa: is cancer research a luxury or necessity?
ecancermedicalscience, 2019
Decision makers dealing with resource allocation in Africa have the impression that cancer research is a luxury. As a result of this, very few or no resources are allocated for cancer research in Africa. Since in healthcare, clinical and epidemiological research provides an evidence base for formulation of health policies and facilitates decision making by policy makers, the lack of evidence base makes decision making intuitive. A situation like this is not cost-effective and is unacceptable. It is, therefore, important that for Africa to make effective decisions to improve the health of its population, cancer research informing policy and decision makers is a necessity and not a luxury.
Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions
International Journal for Equity in Health
Introduction Cancer is a significant public health challenge globally, with nearly 2000 lives lost daily in Africa alone. Without adequate measures, mortality rates are likely to increase. The major challenge for cancer care in Africa is equity and prioritization, as cancer is not receiving adequate attention from policy-makers and strategic stakeholders in the healthcare space. This neglect is affecting the three primary tiers of cancer care: prevention, diagnosis, and treatment/management. To promote cancer care equity, addressing issues of equity and prioritization is crucial to ensure that everyone has an equal chance at cancer prevention, early detection, and appropriate care and follow-up treatment. Methodology Using available literature, we provide an overview of the current state of cancer care in Africa and recommendations to close the gap. Results We highlight several factors that contribute to cancer care inequity in Africa, including inadequate funding for cancer researc...