World Cancer Day: Closing the care gap in Nigeria.

Cancer, one of the deadliest diseases in the world, does not respect race, gender, class or age.

It is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body, according to medical experts.

The World Health Organisation (WHO) say that cancer is one of the world’s leading causes of death. Its burden is growing.

A 2021 WHO report says the world crossed a sobering new threshold with an estimated 20 million people diagnosed with cancer, while 10 million died.

The report also said the number could continue to rise in the decades ahead.

“Yet all cancers can be treated while many can be prevented or cured.

“Care for cancer, like so many other diseases, reflects the inequalities and inequities of our world.

“The clearest distinction is between high- and low-income countries, with comprehensive treatment reportedly available in more than 90 per cent of high-income countries but less than 15 per cent of low-income countries”, the report said.

However, there is no specific cure for cancer but treatment could be accessed through drugs, surgery and radiography.

However, caring for cancer patients is regarded as a herculean task because of cost which even the rich consider astronomical.

This informed “Close the Care Gap” theme for three-year (2022-2024) the World Cancer Day commemorated every Feb. 4.

The aim is to call on all stakeholders to collectively and individually commit to strengthening actions aimed to improve access to quality care, including screening, early detection, treatment and palliative care.

In 2022, a Lancet Oncology Commission report said that Nigeria lost about 5.9 billion dollars to cancer deaths and other cancer-related factors in 2019.

The highlights of the report were that cancer was greatly impacting economies in Sub-Saharan Africa.

Though experts are of the opinion that a lot was being done to mitigate the impact of the disease in Nigeria, it is a fact that it requires a holistic approach to feel the impact of the interventions.

The President, Nigerian Cancer Society (NCS), Dr Adamu Al-Hassan Umar, said that the theme “Close the Care Gap” was intended to raise awareness among policymakers, government and professional oncologists to the gaps that exist in cancer care and healthcare delivery.

“This year we are continuing with the close the care gap campaign to harmonise and understand where we have come from, where we are and where we intend to go.

“As cancer advocates we have a desire to see that particularly in a country like Nigeria, that Universal Health Coverage (UHC) covers for all types of cancer and not only for selected cancers or selected individual category because cancer care is very expensive even to the rich man.

“Last year the National Health Insurance Authority (NHIA) Act was passed into law and in the Act, health insurance is now compulsory for all Nigerians.

“In that new Act about N700 million is earmarked for the vulnerable people every year to help them to access health care.

Umar said the implementation of the Act remained the major problem because of lack of infrastructure at primary, secondary and even tertiary healthcare levels.

“Also, we have the issue of manpower. Nigeria is a country that has less than 100 Clinical Oncologists and this is a country of over 200 million; we are talking about chemotherapy machines being readily available”, he said.

For the President, Association of Radiation and Clinical Oncologists, Nigeria (ARCON), Dr Amaka Laosebikan, there has been progress in access to treatment which has helped some Nigerians have quality treatment at no cost.

“We have also seen a very marginal increase in the number of functioning radiotherapy machines across the country.

“We still do not have an organised screening program or established school based vaccination program and this is a major flaw in our efforts to close the care gap”, she said.

According to her, there is need to critically identify the gaps in cancer care and treatment and work out strategies for closing them.

“I think priority should focus on data generation for meaningful planning and forecasting as well as identify socio-culturally acceptable practices to improve knowledge on some early symptoms”, she said.

According to Dr David Oyedeji, the Deputy Chief of Party, KP Care 2 project said studies in Nigeria had linked low uptake of cervical cancer screening services to lack of adequate information of the populace about cervical cancer.

KP CARE 2 is funded by Society for Family Health (SFH), a Non-Governmental Organisation (NGO), through USAID. It operates in Sokoto, Kebbi, Zamfara, Borno, Bauch an Adamawa.

“SFH will continue to expand its reach, bringing cervical cancer screening services into communities where access is limited or unavailable thus, closing the gap in access to cervical cancer screening and treatment services”, he said.

Nigeria, the Dr Okpako Okpikpi, the National Coordinator, National Cancer Control Programme (NCCP) FMoH, said the Federal Government had sponsored by the several sensitisation programmes on early detection of cancer.

“Many are being deceived to believe that cancer diagnosis is a death sentence while others are misguided to think that it is mysterious and nothing can be done medically about it.

“So the preventive aspect of it is to expose people to the knowledge about cancer.

“Drugs play a major role in the treatment of cancer, the other is surgery and the other is radiotherapy using x-ray to treat cancer these are the three modalities of treating cancer”, he said.

Okpikpi also said that the government has made some money available to assist cancer patients of breast, cervix and prostrate cancers.

“The patients go through a selection criteria to qualify and after that they are enlisted in the programme and government takes it up from there”, he said.

Dr Uchechukwu Shagaya, the Head, Radiotherapy and Oncology Department, National Hospital, Abuja, said cancer care was a continuum from prevention to palliation.

According to her Nigeria has done a lot in bridging the care gap although more still needs to be done.

“We have quite a lot of advocacy going on about awareness, screening, health talks in churches, mosques, schools and various centers.

“When we go into the treatment proper, the federal government’s cancer care fund has helped in this regard but then we ask for more and there have been changes”, she said.

She, however, said that more needs to be done about the care gap by the caregivers.

“Cancer is not a one day disease or an infectious disease that you can give a vaccine for and it goes away or has a one-stop treatment; it is a continuum”, she said.

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