August 27, 2016

The burden of Cancer in Nigeria 



By Sanni Onogu

The menace of cancer in the country has continued to be of great concern to all due, to its destructive tendencies in family life and colossal amount of funds required for diagnosis and treatment. The death of a cancer patient often means the loss of a breadwinner or total impoverishment of survivors due to high cost of treatment which often drain the resources of victims and their family members.

Cancer-pixThe Executive Secretary of the  Committee Encouraging Corporate Philanthropy (CECP), in Nigeria, Mr.  Abia Nzelu, had told the media that “Nigerians spend $200 million annually on treatment abroad.”  Nzelu, according to the report spoke at a press conference jointly organized by CECP and the Association of Advertising Agencies in Nigeria, to mark the 2015 World Cancer Day (WCD), in Lagos.

The event he said was meant to raise public awareness about the disease and to underscore the need for  government at all levels to make provision for cancer treatment centres across the country. He lamented that  the outcome for Nigerians who embark on cancer-related medical tourism is often poor, because of late detection.

On its part, the World Health Organization (WHO) said about 24.6million people live with cancer worldwide while about 12.5 per cent of all death is attributable to cancer. It further estimates that  over 100,000 Nigerians are diagnosed with cancer yearly, while about 80,000 die from the disease. This brings the consequences of the cancer epidemic to 240 Nigerians every day or 10 Nigerians every hour, dying from cancer. It noted that the country’s cancer death ratio of 4 in 5 affected persons is one of the worst in the whole world.

The grim statistics above accounts for the  earnest quest by the 8th National Assembly to urgently tackle the dire health challenge posed by the incidence of cancer to Nigerians and to lay a solid legal foundation upon which present and future superstructure of interventions aimed at the control, treatment and prevention of the disease in the country would take root. It is worthy of note that while it has been introduced by both the Red and Green Chambers, the Senate has already considered and passed its own version of   the “Bill for an Act to provide for the establishment of the National Institute for Cancer Research and Treatment.”

Chairman, Senate Committee on Health, Senator Lanre Tejuoso, while presenting the report on the Bill to the Senate for the third and final reading, explained that Cancer has been identified as one of the public health problems worldwide. “The disease affects all categories of humanity. Cancer is known to be the second common cause of death in developed countries and third leading cause of death in developing countries of which Nigeria, with its population is highly affected,” Tejuoso said.

He said the control, treatment and research on cancer has tremendously improved in the developed economies and even in some developing nations like India – where efforts of science and improved national strategy against cancer have been harnessed and deployed to fight cancer related deaths – such achievements were only made possible through the establishment of advanced cancer research infrastructure, new cancer centres and improved treatment procedures.

“It is sad to note, that Nigeria has not done enough to fight cancer as evident by lack of adoption of a national strategy that focuses on research, improved awareness and provision of treatment centres. This certainly must be the reason the spread of the ailment is not abating in Nigeria,” he stated.

The bill is meant to bridge this yawning gap in the national efforts to properly diagnose and manage the cancer pandemic. The objectives of the Bill among others is to provide a national leadership in cancer research, prevention, control and treatment; guide scientific improvements to cancer research prevention, treatment and care; coordinate and liaise between wide range of groups and health providers with an interest in cancer; and assist with the implementation of government policies and programmes in cancer research, prevention, control and care. Highlighting the relevant provisions of the legislation, Tejuoso noted that the broad-base participation at the public hearing conducted by the Committee, agreed with the intentions of the Bill. “Its intent is to ensure that all forms of cancer disease are prevented, controlled and treatment and care for cancer patients provided, with national strategies that focuses on cancer research,” he said.

To ensure that the proposed institute is manned by qualified manpower that would effectively and efficiently carry out its mandate of curtailing the cancer scourge and ensuring accessible and cost effective treatment to those already plagued by the health condition, the Bill, flowing from the input of stakeholders and development partners, provided that health professionals with cognate experience be made to compose the membership of the board of the institution.

Aside from a nominee of the Minister of Health, who should be “preferably a Civil Servant with 10 years’ experience”, the board is to comprise of eight persons drawn from the following groups: Radiologists, Medial Laboratory Scientists, Physiotherapists, Nigeria Cancer Society, Civil Society Organizations, a cancer survivor living free of cancer for a minimum of five years, National Complementary and alternative Medical Association (NACAMA) and the National Association of Nigeria Traditional Medicine Practitioners (NANTMP).

To avoid ambiguity, the Bill also provided that the Director of the Institute should be an Oncologist with 10 years research and administrative experience and preferably a professor. According to Wikipedia, “Oncology  is a branch of medicine that deals with the prevention, diagnosis and treatment of cancer. A medical professional who practices  oncology  is an  oncologist.”  Moreover, to ensure the financial sustainability of the   institute on a long term, the Bill provided that the institute can leverage on the Public Private Partnership ((PPP) model for additional funding needs. Clause 10 subsection 3 of the bill provided that  “the board shall establish Public Private Partnership (PPP) wherever possible for providing clinical services, defray costs and maximize efficiency” in tandem with best global practices.

The institute when established is to among other administrative and technical function, “create a central online database for statistical analysis to create access by both public and private individuals with a view to attracting donor agencies; establish a department of telemedicine for collaboration with peers both within and outside the country;

responsible for establishing a cancer preventive protocol according to age and family history of every Nigerian with a view to carrying out a public awareness campaigns for screening right from the primary health centre to the secondary and tertiary hospitals with the ultimate referral centre for everything cancer being the institute; this is aimed at eradicating medical tourism by the theme ‘Operation know your health centre and referral point.”

The Senate Committee on Health had in its findings/observations noted among others that: “The consensus of opinion of stakeholders and the general public favoured the enactment of the legislation (i.e. National Institute for Cancer Research and Treatment Bill, 2016); the absence of legal framework for the management of cancer has greatly affected the delivery of appropriate control, prevention, treatment and care of the disease in Nigeria.” The chairman of the committee specifically lamented that “from the stakeholders’ meeting, it was evident that Nigeria was yet to do enough in the area of improved national strategy in the fight against cancer.”

The Senate President, Dr. Abubakar Bukola Saraki had thanked his colleagues for approving the passage of the legislation. He stated that the passage of the Bill will go a long way in changing the lives of Nigerians and also add value to their living standard.    “As someone who has lost a loved one to cancer,   it gives me great joy to announce the passage of cancer research Institute @NGRSenate,” Saraki later said on his Twitter handle.  “Once established,” the Senate President   added, “the National Institute for Cancer Research and Treatment will provide a holistic national strategy for dealing with cancer.”

It is pertinent to mention that the priority given to the consideration and speedy passage of bill is no doubt predicated on the resolve of the 8th Senate to ensure that relevant laws that would improve the health and economy of the average Nigerian are promptly enacted in line with its Legislative Agenda.

The absence of such laws and critical agencies in the past, if it must be said, are directly or indirectly responsible for the humongous financial resources, time and energy expended by Nigerians in seeking diagnosis and treatment of cancer ailments in countries outside our national boundaries. It is hoped that with the passage of the Bill by the Red Chamber and the expected concurrence of the Green Chamber anytime soon, cancer patients in the country would have their burden of raising scarce foreign exchange for oversea medical tourism drastically scaled down, if not totally lifted.

  • Onogu is the Chief Press Secretary to the Senate President.