The State of Oncology in Africa
The Report’s Executive Summary
Written about cancer in Africa by health professionals working in Africa or international colleagues working closely with Africa, identifies ‘The State of Oncology in Africa, 2015’ as a unique report. Overall, it paints a depressing and deplorable picture of the current situation regarding cancer in Africa. Many patients do not seek traditional medical advice. Those who do, do so when the cancer is at an advanced stage when cure is no longer possible. There is a lack of oncologists from all disciplines, nurses and the necessary health professionals and technicians to support their work. There is a lack of treatment centres. There is a lack of treatments. Most countries do not have any Radiotherapy equipment.
Most countries do not have access to opioid drugs for palliative care and pain control. The situation is bound to get worse as the population grows and ages and cancer risk factors imported from high-resource countries begin to have their effect. The evidence is clear. Over the next decades, cancer will cause Africans to suffer and die in greater numbers; much greater numbers.
Throughout the individual chapters there are monotonous statements about patients not being able to afford the cost of the most basic chemotherapy protocols. The introduction of Universal Health Coverage would be a great advantage to cancer patients in Africa.
Yet there is hope. There are oncologists, nurses and other healthcare professionals and technicians doing a magnificent job in frequently desperate circumstances, without adequate resources or infrastructure, who deserve our full admiration. There is hope from the success of high-quality, sustainable projects such as the AMPATH model in Eldoret (Kenya) and in the activities of Hospice Africa Uganda (Kampala, Uganda). Unfortunately, it is not enough. Significantly, both these extraordinary examples rely on international charitable donations rather than local or international government funding.
There is a wide variety of statistics available regarding cancer in Africa, many just estimates of the situation. However, statistics are patients with the tears wiped away. 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 to improve the situation in the poor countries 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.
It is impossible to avoid the conclusion that there is a need for a major Private-Public partnership, involving a number of sources from different areas, to make the necessary progress with the briefest delay. The partnership needs the commitment of the wide span of industries involved in the technology for diagnosis and treatment. It needs the commitment of Governments and Non-Governmental Organisations to be effective. Effective will be measured against the Right of every patient with cancer to have the most appropriate treatment and care for their disease.
Working to improve health must cease to be viewed as a competition. Public and Private organisations have an underlying suspicion of each other that must be overcome in the interests of improving cancer care and outcome worldwide. The situation as portrayed in this Report is dramatic and urgent and it behoves all parties to put this frequently deep-rooted suspicion behind them and develop an effective collaboration to improve this key aspect of Public Health throughout the world.
It is essential to move from a passive position to an active one. We can turn our heads and walk away from this situation and betray all those wonderful clinicians, nurses and other personnel grasping with the overwhelming problem of cancer on the Continent. Or, we can do something.
As with cancers everywhere, African cancers deserve to be prevented, to be treated, to be cured and to be palliated. If we don’t do it now, starting immediately, it will be too late and Africa’s cancer crisis will continue to grow out of control.
We make this call to action to African governments, foreign governments and international organizations to address the challenge posed by Cancer in Africa with specific, coordinated actions as laid out on the facing page.
The situation with cancer in Africa is critical. Global Society cannot, once again, react too slowly to an African health crisis.
Peter Boyle, Twalib Ngoma, Richard Sullivan, Ntokozo Ndlovu, Philippe Autier, Cristina Stefan, Kenneth Fleming and Otis W. Brawley