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The cancer threat to Africa’s future

Mar 20,2018 - Last updated at Mar 20,2018

CHICAGO — One of the most pressing public-health challenges in Africa today is also one of the least reported: cancer, a leading cause of death worldwide. Every year, some 650,000 Africans are diagnosed with cancer, and more than a half-million die from the disease. Within the next five years, there could be more than one million cancer deaths annually in Africa, a surge in mortality that would make cancer one of the continent’s top killers.

Throughout Sub-Saharan Africa, tremendous progress has been made in combating deadly infectious diseases. In recent decades, international and local cooperation have reduced Africa’s malaria deaths by 60 per cent, pushed polio to the brink of eradication and extended the lives of millions of Africans infected with HIV/AIDS.

Unfortunately, similar gains have not been made in the fight against non-communicable diseases (NCDs), including cancer. Today, cancer kills more people in developing countries than AIDS, malaria, and tuberculosis combined. But, with Africa receiving only 5 per cent of global funding for cancer prevention and control, the disease is outpacing efforts to contain it. Just as the world united to help Africa beat infectious disease outbreaks, a similar collaborative approach is needed to halt the cancer crisis.

Surviving cancer requires many things, but timely access to specialists, laboratories, and second opinions are among the most basic. Yet, in much of Africa, a lack of affordable medications, and a dearth of trained doctors and nurses, means that patients rarely receive the care they need. On average, African countries have fewer than one trained pathologist for every million people, meaning that most diagnoses come too late for treatment. According to University of Chicago oncologist Olufunmilayo Olopade, a diagnosis of cancer in Africa is “nearly always fatal”. 

Building healthcare systems that are capable of managing infectious diseases, while also providing quality cancer care, requires a significant investment in time, money, and expertise. Fortunately, Africa already has a head start. Past initiatives, like the Global Fund to Fight AIDS, Tuberculosis, and Malaria, the US President’s Emergency Plan for AIDS Relief, and the World Bank’s East Africa Public Health Laboratory Networking Project, have greatly expanded the continent’s medical infrastructure. National efforts are also strengthening pharmaceutical supply chains, improving medical training and increasing the quality of diagnostic networks.

Still, Africans cannot face down this threat alone. That is why the American Society for Clinical Pathology, where I work, is cooperating with other global healthcare innovators to attack the region’s growing cancer crisis. We have teamed up with the American Cancer Society (ACS) and the pharmaceutical company Novartis to support cancer treatment and testing efforts in four countries: Ethiopia, Rwanda, Tanzania and Uganda. Together, we have brought immunohistochemistry, a key diagnostic tool, to seven regional laboratories, an effort we hope lead to more timely cancer diagnoses and greatly improve the quality of care.

To complement these technical efforts, the ACS is also training African healthcare professionals how to carry out biopsies and deliver chemotherapy. That initiative, funded by Novartis, is viewed as a pilot programme that could expand to other regional countries.

Finally, our organisations are advocating for enhanced cancer-treatment guidelines in national healthcare planning efforts, protocols that we believe are essential to improving health outcomes. These initiatives are in conjunction with other undertakings, such as a joint ACS-Clinton Health Access Initiative programme to broaden access to cancer medications.

When the world took notice that infectious diseases like HIV/AIDS, polio and malaria were ravaging Africa, action plans were drawn up and solutions were delivered. Today, a similar global effort is needed to ensure that every African with a cancer diagnosis can get the treatment they need. Now, as then, success depends on coordination among African governments, health-service providers, drug makers and non-governmental organisations.

There is no place on Earth that is immune from the dread of a cancer diagnosis; wherever the news is delivered, it is often devastating to recipients and their families. But geography should never be the deciding factor in patients’ fight to survive the disease. Cancer has been Africa’s silent killer for far too long, and the global health community must no longer remain quiet in the face of this crisis.

 

Danny A. Milner, Jr. is Chief Medical Officer of the American Society for Clinical Pathology. Copyright: Project Syndicate, 2018. www.project-syndicate.org

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THANKS TO DANNY A. MILNER FOR BRINGING OUT THIS EPIDEMIC WHICH THE INTERNATIONAL COMMUNITY ASSUMED NOT APPLICABLE TO AFRICA. WHAT I DO NOT AGREE WITH DANNY IS THAT THE STATISTICS IS WRONG BECAUSE THE ROUGH ESTIMATE BY SAMPLING IS MORE THAN FOUR TIMES THE FIGURE STATED. IN ADDITION, NO ONE CAN STATISTICALLY SEPERATE THE CAUSES AND EFFECTS OF COMMUNICABLE AND NON-COMMUNICABLE DISEASES IN AFRICA. HIV/AIDS CAUSES CANCER SO AS OTHER PREVENTABLE DISEASES. MOST HEALTH CARE FACILITIES ARE NON-FUNCTIONAL, PUBLIC HEALTH IS ZERO AND THE SUPPORT SYSTEM FUNDS ARE STASHED IN THE WEST, FUNDINGS FROM THE PRIVATE SECTORS ARE USED FOR ADMINISTRATIVE PURPOSES SO ANY FUNDING FROM THE WEST TENDS TO END UP CLOSE TO ZERO AND THEY STILL PRODUCE BOGOUS STATISTICAL DATA THAT CLAIMS THAT THE JOD IS DONE. IN ONE SUCH CASE I WENT FOR A LECTURE ONLY TO SEE DATA WHICH CLAIMS THAT THE PREVELENCE RATE OF MALARIA IN LAGOS, NIGERIA HAS BEEN REDUCED TO ZERO WHICH OBVIOUSLY IS NOT TRUE BECAUSE THERE IS NO SUCH A THING IN EPIDEMIOLOGY. MAY BE THE BANKS WHERE ALL THOSE STOLLEN FUNDS ARE STASHED IN THE WEST CAN SEND THEM BACK WHERE THEY BELONG FOR THE DEVELOPMENT OF OUR HEALTH CARE INSTITUTIONS AND SOUND PUBLIC HEALTH POLICIES.

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