Cancer is on the rise in sub-Saharan Africa. But is enough being done?

International health groups campaign on infectious diseases such as Ebola, malaria and AIDS in sub-Saharan Africa. But the region has a rapidly growing number of people with cancer — and most seem to have been left to their fate.

Photo by: Reuters
Photo by: Reuters

There are more than 600,000 deaths annually in Africa from cancer.

Updated May 10, 2017

With over one billion people, Africa is the world's second-largest and second-most populous continent.

Infectious diseases such as malaria, Ebola and AIDS are widely known of in sub-Saharan Africa, but the region is also suffering from another growing phenomenon: cancer.

“Cancer should be given the priority it deserves,” Professor Jean-Marie Dangou, the World Health Organisation’s African arm, WHO-AFRO Regional Adviser for Cancer Control, told TRT World. “Governments need to take urgent and concrete action,” he said.

Fifty-two of the 55 countries with no radiation therapy facilities were members of the UN, of which 30 were in Africa as of 2014, according to International Journal of Radiation Oncology report. (Reuters)

How many people are affected by cancer in sub-Saharan Africa?

The exact number is not known, but in 2010, there were around 850,000 new cancer cases, a report by the International Agency for Research on Cancer. 

But in 2008, 421,000 died because of cancer in Sub-Saharan Africa, according to a report from the American Cancer Society. 

“By the year 2030, cancer and other non-communicable diseases may overtake some infectious diseases as leading causes of death in sub-Saharan Africa,” a 2016 WHO report said.

How is cancer being treated in sub-Saharan Africa?

The main types of treatment such as surgery and chemotherapy services are offered in general hospitals.

“We cannot say ‘cancer treatment is nonexistent in the region’. I’d say it’s insufficient — and not up-to-date,” Dangou said.

But “dedicated cancer treatment centres in sub-Saharan Africa except South Africa are scanty and all located in capital cities,” Dangou said.

“These rare centres mostly provide radiotherapy, mainly cobalt therapy,” he added.

Cobalt therapy is a medical use of gamma rays to treat conditions such as cancer. But in developed countries, it is now being replaced by other technologies such as linear accelerators.

“Nowadays, several countries in Africa embarked (such as Niger, Burkina Faso, Swaziland, Nigeria, Chad) on radiotherapy centre projects,” Dangou said.  

In sub-Saharan Africa, cervical cancer remains the leading cause of cancer death among women according to WHO's 2014 report. (Reuters)

Why is the survival rate of cancer patients low in sub-Saharan Africa?

The survival of cancer patients in Africa is far less likely than is the case in high-income countries. This is because most cancer patients in Africa are diagnosed at late stages or at the end-state of the disease.

For example, the 5-year survival rate of women with breast cancer in Europe is 82 percent, whereas it is 46 percent in Uganda, a little less than 39 percent in Algeria, and 12 percent in Gambia.

The delayed diagnosis for the patients is due to the low level of cancer awareness among the population and the health workers.

Dangou said that effective early diagnosis can help detect cancer at an earlier stage. But it can also aid treatment that is generally more effective, less complex and less expensive.

What are the reasons behind the failure?

Health systems in sub-Saharan countries are mostly broken due to a weak infrastructure, a shortage of healthcare professionals, epidemics and outbreaks as well as conflicts and mass displacement.

“There is a complex interaction between the costs of globalisation on health governance, Africa’s deficit of leadership, institutions and capacities and the triple burden of diseases, communicable diseases, non-communicable diseases as well as nutritional and metabolic conditions,” Dangou said.

And people aren’t empowered to improve their health because of contributing factors such as poverty — and they’re also unable to readily access health care.

In some areas, women diagnosed with breast cancer face stigma and shame. (AP)

What are the challenges that cancer patients in the region are facing?

“Cancer affects the most vulnerable and the cancer burden imposes a substantial financial toll on patients, families and societies, which are felt most acutely by the global poor,” Dangou said.

“Lost jobs, lost income, and high treatment costs, as well as potential complications can push poor families into destitution.”

The price of cancer medication doesn’t only affect patients or their families. It also poses  major challenges for a nation’s economic development.

“If the health and economic impacts of cancer are reduced, communities will be stronger and better equipped or able to contribute to a more prosperous future for their countries,” Dangou said.

“Governments will be better equipped/funded to focus on services and systems needed for sustainable futures.”

Where are international health organisations?

There are many international health groups operating in sub-Saharan Africa. But most of them are focused on infectious diseases such as AIDS, malaria and Ebola, in order to stop their spread.

Cancer is ignored largely because it is not an infectious disease and cannot be passed from person to person.

WHO, and the international community, have set targets to reduce premature noncommunicable disease deaths by 25 percent by 2025 and by one-third by 2030. (Reuters)

What is needed?

In order to fix the current situation, sub-Saharan Africa needs a wide policy towards improving health conditions.

Part of this must be “to strengthen cancer prevention and control, reduce premature deaths and improve quality of life and cancer survival rates,” Dangou said.

An emphasis should be placed on strengthening capacities for screening, early diagnosis and treatment of cancers, as well as strengthen public awareness of the disease, he said.

“People should know that cancer is a preventable and curable disease,” he continued.

“Each individual should commit to prevent cancer by making healthy lifestyle choices and support others when needed.

“Cancer patients and survivors should take control of their cancer journey, share their story and advocate for cancer prevention and control.”

Author: Zeynep Sahin