‘ Available radiotherapy machines inadequate for cancer treatment, management’
CITING cancer as the second leading cause of death globally, the World Health Organisation ( WHO) has stated that an estimated 19.9 million new cases of cancer and almost 10 million deaths from cancer are recorded yearly.
Indeed, the body warned that the cancer burden will increase by approximately 60 per cent over the next two decades, further straining health systems, people, and communities.
The predicted global burden will increase to about 30 million new cancer cases by 2045, with the greatest increases occurring in lowand middle- income countries.
In Nigeria, the prevalence of cancer in Nigeria is rising at an alarming rate, posing a significant threat to the health and well- being of Nigerians.
According to the federal government, over 124,000 cases of cancer were recorded in the country in 2020 and this resulted in 78,899 deaths.
The situation is compounded by the dearth of specialists and necessary equipment required for proper treatment and management of the disease.
According to the Association of Clinical and Radiation Oncologists of Nigeria ( ARCON), Nigeria has less than 100 oncologists providing cancer treatment to over 200 million people.
Based on the International Atomic Energy Agency ( IAEA) standards, countries are supposed to have one oncologist per 100,000 population but in Nigeria, less than 100 oncologists are providing treatment for a population of over 200 million instead of at least 2500 oncologists.
ARCON also decried the shortage of radiotherapy machines in the country, stressing that less than 20 radiotherapy machines are functional in the entire country.
The International Atomic Energy Agency ( IAEA) ideally recommends four radiotherapy units per million people; hence, Nigeria needs over 200 radiotherapy machines.
The South- south region of the country, with an estimated population of about 26 million people has no single radiotherapy unit despite the existence of a cancer and cardiovascular hospital built by one of the former governors in the region.
Painting what seems like a gloomy picture of the cancer care situation in Nigeria, the Director General of the Nigerian Nuclear Regulatory Authority ( NNRA) Ya’u Usman Idris, said that Nigeria has only 14 radiotherapy machines in the country out of which Eight are not safe.
According to him, only six out of the 14 radiotherapy units in Nigeria are licensed by the NNRA, which is the regulatory authority.
At the World Cancer Day Symposium organized by Project Pink Blue in Abuja, the NNRA boss lamented that even some of the radiotherapy units, which are licensed by the authority, are not functional.
He said: “We have a serious problem; there’s nothing to celebrate today but to lament. Looking at the case of Nigeria, we have only 14 radiotherapy machines in the country and nine of them belong to the government, five of them belong to private institutions and only six of them are licensed by the Nigeria Nuclear Regulatory Authority which means, the others are not safe. In terms of equipment, Nigeria has only seven Linacs ( Linear accelerators), for a population of 200 million people. “South Africa has 92, Egypt has 76, if you compare those two countries with Nigeria, even the ones we have are not functioning, because today they are functioning, tomorrow they are down. If you go to the Nuclear Medicine, we have only two Nuclear Medicine centres that have gamma cameras and both are down at the National Hospital, Abuja and University College Hospital, Ibadan.”
According to him, ‘ Virtually there’s no gamma camera that is working in Nigeria whereas a country like Tunisia with a population of twenty- something million has about 14 of them working.
“We have only one Positron Emission Tomography Computed Tomography ( PET- CT) and it’s private. Nigeria doesn’t have the money to procure even one, but a private hospital did.
“It is our duty to check the state and status of the equipment, the operations, the services rendered by the facility, and the status of the personnel.
“We also must ensure the quality of the personnel and we find out that most of the hospitals don’t even have qualified personnel with no correct equipment among other defects but then it is our agency they will accuse of not giving license.
“So how do we treat cancer with this kind of equipment with 200 million people? It is not possible. We have a situation in the country, we have gazetted regulations and procedures including licensed experts on how to go about it, yet we are not doing it”.
He however assured that the agency has been given a new lease of life since the assumption of office by the administration of President Bola Ahmed Tinubu.
Idris decried the dearth of capacity to deal with cancer treatment in Nigeria.
He stated that insufficient capacity is a major obstacle to cancer treatment in the country especially due to unavailability or sometimes, inadequate critical equipment required for cancer treatment and management.
However Minister of State for Health and Social Welfare Tunji Alausa said that the Federal Government has concluded plans to establish six new Cancer Centres of Excellence in the following Hospitals - UNTH Enugu ( South- East), ABUTH Zaria, FTH Katsina ( North- West), UBTH Benin ( South- South), JUTH Jos ( North Central), and LUTH, Lagos ( South West), while UMTH Maiduguri is being upgraded ( North- East) with brachytherapy machines and other equipment. He explained that apart from the N20 billion budget allocated for six cancer centres nationwide during the last administration, additional funding has been secured by the present government to facilitate the commencement of the projects.
Alausa explained that the N20 billion budget allocated for six cancer centres nationwide during the last administration’s tenure could not be accessed due to procurement challenges.
The minister observed that by the time the challenges were resolved under the current administration, the prevailing economic conditions had adversely impacted the implementation.
He said: “So, there is no way we could use the N20b to build the six cancer centres. We have to make presentations to the National Assembly for additional budgetary allocation so that we can have enough funding to build the cancer centres. I’m happy to report today that we’ve got the additional funding and the groundbreaking six cancer centres will happen very soon”.
The minister noted that Nigeria is working assiduously to address the high burden of cancer in the country hence, the introduction of the Human papillomavirus vaccine into the country’s routine immunization targeting about 7.7 million teenage girls at no cost to them against cervical cancer
… Only 14 radiotherapy units for over 200m population, out of which eight are unsafe … IAEA recommends four radiotherapy units per million people …. Cancer is second leading cause of death globally
Closing the care gap
Between 2022 and 2024, the focus of World Cancer Day is to help “Close the cancer gap.” This year marks the third and final year of the campaign. The theme for this year is “Together, we challenge those in power”. This theme encompasses the global demand for leaders to prioritize and invest in cancer prevention and care and to do more to achieve a just and cancer- free world.
Improving access to cancer care
In a bid to ensure the affordability of cancer treatments for patients at treatment centers, Roche led a private- sector coalition in 2020, with the support of the International Finance Corporation ( IFC) and Nigerian public authorities, led to the creation of the Nigerian Cancer Health Fund ( CHF).
The CHF’S goal is to enable standard of care cancer treatment to underprivileged populations and to strengthen the national cancer care ecosystem by improving quality of services.
The CHF provides access to funding for treatments, chemotherapy, and radiation therapy services for people with breast, cervical, and prostate cancers. It is being piloted in designated centers across the country.