Cancer treatment does not end with radiotherapy, patients must also take drugs which are very expensive. How is Nigeria dealing with this? Paul Adepoju reports
Mid January 2019, Nigeria’s health minister, Prof Isaac Adewole, announced that patients living with cancer in Nigeria will soon be able to access radiotherapy treatment at the Lagos University Teaching Hospital.
He revealed that the government decided to invest in the hospital’s state-of-the-art cancer treatment cancer because it wanted to improve access to treatment to improve outcomes.
“We noticed that treatment is beyond the modalities that we offer. Our ambition is to replicate it outside the country,” he said.
On the occasion of the 2019 World Cancer Day, the installation of radiotherapy machines for cancer centers in various parts of the country is at the top of the list of Nigerian health ministry’s talking points. Furthermore, Nigeria’s President, Muhammadu Buhari, has signed into law the National Institute for Cancer Research and Treatment (Establishment) Act, 2017.
But numerous challenges remain, one of which is limited funding.
For instance, the health ministry in 2018 revealed Nigeria needs N93 billion for the National Cancer Control Plan 2018-2022 which is aimed at reducing the incidence and prevalence of cancer and improving outcomes nationwide. This amount is more than what was approved in the budget for the running of the entire health ministry.
Beyond the bottlenecks of policies and access to radiotherapy, cancer patients and their loved ones struggle with the high cost of cancer treatment.
It is worthy to note that while efforts are being made to procure and install more radiotherapy machines at government-owned cancer centers across Nigeria, the unpopular nature of health insurance in Nigeria puts the financial burden of cancer treatment squarely on the shoulders of the patients and their relatives. The burden is very high, the treatment of breast cancer is an example.
According to a report, women in Nigeria need from N2.1 million to N29.2 million to treat breast cancer depending on type and stage. The woman would have to go through different stages of diagnosis, chemotherapy, surgeries among others to get treated.
These include eight series of diagnosis that cost between N232,000 to N311,000; three surgeries which cost N670,000 to N3.3 million; 10 sessions of chemotherapy that cost about N916,000 to N2.6 million and finally 10-23 sessions of radiotherapy, which may cost N138,000 to N360,000.
The high cost of cancer treatment has been identified as a major concern since cancer affects very high number of Nigerians, most of whom cannot afford the cost but are expected to pay for the treatment — unlike communicable diseases such AIDS, tuberculosis and several others that thanks to donor funding, are able to assess free treatment.
Putting these and other trends into perspective, Jennifer Dent, President of BIO Ventures for Global Health, told healthnews.ng that Nigeria should not wait for donor funds for cancer control.
“Nigeria needs to step up and take responsibilities to invest in cancer,” Dent said.
Nigeria-BVGH drug access program
Dent told healthnews.ng her organization is working with the Nigerian government to make cancer drugs to be more affordable and accessible to cancer patients in Nigeria.
Here is what happened:
The Federal Ministry of Health developed a list of priority oncology drugs approved by the United States Food and Drug Administration to treat five of the most common cancers in Nigeria (breast, cervical, colorectal, liver, and prostate). During the cancer stakholders meeting, the oncology teams added pediatric and head & neck cancers to this list.
With the support and guidance of the Minister of Health and his administration, BVGH conducted needs assessments of Nigerian hospitals to quantify the demand for the priority drugs and understand current treatment protocols. The results of the needs assessments represent the first comprehensive data set on cancer medication usage by Nigerian oncologists.
Outcomes of the two-day planning and consultation meeting in Abuja with chief medical directors, oncologists, pharmacists, nurses and procurement managers included alignment on common treatment regimens and drugs; establishment of expedited drug registration, importation, and distribution processes; and creation of mentorship linkages between Nigerian and American oncologists.
The Federal Ministry of Health released an RFP, inviting selected manufacturers of the priority drugs to outline the terms by which they could provide safe, sustainable, and affordable access to their medicines through the pilot program. Following the completion of the pilot program, the Federal Ministry of Health and BVGH intend to scale up the initiative to serve more cancer patients across Nigeria.
What is expected to happen is for drug companies to compete to produce and supply large amounts of specific cancer drugs. This is expected to significantly reduce the prices of cancer drugs in Nigeria.
Even with the bright prospects of the initiative, Dent admitted that not all Nigerians will be able to afford the drugs.
“The drugs will still not be affordable for many cancer patients in Nigeria’s tiered system,” she told healthnews.ng, while suggesting a system should be put in place that will ensure that individuals that can afford the treatment are paying for the drugs while those that cannot afford the cost are getting the drugs for free.
This idea apparently excited the health minister whose ministry was able to get a budgetary allocation for this joint venture as confirmed by BVGH although the budgeted amount was not made public.
As Nigeria’s Minister of Health and an oncologist, I have personally witnessed the devastation that cancer has caused our citizens, and I will marshal all the resources of my office to prevent further needless suffering and death.
Professor Isaac Adewole
Although the time when the first set of drugs will be available in the Nigerian market hinges on a number of factors including the approval of the budget and release of funds, Dent said she and her organization will feel satisfied when a Nigerian cancer patient receives the first dosage delivered through the program.
“Success is when we see the first patient treated with full treatment regimen and he or she is cured of cancer,” she told healthnews.ng. How soon that will be probably entirely depends on Nigeria.