Cancer is quietly becoming Nigeria’s most relentless killer, outpacing a health system still chasing yesterday’s battles.
When the World Health Organization released its new investment case on non-communicable diseases, the findings spoke directly to Nigeria’s unfolding cancer crisis. Globally, cancer and other NCDs claim millions of lives before the age of 70, yet WHO estimates that with just three dollars per person annually, countries could save millions of lives and reap vast economic returns.
For Dr. Nwamaka Lasebikan, former Director of Research and Innovation at the Nigerian Institute for Cancer Research and Treatment (NICRAT), the report reflects realities she encounters every day. “To be honest, the fate of an average Nigerian living with cancer right now is really not too good,” she told healthnews.ng managing editor, Paul Adepoju. “There have been some hitches with the operationalization of the Cancer Health Fund… that disrupted the ability to access funds for the top three cancers — cervical, prostate and breast. So that has impacted negatively really, because as you know, in Nigeria, most patients access their treatment out-of-pocket. And you know what that means in terms of the huge financial burden.”
However, progress has been made in some areas. “In terms of radiotherapy machines, there has been progress,” she explained. “Two months ago, the minister went around to three sites to commission three additional linear accelerators in diverse regions… I think we now have about 16 linear accelerators scattered around the country. We know this is not enough, but I’m highlighting it in the sense of progress.”
Yet diagnostics remain a critical bottleneck. “Survivors actually brought that up,” she said. “They complained that they had to waste resources because tests done in Facility A were not accepted when they went to an oncologist. That begs the question of quality assurance. CT scans are readily available, the problem is affordability. MRIs are not as widely available, and again affordability is the issue. We have only one functional PET scan in Nigeria. These facilities are only in urban settings. In rural settings, they are not there, and women often travel many miles at great cost.”
On financing, she acknowledged new moves but cautioned that the system is still weak. “One of the problems with the Cancer Health Fund was because they wanted to expand the platform to take in more cancers and make funds available to more people. There is also a Catastrophic Health Fund set aside, up to a billion or thereabouts, to cover chronic diseases like kidney disease and cancer. We are expecting a rollout in the not too distant future so patients with cancer can begin to benefit.”
She noted that prevention efforts, particularly on cervical cancer, have gained momentum. “Advocacy is what is driving it,” she said. “The advocacy for cervical cancer elimination is quite high, starting from the WHO asking member states to conform… There was also a time when Nigeria was looking at adopting the WHO plan for breast cancer elimination… but we haven’t heard much about progress yet.”
Health financing models from other countries have struggled to take root. “About four years ago, the ‘sin tax’ was proposed to the National Assembly to increase taxes on sugary beverages and tobacco, but it did not scale because of pushback from those industries,” she recalled. “Other countries like Thailand have had success with such models. Nigeria needs to look at other sources, but as you know, citizens are already struggling with multiple taxes.”
Her deepest concern is not infrastructure but people. “I am exceptionally concerned about the workforce — the dwindling workforce in the oncology space. Not just doctors, but every cadre responsible for delivering safe and effective care. We need to declare a state of emergency. With the trajectory we are on, we will not even be close to meeting the number of oncologists needed in the next 20 to 30 years.”
Still, she finds hope in the growing activism of those who know cancer best. “What I am optimistic about are cancer survivors,” she said. “They are becoming more vocal, demanding a seat at the table, and demanding that their lived experiences are heard. They should be guided so that we can tailor our limited resources for the best gains. We need them to be involved at every level — policy, clinical, and community.”
Her message to Nigerians just beginning the cancer journey is one of caution but also encouragement. “Cancer is not a death sentence,” she said. “We have people who have lived 15 years or more who can speak to that. Alternative practice is becoming common, but while some use it for symptom relief, others abandon treatment for it. I would advise sticking with evidence-based treatments and keeping open communication with doctors. Some complementary medicines can be counterproductive. It is not a sprint, it is a marathon… open communication, early diagnosis, and positivity are key.”
Find below the transcript of Paul’s interview with Dr. Lasebikan.
Q: How would you describe the fate of an average Nigerian living with cancer right now?
A: To be honest, the fate of an average Nigerian living with cancer right now is really not too good. There have been some hitches with the operationalization of the Cancer Health Fund. There was a migration from one platform to the other because we were expecting an expansion of that platform. That disrupted the ability to access funds for the top three cancers — cervix, prostate and breast. So that has impacted negatively really, because as you know, in Nigeria, most patients access their treatment out-of-pocket. And you know what that means in terms of the huge financial burden.
Q: What progress has been made in terms of radiotherapy and diagnostics?
A: In terms of radiotherapy machines, there has been progress. Two months ago, the minister went around to three sites to commission three additional linear accelerators in diverse regions. UNTH already had one radiotherapy machine, then a second one was bought by the federal government. The University of Benin Teaching Hospital had not had a functional radiotherapy facility for many years, so that was also commissioned. There are now about 16 linear accelerators scattered around the country. We know this is not enough, but I’m highlighting it in the sense of progress.
For diagnostics, survivors complained that they had to waste resources because tests done in Facility A were not accepted when they went to an oncologist. That begs the question of quality assurance. CT scans are readily available, the problem is affordability. MRIs are not as widely available, and again affordability is the issue. We have only one functional PET scan in Nigeria. These facilities are only in urban settings. In rural settings, they are not there, and women often travel many miles at great cost.
Q: What about financing cancer treatment?
A: One of the problems with the Cancer Health Fund was because they wanted to expand the platform to take in more cancers and make funds available to more people. There is also a Catastrophic Health Fund set aside, up to a billion or thereabouts, to cover chronic diseases like kidney disease and cancer. We are expecting a rollout in the not too distant future so patients with cancer can begin to benefit.
Q: We hear a lot about cervical cancer elimination. Why is prevention getting more attention there compared to other cancers like breast cancer?
A: Advocacy is what is driving it. The advocacy for cervical cancer elimination is quite high, starting from the WHO asking member states to conform. When we did the cost analysis using the C4-2 costing tool, the amount for prevention of cervical cancer is obviously much less than for tertiary prevention. That point was pushed strongly during the launch. There was also a time when Nigeria was looking at adopting the WHO plan for breast cancer elimination. WHO technical leads are working with NICRAT to see how the global breast cancer initiative can be domesticated, but we haven’t heard much about progress yet.
Q: What about health financing models like taxation on tobacco or sugary drinks, which other countries use?
A: Health financing for cancer requires a lot more development in Nigeria. The Cancer Health Fund was supposed to be co-funded by the private sector, but that has not happened. About four years ago, the “sin tax” was proposed to the National Assembly to increase taxes on sugary beverages and tobacco, but it did not scale because of pushback from those industries. Other countries like Thailand have had success with such models. Nigeria needs to look at other sources, but as you know, citizens are already struggling with multiple taxes.
Q: What are you most concerned about, and what gives you hope?
A: I am exceptionally concerned about the workforce — the dwindling workforce in the oncology space. Not just doctors, but every cadre responsible for delivering safe and effective care. We need to declare a state of emergency. With the trajectory we are on, we will not even be close to meeting the number of oncologists needed in the next 20 to 30 years.
What I am optimistic about are cancer survivors. They are becoming more vocal, demanding a seat at the table, and demanding that their lived experiences are heard. They should be guided so that we can tailor our limited resources for the best gains. We need them to be involved at every level — policy, clinical, and community.
Q: Finally, what would you say to someone just beginning the cancer journey?
A: Cancer is not a death sentence. We have people who have lived 15 years or more who can speak to that. Alternative practice is becoming common, but while some use it for symptom relief, others abandon treatment for it. I would advise sticking with evidence-based treatments and keeping open communication with doctors. Some complementary medicines can be counterproductive with systemic treatments. It is not a sprint, it is a marathon, and many life-changing decisions have to be made. Open communication, early diagnosis, and positivity are key.