COVID-19: Cancer & Patients

Cancer Control in Nigeria : Can we get it right?


Dove Haven Foundation organized a virtual symposium titled: "Cancer Control in Nigeria: Can We Get It Right?"
The symposium was organised as part of the organisation’s statutory activities to reduce cancer threat, especially in Nigeria.
The Guest Speakers at the symposium were "
  • Professor Francis A. Durosinmi-Etti, Chief Clinical Oncologist, NSIA-LUTH Cancer Centre, LUTH.
  • Dr. Rahmatu Y. Hassan, Chief Consultant at Asfar Medical and Immediate past National Coordinator, National Cancer Control Programme, Federal Ministry of Health, Nigeria
  • Professor Oladapo Campbell, Visiting Consultant Radiation and Clinical Oncologist, Department of Radiotherapy and Oncology, Usmanu Danfodiyo University Teaching Hospital, Sokoto
  • Dr. Rafiu Isamotu, the Hon. Commissioner for Health, Osun State.
The Professors are members of the Dove-Haven Foundation Technical Team while Dr. Rahmatu is a member of the NGO’s Board of Trustees.
The meeting commenced with the singing of the second stanza of the National Anthem. Dr. Ekundayo Samuel, the Executive Director of Dove-Haven Foundation delivered the welcome address and laid the background to the symposium.
He was worried as to the increased rate of cancer incidence in Nigeria coupled with poor infrastructure, lack of accurate data to plan for cancer patients, and also project into the future.
Dr. Ekundayo quoted the cancer report of GLOBOCAN and Federal Ministry of Health as regards Nigeria.
He said that 'the continuous rise in the incidence of cancer burden in Nigeria, Africa and globally was a great concern to them. Knowing that cancer alone kills more than AIDS, Tuberculosis, and Malaria put together worldwide is worrisome.

Globally, in 2018, GLOBOCAN reported that an estimated 9.6 million death occurred from cancer with 18.1 million new cases.
It was projected that by the year 2030, about 30 million people will be living with cancer and one in two persons will have one form of cancer or another if nothing is done.
In Nigeria, 100,000 new cases were reported in 2012 and this figure rose to about 500,000 in 2015 according to GLOBOCAN.
Sadly, sub-Saharan Africa has access to about 5% of the global cancer resources, yet, about 80% of the newly diagnosed cases of cancer occur in this region where Nigeria belongs.
These frightening statistics led us to start this organization last year 2019 in order to salvage the situation'.

However, in pursuit of the organization’s aim of reducing cancer threat and in the spirit of giving back to the society, they have decided to put in place this program in other to enlighten the public on cancer control.
He further said that his hope and aspirations were that this event will give more enlightenment to every Nigerian especially the underserved communities, clinicians, educational and research institutions, policymakers, relevant government MDAs, other NGOs, health correspondents from the media and non-media print, pharmaceutical industries, even cancer patients.

Reacting, Dr. Rafiu Isamotu, the Hon. Commissioner for Health, Osun State in his opening remark, commended Dove-Haven Foundation for organising this very important symposium addressing a key national issue.
The Commissioner for Health further stated that cancer screening is key in the control of cancer in Nigeria. Speaking further on the increased rate of cancer cases in the country, he stressed that hardly will you found someone who does not know someone with cancer if they themselves are not harbouring the disease.
He encouraged States and the Federal Government to intensify screening programs as this will help to detect most people with cancer.
The cost of treating cancer is huge he said, therefore the need to detect cases early because, when detected early it is easier and cheaper to manage.

Dove-Haven Foundation has risen to the challenge of increasing the overall survival of the population she represents through this symposium.
Prof Francis Durosinmi-Etti, who gave the first lecture during the symposium started by picking on the topic; cancer control in Nigeria, can we get it right, he believes as an optimist that Nigeria can get it right.
He was also quick to recognised the immense contributions of the Federal Ministry of Health especially those at the National Cancer Control Programme desk.
Prof Durosinmi-Etti said the Federal Government had good intentions for her citizens.
One of such is the establishment of the first National Cancer Control Plan (2008-2013), and the recent plan covering 2018-2022. He mentioned that the document contains a road map, a coordinated program that is holistic in nature.
This document can be obtained from the Ministry and also available online.
He stated that cancer of the breast and cervix forms over 50% of cancers in females in Nigeria and prostate cancer is the commonest in males, however, colorectal cancer is on the increase and this is common in both males and females. Prof Durosinmi-Etti mentioned that the best cure for these cancer types is early detection.

On her part, Dr. Rahmatu Hassan responded by saying that Nigeria can get it right in the area of cancer control.
She said further that to control is to dominate, have power, regulate and there are tools implored in the control of cancer in Nigeria such as prevention which includes lifestyle changes for example in the case of cervical cancer, immunization against the causative agent human papillomavirus; an education which includes awareness, training; infrastructure such as equipment and buildings; data generation and research, this will help in planning.
Dr. Rahmatu said that the Federal Ministry of Health has been working with the Nigerian National System of Cancer Registries and at the moment, the Ministry has about 30 cancer registries.
The individual registry helps to gather data from the assigned coverage area.
They gather data and transmit to the Ministry, the Ministry then work with the data and can in the same vein transmit to the International body to quote on behalf of Nigeria.
She said another tool the Government has been using to control cancer is the use of Palliative care.
There is the Association of Auspices and Palliative Care with branches in most of the hospitals in Nigeria.
However, she used the medium to ask the Association to be more active in the dispatch of their functions.
Dr. Rahmatu clearly urges non-governmental organisations to diversify in their mode of operation rather than every NGO focusing on cancer awareness and screening.
NGOs or stakeholders should have niches or specific areas of interest. She finally said that the mental health aspect of cancer control should be carefully looked into.
Prof Durosinmi-Etti further said that the Government is doing a lot to improve radiation therapy services in the country.
For example, there is a public-private partnership arrangement between LUTH and National Sovereign Investment Authority (NSIA).
This arrangement has brought about the establishment of the NSIA-LUTH Cancer Centre in Lagos which at the moment is the best in West Africa.
He also mentioned that there are other good cancer centres in Nigeria such as National Hospital, Abuja, UCH, Ibadan, etc.
There was a question as regards the huge cost of treatment that the masses couldn’t afford.

Prof Durosinmi-Etti said that many centres have failed in the past because we are deceiving ourselves, nothing good comes out cheap in life.
He acknowledged that the cost of treatment is indeed high beyond the reach of the masses, however, these centres are not charging as much as other countries are charging yet they have similar facilities.
In Europe or America for example, you will pay about 6-10 times the cost of what you will pay in Nigeria. Prof Durosinmi-Etti later said that stakeholders and the Government should intensify the support for the cost of treatment to the masses.

While reacting, Prof Oladapo Campbell said he remained optimistic about cancer control in Nigeria as the Federal Government through the National Cancer Control Plan (2018-2022) has a big dream of controlling cancer in Nigeria.
He called on the Government to implement the immunisation plan in the document where the populace will be vaccinated against hepatitis B and human papillomavirus which are risk factors to some cancer types.
Prof Campbell also said he is worried about the implementation of the NCC plan that will lapse in 2022.
Looking at the poor states of our cancer centres, for example, there is only one megavoltage machine to twenty million Nigerians compared to Egypt (1 to 1.8 million) and Australia (1 to 0.21 million).
Other challenges are the cost of this equipment, lack of maintenance engineers, manpower, lack of quality assurance for these machines.
He mentioned that at the moment only 6 radiotherapy machines are functional in the country. He reiterated the need to have auspices and palliative care centres in most of our hospitals.

Prof Campbell recommended that manufacturing companies saddled with the production of chemotherapy drugs should be:
  • Situated in Nigeria to help reduce the cost of chemotherapy treatment.
  • Medical oncology unit should be established in the two postgraduate colleges in Nigeria to take care of chemotherapy treatment.
  • The promise of the Federal Government regarding funding in the NCC plan should be implemented.
  • The State Governments should be active in the NCC plan.
  • Donors should be encouraged to review their roles and participation in the NCC plan.
  • Federal Government should increase the about US$105 per capita spent on the health of every Nigerian compared to the US$ 5000 per capital spent by the US on her citizen.
Prof Durosinmi-Etti mentioned that there is no need to have equipment that the populace cannot access and the fact that cancer matters should not be left to NGOs to handled; giving credit to the NGOs doing a great thing in the area of cancer and cancer-related matters including Dove-Haven Foundation.
He advocated for the release of the budgetary allocation for health in the current budget and the one in the NCC plan which is close to about 100 billion nairas.
Prof Durosinmi-Etti further called on the National Health Insurance Scheme to look in the line of cancer management in the country, considering the cost of treatment.
He commended the efforts of the Federal Government in the area of training health workers on cancer treatment at all levels.
Prof Campbell emphasised that public-private partnerships should be encouraged while the Government should give assurances to the private sector since they are capitalist.
Since cancer control involves everyone, religious leaders, traditional leaders, primary health care centres and local government officials should be involved in this fight.
There is also the need for the citizens to know what to do to stay off cancer.
He categorised cancer predisposing factors to two; environment (such as lifestyle, smoking, diet, alcohol intake, infections, obesity) and biology (such as familial and hereditary factors, hormonal), others are age, race, radiation, family history, etc.

Prof Durosinmi-Etti on a final note, pleaded with the Government to adopt and implement the recommendations in the NCC plans, while also urging the Leaders of the 36 States including the Federal Capital Territory to adopt and implement same.
And every concern on cancer should be directed to the desk of the National Cancer Control Programme at the Federal Ministry of Health.
Prof Campbell also pleaded with the Federal Government to improve on cancer support especially in the North-East part of the country and to upgrade the facilities in Gombe and Borno to a comprehensive cancer centre.
Also at the symposium is Prof Oyeronke Odunola, a Technical Adviser to Dove-Haven Foundation, and Director of Research, Cancer Research and Molecular Biology Laboratories, Department of Biochemistry, University of Ibadan.
Prof Odunola said that at the level of the individual, there is a need to be our brother’s keeper and also the need to increase cancer awareness and build capacity in this area.
We should not be tempted to believe that everyone knows about cancer while also encouraging those with the disease that cancer is not a death sentence.
Mr. Temitope Mark, Secretary, BoT of the organisation gave the vote of thanks and the closing prayer was said by singing the second stanza of the National Anthem.
Other participants at the symposium are stakeholders of Dove-Haven Foundation, several cancer-focused NGOs, oncology Experts from Local, State and Federal levels, etc.