Improving cancer care access in Africa

In 1970, 15% of the world’s new cancer cases were found in low- and middle-income countries (LMICs).

In 2008, 56% of the world’s new cancer cases were found in LMICs.

By 2030, it is estimated that a whopping 70% of new global cancer cases will be found in LMICs.

What about survival rates here? Well, they’re much worse than they are in wealthy nations. One of the primary reasons for this is the inaccessibility of oncology drugs. Published in The Lancet Oncology, a 2020 survey of 948 oncologists (165 of whom were from LMICs) revealed the stark reality of the global distribution of essential drugs. Of the 20 most critical oncology drugs, only one was widely available in LMICs at a price that was within patients’ means. As for Herceptin, a drug used to treat aggressive HER2-positive breast cancer – two-thirds of the oncologist-respondents from LMICs said that prescribing the drug put their patients at risk of catastrophic health expenditure.

The cancer burden in Africa

These epidemiological trends are also evident in Africa’s cancer burden. In Nigeria, for instance, the incidence of cancer is on an upward trajectory. Specifically, the West African country is predicted to witness a 46% increase in prostate cancer cases and a massive 67% increase in breast cancer cases by 2030.

Meanwhile, in Kenya, too, the scourge of cancer is a serious public health concern. After infectious and cardiovascular diseases, it is the third leading cause of death. The annual incidence of cancer jumped from 37,000 new cases in 2012 to 47,887 in 2018. Simultaneously, the yearly cancer mortality rate also rose by nearly 16%. Over the coming two decades, the number of new cancer cases in Kenya is projected to skyrocket by over 120%.

This exponential growth in cancer incidence is part of a larger trend – the growing epidemiological shift towards non-communicable diseases (NCDs). 77% of deaths due to NCDs, no longer considered diseases of affluence, occur in LMICs. In Africa, cardiovascular disease, obesity, diabetes, oral diseases, respiratory diseases, mental illnesses, and cancer are all becoming increasingly common. As per the WHO in 2022, in 7 of Africa’s 54 nations, as many as 50% to 88% of deaths can be pinned on NCDs.

These statistics are interesting because, historically, Africa has been home to a disproportionate share of the world’s infectious disease burden. Think Ebola, Lassa virus, cholera, malaria, HIV/AIDS, tuberculosis, and neglected tropical diseases (NTDs). Africa still bears a heavy infectious disease burden, but the addition of NCDs only makes the situation more challenging. Health systems are already strained; the addition of the long-term care needs associated with chronic NCDs puts added pressure on developing health sectors.

Within this scenario, it becomes even more important to find innovative and sustainable ways to bring essential oncology drugs to people in Africa. The cancer burden in Africa is growing and governments, development agencies and pharmaceutical companies need to find ways to address it without getting overwhelmed or distracted by competing public health needs.

Meeting patients where they are: Improving cancer care access in Africa

In 2019, after many years of medical training in the United States of America, the oncologist Fredrick Chite Asirwa returned to his home country of Kenya to set up the International Cancer Institute, or the ICI. Located in Eldoret in western Kenya, the ICI isn’t a fancy hospital complex, but it is doing important work in bringing cancer care to the people who haven’t historically had access to it.

The ICI houses highly advanced diagnostics machines. It is training physicians, taking an active role in clinical trials, building digital cancer registries, and lending support to government initiatives to decentralise care. In short, the ICI is a promising example of how to bridge the distance between high-quality oncology drugs and the African patients who desperately need them.

In 2015, a Big Pharma company tried to bring specialised oncology therapies to Kenya. The endeavour was not a success, but it offered many lessons about the challenges plaguing the African healthcare ecosystem. It highlighted that the mere availability of drugs was not enough to get patients to take them. This situation highlighted that improving access to cancer treatment in Africa is a matter of education, economics, and infrastructure.

Education. When this initiative was introduced in Kenya, the country had close to no testing for the HER2 gene and no national cancer guidelines. This meant that patients were not aware of the specific genetic biomarkers characterising their cancer. In the off chance that they were, the absence of national guidelines meant that health professionals were ill-equipped to deploy effective treatment plans.

The first step to improving access to cancer care in Africa would be to improve awareness – among patients, policymakers, pharma sector stakeholders, and health professionals. Eliminating information asymmetries can help patients make informed decisions and access the most appropriate drugs.

Financing. When the aforementioned programme was introduced, Kenya did not have a budget for cancer care, meaning that the government struggled to make its share of payments. So finding effective financing programmes is critical to improving oncology drug access in Africa. A deal signed in 2022 between Kenya and the Big Pharma company saw better results as this time, the cost of the cancer drugs was covered fully by the National Health Insurance Fund.

In future attempts to make oncology treatment accessible in Africa, it is important to consider how the drug will be paid for and whether the selected financing mechanism is sustainable in the long term.

Infrastructure. When countries make their own pharmaceutical products, they have more autonomy in pricing and distribution models. Accordingly, building appropriate infrastructure in Africa is key to improving access to affordable cancer care.

This infrastructure includes not only primary, secondary and tertiary health centres but also digital health technologies, a skilled workforce, and most importantly, pharmaceutical manufacturing facilities.

One way to get such facilities up and running in no time is to use PodTech™’s Oncology Podule™. Designed specifically to accelerate and fortify the local production of oncology drugs, they can overcome critical gaps in cancer treatment availability. And not just at dedicated manufacturing plants – PodTech™’s Oncology Podule™ enables hospitals and healthcare centres to manufacture essential cancer medications on-site.

By 2030, it is estimated that a whopping 70% of new global cancer cases will be found in LMICs. But with PodTech™’s revolutionary podules™, we can be much better equipped to deal with this cancer burden.

In most developed countries, cancer is no longer a death sentence. With advancements in medical research, cancer patients can recover and live full, healthy lives for the rest of their years. There is no reason why these pharmaceutical and medical improvements cannot reach patients in LMICs in Africa and beyond. Improved cancer care can be a reality in every part of the world. With PodTech™, it is possible.