Message of the WHO Regional Director for Africa, Dr Matshidiso Moeti
A young girl from Rwanda with a tumor the size of a cauliflower on her face met a doctor. The young girl was one of the doctor’s first patients. The girl’s father, a subsistence farmer, had tried traditional solutions, but the tumor had grown, and his expenses too. The family needed an oncologist. Eventually, the doctor called the one who talked her through the treatment that saved the girl’s life.
We join the international community commemorating World Cancer Day today, 4 February 2023. The theme of this year is “Close the care Gap: Uniting our voices and taking action.” This year’s campaign summons like-minded people to be united as we build stronger alliances and new innovative collaborations in the fight against cancer.
Cancer is a public health issue of major concern.
The numbers are stark. Approximately 1.1 million new cancer cases occur each year in Africa, with about 700,000 deaths. Data estimates show a considerable increase in cancer mortality to nearly one million deaths per year by 2030, without urgent and bold interventions.
We should recall that the most common cancers in adults include breast (16.5%), cervical (13.1%), prostate (9.4%), Colorectal (6%), and liver (4.6%) cancers, contributing to nearly half of the new cancer cases. With significant data challenges, childhood cancer incidence in sub-Saharan Africa is estimated at 56.3 per million population. Current projections show that Africa will account for nearly 50% of the global childhood cancer burden by 2050, compelling expeditious efforts to confront this concern, as was done for the young girl from Rwanda.
In that view, it is important to celebrate some achievements we have made as a region, at the country level. Twelve countries in the region have valid National Cancer Control Plans. WHO is supporting eleven additional countries in developing or updating their National Cancer Control Plans aligned to the global cancer initiatives coupled with the presence of governance structures at the government level to implement Cancer Plans.
Countries such as Ghana, Senegal, Zambia, and Senegal have developed National Treatment Guidelines for childhood cancer. Twenty-five countries have developed and are using Cancer Guidelines. Political will remains significant in improving the cancer landscape. Including childhood cancer medicines in the National Health Insurance Scheme in Ghana and Zambia is a good example. Such a strategic action will significantly contribute to the increase in survival rates for children with cancer in these countries.
We are collaborating with Childhood Cancer International to develop and pilot the Mental Health and Psychosocial Support guidelines for children in Burkina Faso. It is gratifying to note the steady increase of HPV vaccination national introduction by 51% of countries in the region, although coverage remains concerning
Currently, 16 countries have introduced high-performance-based screening tests in line with WHO recommendations and plan to scale up cervical cancer screening. The introduction of gynecologic oncology Fellowships for improved access to cervical cancer treatment services in Malawi and Zambia is commendable and innovative.
Working closely with the International Agency for Research on Cancer (IARC) in cancer registration, we launched three collaborating centers in Cote d’Ivoire, Kenya, and South Africa. The centers will facilitate capacity building for local staff and improve data quality for effective decision-making.
Despite these achievements, stumbling blocks remain on our path. These include the low availability of Population Based Cancer Registries; limited health promotion; inadequate access to primary prevention and early detection services; the scarcity of diagnostic facilities that increase delays in diagnosis and treatment. Provision of palliative care is rare in Africa, notwithstanding the significant need for it. Africa has only 3% of the world’s cancer treatment facilities, with radiotherapy available in just 22 countries in sub-Saharan Africa, contributing to very low survival rates.
By uniting voices and action, we can address cancer at individual and community levels: Choosing healthy lifestyles, getting vaccinated, and getting routinely screened against preventable cancers. Parents have the responsibility to ensure their eligible daughters receive HPV vaccines.
I call on Governments to develop/update national cancer control plans, provide sustainable financing and invest in cancer registration. I encourage Governments to incorporate cancer care into essential benefits packages and national health insurance systems. It is also critical to ensure adequate infrastructure for human resource, screening, diagnostics, and treatment. There is equally a need to expand the use of digital health and establish relevant trainings for the cancer workforce.
Finally, cancer survivors can lend their voices as advocates for better cancer services. As persons with lived experience, they should be involved designing cancer services at all levels of health care.
Let us unite against cancer and take action to make universal health for cancer prevention, treatment and care a reality in Africa.