Globally, cancer is the second leading cause of mortality, morbidity, and disability. Highlighting a growing burden, in 2018, there were approximately 18 mn new cancer cases globally, of these 8.2 mn cases were in women. In wealthy nations, lower smoking rates, personalised medicine, more screening, better diagnostics, and novel treatments like immunotherapy are reducing cancer rates and improving survival, even among aging populations. Much of that progress, however, is not reaching Sub-Saharan Africa.
Cancer deaths in Sub-Saharan Africa now kills more than a half a million people each year. The rise of cancer in Sub-Saharan Africa has hit women especially hard. Breast cancer deaths in the region have increased 70% over the last two decades and combined with cervical cancer now cause one out of every five cancer deaths in Sub-Saharan Africa. In contrast, breast cancer mortality rates have fallen in high-income countries. Cervical cancer, which is completely preventable with HPV vaccine, is increasingly becoming a health threat only experienced by poor women in poor nations.
Cancer And UHC
Kenya, for example has a National Cancer Control Strategy 2017-2022 which highlights the role of partners including the responsibility of the private sector to engage in various activities such as surveillance mechanisms to ensure affordable cancer commodities and resource allocation.
Highlighting the government’s partnership with the private sector, in January 2015, GE Healthcare was selected by the Ministry of Health as part of Kenya’s progressive ~USD420mn Managed Equipment Services (MES), to provide radiology infrastructure in 98 hospitals across 47 counties. Under MES, GE has deployed 585 units of diagnostic imaging equipment including digital mammography, x-ray and ultrasound systems across all 98 hospitals. In October 2018, GE Healthcare successfully installed Positron Emission Tomography–Computed Tomography (PET-CT) scanner and Cyclotron – the first in Sub-Saharan Africa, excluding South Africa – at Aga Khan University Hospital (AKUH) in Nairobi. The technology will improve the diagnosis and treatment of cancer, heart disease and other diseases.
This public private partnership model has had many benefits including, patients having access to a fee for service plan. Additionally, the government has been able to spread the budget of financing the equipment across multiple years and as a result more than 30% of level 5 hospitals have increased their capacity of breast cancer screening through in-house mammography.
There have been a few successful PPPs that have made a large impact in cancer care across African nations. National and regional guidelines need to be crafted with a woman in mind as their needs and circumstances are affected by a plethora of factors including, level of education, geographic location, social and economic constrains, among others. Furthermore, it is vital that governments leverage private sector strengths in order to shape sustainable policies that support UHC and chronic diseases such as cancer with a focus on women’s health.
In Sub-Saharan Africa (SSA), breast cancer was the most common cancer diagnosed in women in 2018. A key breast cancer control priority in this region is to improve survival rates which are now among world’s lowest. To do this, as per the Breast Health Global Initiative’s recommended phased implementation approach, SSA countries need to develop and strengthen programs to ensure the early diagnosis of symptomatic breast cancer, in parallel with improvements in timely access to appropriate treatment.