Laz Ude Eze
February 4 is World Cancer Day; a day set aside by cancer advocates globally to raise global awareness, improve education and catalyse individual and government actions towards cancer control. I have been reflecting on the cancer situation in Nigeria and the efforts of critical stakeholders towards cancer control in Nigeria. This reflection is inspired by the theme of the World Cancer Day, “I am and I will” which seeks to promote individual commitments and actions against cancer.
My feelings were mixed. One, I remembered Mr. KC – my friend and schoolmate, who died of Pancreatic Cancer in November 2019 at the age of 39. A year earlier, he had mourned his sister who died of colon cancer. Also, his elder sister (a widow) was killed by breast cancer in January 2020 (two months after KC’s death). She lost her husband a couple of years earlier to anal cancer. Both parents died within the past decade, one was killed by cancer. This is not fiction! Can you imagine the havoc cancer has wrecked on one family just within 5 years?
Two, I reflected on a case of an oncologist in a teaching hospital in one of the South South states who detected Stage 1 breast cancer on herself recently during a routine mammography. She earns more than five hundred thousand naira monthly and is not poor by any standard. But she requires N14 million, more than her annual salary, for a complete course (18 doses) of combined pertuzumab/trastuzumab treatment. A pharmaceutical company offered support with 5 doses of the drugs, Pink Oak Cancer Trust will help with 3 doses and she may have to procure the rest.
Three, I reflected on the huge efforts being made by various non-governmental organisations in Nigeria who are working tirelessly with minimal funding support to create awareness and raise funds to help cancer patients win the fight. I have worked in this space for two and a half years and I must confess, working in the cancer space is very traumatic. I have much respect to colleagues who have worked in this space for a long time. I feel happy about the progress made in the past decade especially in the area of awareness creation in urban areas. However, it is like a drop of water into an ocean, majority of our critical stakeholders and population lack knowledge about cancer, its prevention and care. As a result, many still die from the ignorance. How do we reach them?
Cancer is a monster. It is a terror. It kills and destroys. The bad news is that seven out of 10 Nigerians with cancer get killed by the disease. The good news is that this situation is reversible. How? One may ask. Who? One may also want to know. I will attempt to answer these two questions. I have identified two main elephants largely responsible for high cancer death rates in Nigeria. First is late detection or diagnosis of cancer which may be caused by ignorance, lack of money to seek medical care or lack of equipment of trained manpower to make accurate diagnosis. Second is the inability to access treatment which is mainly caused by lack of money, unavailability or inadequacy of treatment facilities and personnel.
To save Nigerians from Cancer, we must start by address all the factors responsible for late detection and lack of access to effective treatment. Everyone is a stakeholder and everyone’s commitment is required. However, government at the local, state and federal level must provide leadership and demonstrate a strong political will. So far, Nigeria has been moving at a snail speed in this regard. The local government areas must invest in awareness creation working with Ward Development Committees, religious groups and other stakeholders in the communities. The state government has to invest sufficiently and make cancer screening services available and affordable. The federal government should create enabling environment for more private sector investment in provision of tertiary oncology care services. A key way of doing this is by subsidising the cost of care in the short term and achieving universal health coverage by 2030.
More so, citizens of Nigeria have roles to play too. Let everyone seek the right knowledge and erase misconceptions about cancer from their brain. Cancer is treatable and curable. Cancer is not a curse. Herbs don’t cure cancer. We can all become advocates and mount pressure on government to perform their primary responsibility of securing lives and properties. Cancer kills over 70,000 Nigerians in one year, more than Boko Haram has killed in 10 years. Fighting cancer has become a security issues that continually threatens not only lives but also the wobbling economy of Nigeria. While I commend the media for the visibility being given to cancer advocacy in recent times, I will like to see a more proactive approach in awareness creation and pushing government to taking appropriate and timely actions.
As we commemorate the World Cancer Day, I commend those who are leading this fight against cancer in Nigeria including the likes of Mr. Fola Adeola who has made a personal donation of more than N20 million to Pink Oak within the past 2 years towards the treatment of cancer patients, and Mr. Runcie Chidebe who has remained a strong voice for the patients. I encourage you, yes you to have an individual reflection on what you can contribute towards cancer control in Nigeria. The least could be to donate any amount you can afford to non-governmental organisations working to defeat cancer. Now, can you help me to answer the question: who will save Nigerians from this terror called cancer?
Laz Ude Eze is a Public Health Physician and the Executive Director of Pink Oak Cancer Trust – Nigeria’s First Cancer Treatment Fund. He tweets @donlaz4u.