Every effort is being made to rein in cancer

National Cancer ambassadors camp outside Afya House during a peaceful demonstration on August 1, 2019, to educate the public on cancer. [Edward Kiplimo,Standard]

Non-communicable diseases (NCDs), including cancer are chronic. They are caused by a combination of genetic, physiological, environmental and behavioural factors.

The NCDs kill 40 million people annually, equivalent to 70 per cent of all deaths globally, according to World Health Organisation.

Kenya is experiencing an epidemiological transition in its disease burden from infectious to non-communicable diseases, resulting in a double burden.

The largest burden comes from cardiovascular diseases, common infectious diseases and cancers respectively. The top five cancers in Kenya include breast, cervical, oesophageal, prostate and colorectal.

The number of cancer cases has risen due to ageing populations resulting from improved life expectancy and increasing adoption of risky behaviour such as consumption of unhealthy diets, lack of physical exercise, harmful use of alcohol and tobacco. Infections due to HIV, Human Papilloma Virus, Hepatitis B and C viruses have also contributed significantly to the cancer burden in Africa.

It is estimated that 47,887 new cases of cancer are detected annually with about 3,200 new cases among children below 18 years. Some 32,987 people die of cancer annually in Kenya.

The increased reported cases of cancer is also attributed to increasing awareness among Kenyans and better diagnostic capacities.

Consequently, Kenya has prioritised prevention and control of NCDs as part of its progress towards vision 2030 and launched the National Strategy for the Prevention and Control of Non-Communicable Diseases 2015-2020 and the National Cancer Control Strategy 2017-2022 as key policy documents.

The aim of the cancer strategy is to reduce cancer incidence, morbidity, mortality through prevention, screening and early detection, effective partnerships in diagnostics, treatment, palliation, financing, setting up cancer registries and research.

The Government has set up other strategies to increase manpower in oncology services, investment in equipment and automation of healthcare towards sharing of human resource skills across the country leading to increased access to cancer services and reduced the patient load at the national referral hospitals. 

Screening for breast cancer is now routinely done through manual palpation at all primary healthcare facilities and that of cervix through visual inspection using a special dye.

Mammography services are available in every county referral hospital following implementation of the national government’s Managed Equipment Service project while screening for colorectal cancer is available at Level 5 and 6 facilities.

Secondly, treatment services have been decentralised so that detected cases are linked to care.

Kenyans are now able to access chemotherapy in seven county referral hospitals in Mombasa, Kisumu, Kakamega, Garissa, Nyeri, Nakuru and Meru. Similar services will soon be available in Embu, Bomet and Machakos hospitals.

The hospitals have been kitted with chemotherapy chairs, biosafety hoods, essential drugs and capacity building for health workers.

The essential medicines for cancer are procured through KEMSA and availed to all county chemotherapy units as well as Kenyatta and Moi Teaching and Referral hospitals.

In addition, there are ongoing interventions to further strengthen our capacity to manage cancer, which include operationalisation of Kenyatta University Hospital within a month at an estimated cost of Sh1.5 billion and construction of radiotherapy centres in Mombasa, Garissa and Nakuru at a cost of KSh1.5 billion.

Other initiatives include equipping Moi Teaching and Referral Hospital with radiotherapy equipment by end of this year valued at Sh350 million and establishment of an oncology reference laboratory at National Public Health Laboratory within a month to support county labs in cancer diagnosis.

Oncology package

On financing and access, NHIF’s oncology package which covers consultation, radiotherapy and chemotherapy has enabled Kenyans to access cancer treatment in  public and private sectors.

To ensure provision of quality healthcare, Kenya has a progressive increase in the number of oncologists, which currently stands at 35 with an additional 20 in training institutions while short-term local training programmes have been established in collaboration with local teaching institutions.

Last week, I inaugurated Cancer Institute Board of Trustees to coordinate health sector response to the growing cancer burden.

The mandate of the board is to coordinate and centralise all information and activities related to cancer prevention and control.

The board will focus on short to medium-term initiatives including, coordination of stakeholders to set up behaviour change programmes at the community level focusing on lifestyle modification and collaboration with stakeholders to enhance capacity building of health workers.

Sicily Kariuki is the Cabinet Secretary, Ministry of Health