What Kenya can do to ease cancer burden

Newly commissioned Regional cancer centre at Rift Valley provincial general Hospital in Nakuru on June 6, 2022. [Kipsang Joseph, Standard]

The world aims to cut premature mortality from all non-communicable diseases by 25 per cent by the year 2025. This “25 by 25” stretch target emphasizes the necessity of tackling cancer, which kills an estimated 10 million people annually.

However, for many patients globally, access to high-quality healthcare remains a dream, worsened by the Covid-19 pandemic. The IQVIA Institute’s Global Oncology Trends 2021 report says that oncologists in many countries reported caseloads of 26 to 51 per cent lower than pre-pandemic levels, despite a marked shift to remote consultations.

This means many patients ignored seeking care, cancer screening programmes were disrupted, scans, diagnostics and treatments were delayed, and staff relocated to Covid-19 medical care.

Some previously curable tumors evaded treatment, late presentations increased and clinical trials were dropped. Up to 100 million cancer screening tests may have been skipped, reports show, even as leukemia and lymphoma demonstrably reduced the body’s ability to fight a Covid-19 infection.

However, in countries like Kenya, where access to a combination of diagnostic capabilities, high-quality surgical treatment, a bundle of critical medications, and radiotherapy facilities is limited, the impact could be enormous. 

This is worsened by constant political bickering that often stymies the implementation of policy programmes like the Kenya National Cancer Strategy, which could combat the disease.

Cancer has a low profile in policy agendas due to less political talk and a lack of disease knowledge, hampering efforts to bring many varieties out of the shadows. As a result, nearly 60 years after independence, the effort to realise the fundamental right to live in a cancer-free society, has failed. The reported dysfunction of cancer machines at the Kenyatta National Hospital could further delay treatment, hastening progression and resulting in future peaks in mortality from curable cancers.

One thing the pandemic has taught us is that cancer doesn’t stop and so should be treatment. As the pandemic recedes, we must rethink our national cancer strategy. The first step is what I refer to as the 3As: Awareness: Spread awareness that many cancers can be prevented and cured. Remove the stigma and discrimination that prevent access to care for many patients. Access: Collaborate across the healthcare ecosystem and leverage private-public partnerships to build connected networks that link specialised oncology centres with primary healthcare systems to reach the most remote villages and cancer patients. That includes mainstreaming liquid biopsy to facilitate early diagnosis and ongoing patient management in a community setting.

And then Availability of treatment: Encourage more awareness and access to oncology clinical trials locally. 

Second, we must expand the urgently needed knowledge base in research. There is a strong link between cancer research and public health, and the correlation between highly qualified basic, translational and clinical biomedical scientists and sound public health policies.

However, Kenya has committed so little in human capacity building against the disease despite the glaring risk it poses to universal health coverage.

There’s a need for a policy framework exclusively dedicated to cancer surveillance and research. The absence of high quality, accurate vital statistics hinders the development of novel long-term treatment models.