Why Nigeria’s healthcare remains in critical care despite major policies

78,800 people died of cancer last year in this African country which has one of the world’s highest death rates from the disease

On July 11 of this year, Nigerian singer-songwriter Olanrewaju Fasasi, known as Sound Sultan, lost his long-standing battle with T-cell angioimmunoblastic lymphoma (AITL), a rare form of lymphoma. non-Hodgkin’s, also known as throat cancer.

One of the biggest names in Nigeria’s vibrant entertainment scene to die of cancer, the death of Alanrewaju at the age of 44 rocked the country. His last post on his Instagram account hinted to his fans that the music legend was battling an illness that kept him away from the public. He was undergoing treatment in the United States at the time of his death.

While her death helped advance discussions of the topic of cancer in Nigerian society, the disease is still shrouded in secrecy, with societal stigmas leading many to isolate themselves and not seek help.

Globally, cancer is one of the leading causes of death, accounting for nearly 10 million deaths in 2020, according to a report from the World Health Organization (WHO). About a third of cancer deaths are due to smoking, a high body mass index, alcohol consumption, low consumption of fruits and vegetables and lack of physical activity, the report said, adding that Carcinogenic infections, such as hepatitis and papillomavirus (HPV), are responsible for about 30 percent of cases in low- and lower-middle-income countries.

Nigeria has one of the highest cancer death rates in the world, with around four in five cases leading to death, according to the World Cancer Observatory. The disease was responsible for more than 78,800 deaths in 2020. Women are often the most affected, as breast and cervical cancers are responsible for more deaths than any other in Nigeria. At least 44,699 women died of cancer last year.

In 2018, Nigeria recorded around 116,000 new cancer cases and over 70,000 deaths, which is higher than estimates for HIV / AIDS. Although data is limited, estimates from the Institute for Health Metrics and Evaluation suggest that the cancer death rate in Nigeria was 113.7 per 100,000 people in 2017, compared to 99.2 per 100,000 people in Kenya. .

File: There are over 80 types of cancer, each requiring more expensive drugs and procedures to treat in Nigeria. (AA)

Poor cancer treatment outcomes

Nigeria has extremely limited social protection, with around 95 percent of the population living without health insurance. Less than five percent of Nigerians in the formal sector are covered by the National Health Insurance Scheme (NHIS). And even less, three percent in the informal sector are covered by voluntary private health insurance.

The country has 4 doctors per 10,000 patients and 16.1 nurses and midwives per 10,000 patients, which is below the WHO recommendations of 1 doctor per 600 patients and the critical threshold of 23 doctors, nurses and midwives. -women for 10,000 patients.

Experts warn Nigeria will run out of 50,120 doctors and 137,859 nurses by the end of 2030. Nigeria currently has less than 90 oncologists providing cancer treatment to more than 100,000 patients. with cancer in only nine cancer treatment centers, with only four radiotherapy machines. Across the country.

Nigeria is a party to the 2001 Abuja Declaration, which mandated African Union member states to allocate 15 percent of their national budgets to health, but the country still lags behind. The country spends over a billion dollars a year on medical tourism.

Nigerian President Muhammadu Buhari’s regular trip to the UK for vacation and medical examination is a serious testament to the collapse of the country’s healthcare system.

Runcie Chidebe, founder and executive director of the Health & Psychological Trust Center, known as Project Pink Blue, says lack of funding, policy implementation and political commitment to fight cancer is hampering fight of Nigeria against the disease.

“The harsh reality of the situation in the country is a legitimate cause for concern, attracting and retaining healthcare workers is a bigger concern. The massive migration of healthcare workers to foreign countries confirms the problem in our healthcare sector, and this has only worsened the poor distribution of healthcare workers. “

“Amidst all of this, most of the cancer drugs, chemotherapy and drugs used for cancer patients in Nigeria are not being tested on Nigerians. Therefore, the lack of clinical trials with Nigerians is a very serious problem. Because you would not be so sure if the drug works after being tested with a European or an American and not a Nigerian who is using it. Runcie said TRT World.

While early detection and advances in medicine are contributing to an overall decrease in mortality and morbidity rates resulting from cancer diagnoses, Runcie says Nigeria has not invested much in cancer care.

“The cost of cancer screening is very high and creates a huge barrier between diagnosis and survival, prostate cancer screening costs around N6,000 to N10,000 or more, a mammogram will cost around N5,000,” the clinical breast examination costs N2,000, the Pap test costs approximately N8,000. “

“If you look at the costs, it might seem cheap to a city dweller, but most people in rural areas can’t afford it. “

What can be done?

Chidebe says Nigeria must invest more in cancer screening, research and control, and prioritize health care for all citizens with adequate health insurance.

“Cancer screening is now periodic; Nigeria needs to start moving towards establishing a national cancer screening program that can require our large population to get tested every time they visit a public health facility.

“People only get tested when NGOs report campaigns or on World Cancer Day or when they have symptoms, and when the cancer starts showing symptoms, it’s usually not at a very good stage. , that is why we cannot at this age reduce the late detection of cancer. ”

Chidebe says that while talking about treatments, conversations should also focus on access to human papillomavirus (HPV) before asserting that this is not a problem unique to Nigeria but Africa.
“African leaders need to wake up and start taking charge of the health of Africans, they are not prioritizing health care. As we speak today, the Covid-19 vaccines have been released in less than a year and people can have access to the vaccination but while less than 3,000 people have died from Covid-19 in Nigeria, more than 70,000 people have died of cancer in one year in Nigeria. “

“More than 5,000 women have died from cervical cancer, but many of these women do not have access to the human papillomavirus (HPV) which can prevent cervical cancer in women and Nigerian girls, and we don’t prioritize it, the government isn’t. interested.”

In 2018, the Nigerian Federal Government developed a Cancer Control Plan, a 4-year program aimed at reducing the incidence and prevalence of cancer over the next 5 years and beyond. Part of the plan is involving state governors so that each state has its own cancer center and plan, and is a key part of the federal government’s broader agenda.

Chidebe is concerned, however, that the Cancer Control Plan will become a paper policy.

“The plan was supposed to generate investment and provide prostate cancer screening for men, and cervical and breast cancer screening for women. Unfortunately, most policies end with policies on paper, by no means are they realized, and this is the problem we have in Nigeria.

This year, President Buhari approved around 729 million naira in cancer health funds in 2020 after years of advocacy by the private sector, members of civil society and cancer survivors,

This year and the year before, the federal government has released more than 1.5 billion naira to the health ministry for cancer treatment, but patients do not yet have access to these funds. On November 4, 2021, members of the Senate Health Committee sounded the alarm that the health ministry had not disbursed funds for cancer patients.

Chidebe says that until the Nigerian government begins to prioritize health care and sees it as a compulsory business and not a charity, citizens will continue to wallow in economic hardship and health crises.

Source: TRT World

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