By BUSINESS WEEKLY TEAM

Kenyans are spending a fortune to treat cancer, now ranked third in causing deaths in the country after infectious and cardiovascular diseases.

Estimates show Kenyans could be spending more than Sh100 billion to seek treatment locally and overseas, putting a huge strain on the economy.

The sharp increase in cancer cases is forcing a rethink of Kenya’s healthcare financing systems as families struggle to take care of their loved ones.

Treatment is expensive due to the intensive procedures required. The burden is enormous considering that drugs are imported and that some patients seek treatment outside the country.

The most recent study of the disease published in a journal titled “The Global Economic Cost of Cancer published by the American Cancer Society” shows the economic impact of premature death and disability from cancer worldwide was $895 billion in 2008.

This figure, which excludes direct costs of treating cancer, represented 1.5 per cent of the world’s gross domestic product.

The report uses World Bank classification of countries from the most developed to the least developed and World Health Organisation (WHO) statistics to map out the economic burden.

It employs Purchasing Power Parity (PPP), which enables economists to compare the standard of living between countries by taking into account the impact of various factors, including currency exchange rates. In 2009, Kenya’s economy share of world total GDP, adjusted by PPP was 0.09 per cent.

This translates to a whopping $1.2 billion (Sh101 billion) — meaning the country spent over Sh100 billion on cancer in 2008.

Treating cancer

The amount compares to Sh118.7 billion allocated for teachers’ salaries and recruitment of new staff in the 2012/13 budget and can build three roads of the size of Thika road that cost about Sh30 billion, and still remain with some balance in the bank.

In 2008, the estimated cost of treating cancer was more than the Sh85 billion allocated to the health sector in the 2012/2013 budget.

According to American Cancer Society, the amount excludes thousands of patients who remain uncounted because they don’t get the right diagnosis or never reach hospitals capable of providing appropriate treatment.

“Screening for cancer ranges from Sh1,000 to more than Sh10,000 depending on the age, kind of cancer and medical facility,” said Dr Geoffrey Mutuma, head of Pathology and Oncology Research Unit at Kenya Medical Research Institute.

Mutuma, a specialist in cancer screening, says Government should increase awareness and cancer specialised centres in the country and the costs of cancer will drop drastically.

Health experts say Kenya’s health system has traditionally concentrated on the prevention and control of communicable diseases at the expense of a rising burden of non-communicable diseases (NCDs), such as cancer.  This has resulted in major weaknesses in cancer prevention and control initiatives.

Medical Services minister Anyang’ Nyong’o says the continent is under siege as nine out of 10 deaths from NCDs occur before the age of 60 in African countries.

Half of those who die of chronic non-communicable diseases  are in the prime of their productive years, and thus, the disability imposed and the lives lost are also endangering industry competitiveness across borders.

“Our first task is to create national awareness and sense of urgency on actions to be taken, much as we did when HIV/Aids invaded humanity,” Prof Nyong’o says, adding that the second task would be to be build capacity in terms of infrastructure and personnel. Health economists warn that if allowed to continue unabated, NCDs have the potential to undermine labour supply, productivity, investment and education, four of the main factors driving economic growth with potentially devastating consequences.

According to a study by Harvard University in 2010, over the next 20 years, non-communicable diseases would cost the global economy more than $30 trillion — or 48 per cent of the global gross domestic product (GDP).

Policy analysts agree that most of the interventions required to control NCDs exist outside of the health sector and called for a ‘whole of government and whole of society’ response to the crisis.

While opening Nairobi Hospital’s Oncology and Cancer Treatment Centre on July 10, President Kibaki revealed that cancer cases in Kenya were increasing at an alarming rate. He pointed out that incidences of cancer last year stood at about 28,000 with 22,000 recorded deaths.

“For every one cancer patient, there are two or more family members taking care of the patient for at least three years,” Kariithi Murimi, an economist and director at the Kenya Private Sector Alliance (Kepsa) told Business Weekly.

Expensive care

Murimi says it costs about Sh25,000 every two weeks to visit an oncologist every two weeks. For three years, it means that one spends Sh1.8 million treating a cancer patient.

Add the estimated 5,000 people who seek treatment abroad; each trip costs not less than Sh2 million.

“If Kenya invested in specialised universities in cancer research, the country could reduce the money spent on cancer considerably and even attract medical tourism from other countries in terms of those who visit our country to seek treatment,” Murimi said.

He said it would cost close to Sh17 billion to set up a diagnostic facility university on cancer similar to those found in the US. Fully equipped with students, lecturers and  patients, the facility could be used to carry out research and therefore gather statistics and patterns of disease.

“The cost of cancer could be reduced by early detection. Yet, people don’t look at the advantages of going for cancer screening and therefore early detection,” Patrick Obath, chairman, Kepsa, said.

“The introduction of the medical schemes by government should lay emphasis on detection and prevention if we have to succeed in reducing the cancer cases.”

A policy brief on the situational analysis of cancer in the country prepared by a Parliamentary research team —Departmental Committee on Health — states that up to 80,000 new cases are diagnosed annually, a figure higher than that revealed by President Kibaki.

At the low-end, the brief shows that at Kenya National Hospital (KNH) patients pay Sh300 per session, translating to Sh1,500 a week. The entire six-week session costs Sh9,000, but it is usually hectic as thousands of patients are forced to book weeks ahead of schedule and often count themselves lucky to reach their chance at the queue without the radiography machine breaking down.

Other costs associated with cancer at KNH are equally not friendly. The report shows that for solid tumours, the tests may include but not limited to CT Scans or magnetic Resonance imaging (MRI) and biopsy which costs between Sh10,000 to Sh30,000.

State action

Also it costs between Sh80,000 and Sh130,000 per week in Nairobi for a patient to undergo radiotherapy depending on the hospital. Generally, the sessions last six weeks, which means the total cost of the procedure is between Sh480,000 to Sh780,000.

Disclosure by Public Health minister Beth Mugo and Medical Services minister Anyang’ Nyong’o that they had cancer in many ways spurred an otherwise slow government into action. Both ministers have been treated for breast and prostate cancer. The Government is now pledging serious action to address the epidemic.

Early this month, President Kibaki signed into law The Cancer Prevention and Control Bill (2011). However, patients will wait a little longer for some relief because cancer is not independently funded in the current budget.

Kenya is faced by inadequate and out-dated equipment to mitigate cancer. The Cobalt 60 machines used by Kenyatta National Hospital are the remnants of an old generation, and are equipped with limited capability to optimally treat complex cases.