While in Houston, Texas recently, I had the opportunity to officially tour the highly respected University of Texas MD Anderson Cancer Centre, the leading comprehensive cancer treatment centre in the US.
The country has 68 such centres, established under the National Cancer Act. This centre, affiliated to two major research-based medical schools — University of Texas Medical School and Baylor College of Medicine — combines academic, research and treatment in a massive facility with over 20,000 employees.
In 2013 alone, it admitted 120,000 patients; over 12.2 million pathology/laboratory and diagnostic imaging procedures were performed. It had a revenue budget of $4.1 billion in 2013, with $670 million for research, and provided training to 7,600 students and professions that year.
I was astounded that such a huge establishment could be provided for cancer treatment only. But these facts changed my perception about cancer; like most politician in our country, I held the view cancer was a peripheral problem affecting the super-rich. Regrettably that’s not the case anymore. Most of us now appreciate how people we know and love are dying of cancer even in our remote counties. There are nearly 200 types of cancer, and the statistics are simply shocking.
Globally, there were over 14 million new cases of cancer last year, accounting for one in eight deaths, with 60 per cent of these occurring in the developing countries. It is the leading cause of deaths in developed countries, and the second leading cause of death in the developing countries; and kills more than malaria, TB and HIV deaths combined! As expected, the major cancer causes in developing countries is related to infections, 70 per cent of which are preventable.
For the US, the situation is more alarming. One in four deaths is due to cancer! In 2014, the American Cancer Institute estimates there will be over 1.7 million new cases in the US, and nearly 600,000 deaths. Now, that’s a pretty scary situation and one can appreciate why they have invested so handsomely in prevention and management of this disease. But the global stats above clearly reveal that it is not for the rich only.
In Kenya, there are over 82,000 new cases of cancer annually, and this is an underestimation because the data for most areas outside the urban centres is routinely unavailable. It causes the third highest morbidity in the country, after the infectious and cardiovascular diseases, and accounts for nearly 27,000 deaths each year. That’s more than all the deaths reported by police from crime and accidents. While stomach, liver and cervical types are prevalent, the breast and prostate cancers are the main causes of death in the country.
Yet, even with the knowledge of all these facts, African countries, Kenya included, continue to under invest in the prevention and treatment of the disease. In 2011, Parliament passed a motion urging the government to provide free treatment to all cancer patients in view of the high cost of treatment. Was that a practical decision, given the very minimal resources allocated to this problem?
Policy makers still do not consider cancer a major public health problem in our country. It is ‘politically invisible’ except when it affects the political class, and receives preciously little budgetary allocation. We need to focus strongly on the preventive side too, like restricting tobacco use, improving dietary and physical activity, and early detection through screening tests. Nearly 80 per cent of the cases in Kenya are diagnosed late.
The facilities in Kenya include the four radiotherapy units in Nairobi; none in other parts of the country. There are reportedly 14 oncologists in the country, with about ten physicists and paramedics in the field. Given the scale of the problem in the country, the resources available are grossly inadequate. It is time this nation’s leaders prioritised cancer as a major killer and invest appropriately to save the lives of Kenyans.