How we can contain and manage the rising burden of non-communicable diseases such as cancer

When Kenya crossed the threshold to become a low-middle income country four years ago following the rebasing of its National Accounts, including Gross Domestic Product and Gross National Income, a new health burden begun to rise.

The economic transition has brought with it a gradual increase in Non-Communicable Diseases (NCDs) such as Cancer. It is one of the major NCDs and combined with Cardiovascular, Diabetes Mellitus and Chronic Respiratory Diseases, causes over 60 per cent of total global mortality annually.

Cancer is now the third cause of death in Kenya. This is followed by Infectious and Cardiovascular diseases with new estimates showing that approximately 48,000 cases of cancer are diagnosed each year with close to 33,000 cancer related deaths annually.

The top five cancers in Kenya include breast, cervical, esophageal, prostate and colorectal with a mortality of 66/100,000 population in 2018.

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This rising burden of cancer is fueled to a great extent by shared behavioural risk factors influenced by economic transition, rapid urbanization and adoption of unhealthy lifestyles such as tobacco use, consumption of unhealthy diets, insufficient physical activity and the harmful use of alcohol coupled with an increased exposure to environmental carcinogens.

Very high risk

The global age-standardized incidence rate for cancer is 175.5/100,000, the risk of developing cancer before the age of 75 years is 31.6 per cent while the global risk of dying from cancer before the age of 75 years is 27.2 per cent.

We are cognizant to the fact that to effectively carry out cancer prevention and control, there has to be a multi-sectoral and multi-disciplinary approach.

Both the Kenya National Strategy for the Prevention and Control of Non-Communicable Diseases 2015 - 2020 and the Kenya Vision 2030 social pillar are aimed at improving the quality of life of all Kenyans.

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These objectives are equally in line with the Constitution of Kenya which confers on every person the right to the highest attainable standard of health, which includes the right to health care services.

To address this growing cancer burden in our country, the ministry is implementing the National Cancer Control Strategy 2017-2022 to guide all stakeholders involved in cancer prevention and control.

The strategy prioritizes five key pillars that are critical to holistic cancer prevention and control: prevention, screening and early detection, diagnosis, registration and surveillance, treatment, palliative care and survivorship, coordination, partnership and financing, and monitoring, evaluation and research.

These interventions are being undertaken by both the national and county governments in collaboration with other non-state actors to reduce the incidence of cancer and improve the quality of life of those who develop cancer in Kenya.

To enhance access to essential cancer management services, the ministry has supported the setting up of new chemotherapy units in 10 counties by providing them with chemotherapy equipment and chemotherapy drugs.

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This has gone alongside training health workers on safe handling of chemotherapy drugs a move that will decongest the two main National Referral Hospitals.

Radiotherapy bunkers

The government is also expanding the radiotherapy capacity in our country through the establishment of radiotherapy bunkers across three regional cancer centres by the end of the current financial year. This is aligned to our commitment to establish four comprehensive cancer management centres by 2022.

Other accomplished measures within the strategy are development of education material to build capacity for health workers and citizens, mainstreaming NCDs and cancer screening to other health services, development of physical activity action plans, operationalizing a national cancer registry and a national cancer reference laboratory to improve reporting and data quality on cancer cases as well as epidemiological analysis of region specific risk factors of cancer in the country.

A notable setback in the fight against cancer has been the low uptake of screening and early detection services. To address this, a National Cancer Screening Guidelines was launched on early this month to provide a standard framework for all stakeholders to scale up screening and early detection services in Kenya.

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Synchronised message

The message “Cancer screening and early detection saves lives” needs to reach to all households across the country. It is for this reason that the Ministry has prioritized preventive and promotive health interventions through a Primary Health Care (PHC) approach that includes cancer screening.

Kenya took an active part in the commemoration of this year’s World Cancer day on 4th February, which came a day after the Prince Mahidol Award Conference (PMAC) held in Bangkok, Thailand, from 29 January – 3 February 2019 under a theme “The Political Economy of Non-Communicable Diseases (NCDs): A Whole of Society Approach”.

Responding to the NCDs challenge requires coordinated action by not only the health sector, but many others. For this reason, the United Nations (UN) General Assembly passed the Political Declaration on NCD prevention and control in 2011, reiterating the significance of NCDs programs and the role of multiple stakeholders beyond the health sector.

Similarly, in 2013, the World Health Assembly endorsed the Global Action Plan for the Prevention and Control of NCDs 2013-2020, which highlights the proven cost-effective population-wide and individual-targeted interventions, known as ‘Best Buys’. More actions are required to accelerate the implementation of the Global Action Plan on NCDs and these ‘Best Buys’ beyond health sector through effective multi-sectoral collaborative interventions.

Mrs Kariuki, is the Cabinet Secretary, Ministry of Health

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KenyaGross Domestic ProductGross National IncomeCancerCardiovascular diseases