How cancer scourge is impoverishing families

Cancer is a health problem leading to mortality in both developing and developed countries. In Kenya, it is the third cause of morbidity. It causes seven per cent of total mortality every year.

It is estimated that 29,000 new cases of Cancer occur each year with more than 22,000 deaths annually. Over 60 percent of those affected are below 75 years.

The risk of getting cancer before the age of 75 years is 15 percent while the risk of dying of cancer is estimated at 13 per cent. In spite of numerous intensive interventions, a number of patients still suffer from poor prognosis.

Currently, the main treatments for cancer are chemotherapy, surgery, radiotherapy, hormonal therapy and palliative care.

However, there are new medical interventions such as imaging, Intensity Modulated Radiotherapy and Cone beam radiotherapy which improve health outcomes but at relatively high cost.

The economic impact of cancer care is now a reality and is expected to continue to rise. It requires that all these modalities of treatment are available in the same setting to avoid distant referral and delays in treatment administration.

According to World Health Organization cancer report 2014, it is estimated that 90 people die as a result of cancer every day in Kenya.

This is not good. The Ministry of Health estimates that 80 percent of cancer cases are diagnosed in the late stages when the disease has metastasized to other anatomical sites in the body. Globally, lung cancer has been a leading cause of cancer death among men and breast cancer in women.

Kenya’s burden

Kenya bears the biggest burden of the non-communicable disease due to lack of awareness, inadequate diagnostic facilities, poorly structured referral facilities, high cost of treatment, late diagnosis and high poverty.

Kenya has few cancer specialists who are concentrated in a few health facilities in Nairobi, making it difficult for a majority of the population to have timely access to cancer treatment services, hence the long waiting period.

Some cancer management options are not readily available in Kenya, necessitating cancer treatment abroad. The cost of cancer treatment is dependent on modality of treatment used. The cost can also vary with the type of cancer and stage of cancer.

A survey carried out in three cancer centers in Nairobi showed that patients tend to  suffer from cervical, breast, esophageal and prostate cancers.

A study carried out in 2014 showed that patients on chemotherapy alone use an average of Sh180, 200, while those on surgery use an average of Sh128, 300 and those on radiotherapy alone Sh119,040.

Some patients use a combination of the three treatment modalities and use an average of Sh350, 400 to Sh400, 000.

Other costs incurred in cancer treatment include Sh6,000 – Sh15,000 spent in preliminary investigation and drugs that cost up to Sh30, 000 per course. The cost incurred for most patients are high considering that most are treated for a very long time, which makes it strenuous.

Cancer, for instance, has negative impact on households, their education, as well as in their workforce productivity. It  causes the reduction of income, assets and slows down economic growth.

The crux of the matter

In Kenya, the health sector relies heavily on out-of-pocket payments. The sector is largely underfunded and the poor contribute a larger proportion of their income to health care than the rich and those who are insured are not properly covered to cater for full cancer treatment.

This can be attributed to the low percentage of resources allocated health budgets and the fact that cancer control is the least amongst the priority list competing with communicable diseases.

Only 10 percent of Kenyans have health insurance. This gives a huge burden to many households who spend most of their savings on cancer treatment. The actual cost of cancer in Kenya has not clearly been enumerated.

Cancer is still under-emphasized to the public in Kenya. Cancer is still politically opaque to attract adequate budget allocations for research and policy making in Africa. Access to cancer treatment in some African countries is limited.

Less than 6 percent of global funding for cancer prevention and control is spent in Africa yet most of the cancer deaths, approximately 70 percent, occur in Africa. African governments, healthcare leaders and the global community need to come together to address this burden and provide sustainable solutions.

Cancer cannot be eradicated, but its effects can be significantly reduced if effective measures are put in place to control risk factors, detect cases early and offer good care to those with the disease.

Cancer specialists and other medical professionals have been encouraging Kenyans to take routine check-ups to detect the presence of the disease early. The routine examinations would help stop new infections and further control rising cases of the deadly disease.

 

Dr. Kivuva is a Postgraduate student, Pharmacovigilance,University of Nairobi