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Why women are carrying heaviest cancer burden

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Far more women are being treated for cancer with higher death rates than men, a cost analysis report at the Kenyatta National Hospital shows.

Latest data shows within a year, there are about 2,223 more women being treated for cancer than men at the hospital.

The report suggests that while normally women are more likely to seek medical care than men, the higher rates of obesity in females may be fueling cancers in this group.

A sector performance review by the Health Ministry in October warned that obesity among women in Kenya had reached epidemic proportions.

The midterm review of the Kenya Health Sector Strategic Plan 2014-2018 said at least one in every seven women was obese or had a weight problem.

The higher number of women with cancer, the new study says may also be attributed to the use of birth control pills which are associated with the growth of hormone dependent cancers.

The lower economic power among women may also be fuelling poor treatment outcomes, with many reported to have problems paying hospital bills.

The study, published in the Journal of Medical Economics early this month (June 2, 2018) suggests that half of Kenyans would require a full three-year income to pay for a year’s cancer treatment at KNH.

The study, by the University of Nairobi, University of Strathclyde, UK, Karolinska Institute, Sweden and University of Science, Malaysia shows a cancer patient on chemotherapy, radiation and surgery will pay up to Sh333,462 for a year’s treatment.

In April, a survey by Ipsos Public Affairs found nearly half of Kenyan households earn less than Sh10,000 per month.

Theoretically, such a family would require about three years’ income to pay for a year’s cancer treatment at KNH.

A nurse earning Sh40,000 on average or a police officer earning Sh33,000 per month will require about nine months’ salary for the same treatment.

The cost of treating cancer at KNH -- the only public health facility to offer comprehensive care, radiation, chemo and surgery -- depend on the type of tumour.

The study had investigated the cost of treating cancer at KNH in 2016, and found it is prohibitively expensive for most Kenyans.

“The average cost of treating cancer at Sh161,600 to Sh505,000 is a major concern because most Kenyans cannot afford it,” says the report.

The cheapest to treat, was kidney cancer at Sh68,017 while the most expensive were some rare types affecting the uterus and the throat, at about Sh2.2 million and Sh486,876 respectively.

During the study period, 2014-2016, KNH had treated about 10,000 cancer patients -- 6,279 women and 4,056 males.

On average, patients on chemotherapy alone paid about Sh138,207, while those on surgery alone paid Sh128,207. Those on radiology alone paid Sh119,036.

This though, the study says, does not include a wide range of tests and some medicines not available at the hospital.

But against public perception that radiology is a must-treatment for cancer at KNH, the study shows actually this is the least-used therapy at the hospital.

During the study period, surgery was the most frequent treatment, covering a quarter of patients, followed closely by chemotherapy and then palliative care, with only six per cent put on radiotherapy.

Medicines, the authors say, constituted the single-largest component of the cost, ranging between Sh6,000 and Sh600,000 per treatment course. The researchers want the Government to urgently adopt pro-cheaper medicine policies such as the use of high quality generics.

“Kenya should be able to take advantage of the many cancer drugs patents that have expired and shift to quality generics,” say the authors.

Last month, Kenya’s ailing single mother Cate Ndwiga symbolically took a similar message to the annual meeting of the World Health Organisation in Geneva, Switzerland.

Using Cate’s case, civil society groups at the Geneva meeting demanded that world leaders act to bring down the cost of medicines for the poor.

Cate, who lives in Dandora, Nairobi is currently facing diabetes-related complications - a disease she has lived with for 30 years.

However, the UN push for cheaper medicines has met strong opposition from major drug manufacturing nations in the West and especially the US.

Opposed parties argue the UN proposals will kill innovation in healthcare by denying reward to innovators.

In a fight back last month, the Africa Union unanimously adopted a treaty to establish an African Medicines Agency to give the continent autonomy on pharmaceuticals.

Dr Mukhisa Kituyi, the Secretary General of UN Conference on Trade and Development has hailed the treaty as a significant step towards the production of high quality medicines in Africa.

Dr Kituyi, in a report appearing in the scientific journal, The Lancet, says it is time Africa produced medicines.

Locally, the Federation of Kenya Pharmaceutical Manufacturers has been lobbying the Government to adopt proposals that would boost local production of medicines.

Such proposals seek to increase taxes on drug ingredients, as well as the finished products entering the country.

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