Ministry of Health starts vaccination campaign to tackle third biggest killer disease

By GATONYE GATHURA and MICHAEL NJUGUNA   

Cancer is now emerging as a potentially explosive lifestyle disease, with over 10,600 new cases diagnosed in the country in the last five-years.

Cancer is now is ranked the third biggest killer after heart conditions and communicable diseases such as pneumonia, HIV, and tuberculosis in the country. Even so, globally and especially in developed countries where communicable disease are not considered a major problem, cancer is now the number one killer.

At a recent press conference, the Director of Public Health, Dr Shahnaz Sharif, revealed that while the major communicable diseases are on a significant decline, cancer on the other hand is on the increase.

For example, although the 2013 economic survey indicated pneumonia to have killed 19,508 last year, these were almost 5000 less deaths than the previous year.

At the same time, Aids killed some 9,436 people last year compared to 12,176 the previous year while the Ministry of Health says malaria illness and deaths have in the last few years dropped by 44 and 52 per cent respectively.

Cancer Registry

Cancer data in the country is collected by the Nairobi Cancer Registry based at the Kenya Medical Research Institute and the Eldoret Cancer Registry at the Moi Teaching & Referral Hospital in Eldoret.

This data is then presented to the International Agency for Research of Cancer, a body that is mandated by WHO to generate estimates based on existing data. In most cases, such estimates are usually on or very near the mark but sometimes like happened with HIV in the 1990s such estimates can go awfully wrong.

Prior to the 2003 Kenya Demographic Health Survey (KDHS), the country depended on HIV data collected from several cites where pregnant women went for maternity services and then such would be used to estimate the national prevalence. Then it was estimated to have been as high as 14 per cent.

However, the 2003 KDHS on sampling the general population found the HIV prevalence rates of 14 per cent had been exaggerated by almost double and consequently reversed this to about seven per cent. To avoid such a repeat, it is understood that the Ministry of Health is planning to incorporate national cancer prevalence in the next KDHS expected to be out sometimes next year.

The head of the Nairobi Cancer Registry, Ms Ann Korir, says that if only Kenya can manage to significantly bring down breast, cervical, prostate and throat cancers, the battle would be almost won.

“Today we have the capacity, knowledge and will to diagnose treat and even prevent most of these cancers here in Kenya but there are many infrastructural difficulties,” says Prof Nicholas Abinya, one of the leading cancer surgeons and researchers in Kenya.

For almost a decade, Prof Abinya has been trying to understand why the cancer called Burkitt’s  lymphoma, the most prevalent tumor in children, is mainly found in Nyanza and parts of western Kenya. This tumour mainly affects the jaw and can take a child down pretty fast. It can grow exponentially in size within in a 24-hour period.

Cervical, breast and prostate are the top cancers in the country and if they were knocked out, Prof Abinya says this could be a significant development.

Four-years-ago, the government developed new guidelines for all its health workers in all facilities ordering them to incorporate the top three cancers for routine diagnoses and treatment throughout the country.

The National Family Planning Guidelines for Service Providers 2010 require that anybody visiting a public facility seeking such services also be screened for reproductive cancers – prostate in men, cervical and breast tumors in women.

But getting health centres on board to help in the screening process is a challenge altogether.

Staff at health facilities contacted by The Standard said men were generally reluctant to turn up for prostate cancer screening.

A notice pinned on the wall at the casualty wing of the Rift Valley Provincial General Hospital urged members of the public to go for cervical cancer and HIV screening in rooms 13 and 14. A clinician who was asked to comment on the notice told The Standard: “If you see a notice, it means that the screening is being sponsored. After the sponsor is through with the sponsorship, the notice will not be there anymore.”

Yet as the public health facilities continue to drag their feet on the implementation of the government cancer screening policy, scores of cancer victims are being received everyday at the Nakuru Hospice daily.

The Chief Executive Officer of the hospice, Ms Elizabeth Ndung’u, said that the facility handles about 200 cancer patients monthly.

School girls

The most recent intervention to check the runaway cervical cancer, which affected 4,802 women last year killing almost half of that number, is a national programme to have all young school girls vaccinated against the disease.

In May, the Ministry of Health started a free cervical cancer vaccination campaign that by the end of the year will see some Standard Four girls get three doses before the end of the year.

 “The current phase involves vaccinating 21,000 Class Four girls in Kitui County after which the project will be evaluated and adjustments made before being rolled out countrywide, sometime either next year or in 2015,” says Dr Agnes Nakato, who is coordinating the project for the Ministry of Health.

Kenya, with the help of donors, has negotiated a preferential price of about Sh373 per dose ($4.50). It is estimated that it will cost about Sh7.8 million annually to have all the Standard Four girls in the county, both in public and private schools, covered. 

Assuming about 377,000 girls are enrolled for primary education each year then it would require about Sh141 million to buy the vaccines for all Standard Four pupils. Even so, it will be many years down the road before the impact of such an initiative can be felt.