Tackle cancer in Africa now to prevent catastrophe, say health activistsBMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39215.854016.BE (Published 17 May 2007) Cite this as: BMJ 2007;334:1022
Unless urgent action is taken to try to control the rising incidence of cancer throughout Africa, many hundreds of thousands of lives will be lost to the disease, doctors and politicians warned last week.
The former UK health secretary Alan Milburn, who chaired a two day conference on cancer in Africa last week, said: “There is a potential catastrophe here, and we have an obligation to stop it. This is as much a priority as HIV [and] AIDS, tuberculosis, and malaria—there is no ‘either or.'”
The meeting, attended by over 130 leaders in world health and cancer control, resulted in the “London declaration on cancer control in Africa.” The document, which calls for cancer strategies that tackle prevention, early detection, diagnosis, treatment, and palliative care, will be delivered to the World Health Organization this week with a mandate to make cancer in Africa a greater priority.
Cancer accounts for 12.5% of deaths worldwide, a greater proportion than is caused by HIV and AIDS, tuberculosis, and malaria combined. It is expected that by 2020 15 million new cases of cancer will occur every year, one million of them in African countries, the least able of the developing nations to cope. Only two African countries currently have a cancer plan, the issue often being neglected in favour of more publicised diseases.
“We have been so involved in tackling communicable diseases that we are only now starting to think about palliative treatments for people with cancer,” said Abator Thomas, health minister in Sierra Leone.
There are many words for cancer in Sierra Leone, she said. Some people call it witchcraft, and most do not recognise their tumours or wasting as serious disease. They are often shunned by society and too ashamed to seek help.
An estimated 80% of people with cancer in Africa present to health services with late stage cancer, when palliation is the only treatment option. Even then, with just one hospice in Sierra Leone, for example, and few in Africa in general, many people suffer terribly and die in pain, said Ms Thomas.
She added that her priority on returning to Sierra Leone will be to add morphine to the country's list of essential drugs.
David Kerr, a professor of cancer therapeutics at the University of Oxford, said: “People don't perceive cancer as a developing world problem, but more than 70% of all cancer deaths occur in low and middle income countries. This figure is rising due to increased life expectancy, increased tobacco use, and chronic viral infection.
“Most of my life in the West is about making small incremental changes. But in Africa we can save hundreds of thousands of lives very quickly.”
In Africa 100 000 children die from potentially curable cancer every year. Basic treatments costing just a few dollars a day could take the cure rate from its current level of 5% to 80% within a few years, he said.
Anna Nyakabau, an oncologist at Harare Hospital in Zimbabwe, trained in palliation when she realised that most people she was seeing were in the later stages of cancer. “Palliation is the immediately available treatment modality to the patients. When you palliate patients they are happy and pain free.”