Economic crisis affecting patients’ access to care

The economic crisis in the country has further worsened the plight of cancer patients in Nigeria, the President and Chief Executive Officer of the Nigerian Cancer Society, Dr Adamu Umar, has said.

Speaking in an exclusive interview with PUNCH Healthwise, he noted that the depreciation of the naira and the lack of holistic health coverage have increased the cost of care, leading to the death of some cancer patients who could no longer afford treatment costs.

PUNCH Healthwise in one of its reports noted that since the President, Bola Tinubu announced the removal of fuel subsidy in May 2023, the prices of goods and services witnessed an unprecedented increase.

Subsequently, the Central Bank of Nigeria’s decision to float the naira against other currencies led to naira depreciation and inflation.

Also, the exit of the British pharmaceutical giant, GlaxoSmithKline, in August 2023, led to over 300 to 900 per cent rise in the prices of drugs.

As a result, patients with long-term non-communicable diseases have continued to lament their inability to afford essential drugs.

According to the president of the NCS, which is a collation of cancer advocates in Nigeria, many cancer patients can no longer afford their medications.

Cancer, the World Health Organisation says, is the second leading cause of death globally, accounting for nearly 10 million deaths in 2020.

The National Cancer Institute says it is a disease in which some of the body cells grow uncontrollably and spread to other parts of the body.

Globally, the World Cancer Research Fund International pegged cancer figure cases at 18.1 million in 2020.

In 2020, Nigeria recorded 124,815 new cases, with breast and prostate cancer being the most common cancer types.

Speaking on the country’s current cancer rate, the NCS president stated that there were 120,000 new cases, of which 80,000 patients have died.

To further raise awareness and sensitise the public about cancer, World Cancer Day is commemorated on February 4 every year.

WCD is an initiative of the Union for the International Cancer Control, which is the global cancer governing body. The theme of this year’s celebration is “Close the care gap.”

Further speaking with PUNCH Healthwise, Umar said that although cancer cases among children increased, it cannot be compared to that of adults.

He added that due to the lack of harmonisation in data collection, the prevalence rate of cancer in Nigeria was unknown.

Umar, however, stated that 10,000 new cases were recorded within three months in 2023, indicating an improvement in diagnosis and early hospital presentation.

“The prevalence has not changed in the sense that we have about 120,000 new cancer cases, according to recent statistics, and out of which over 80,000 died of the disease. Most of the cancer presentations we have in Nigeria are late and when cancers present late, of course, one would expect a worse outcome.

“This is one of the major problems we are having in Nigeria. Another major problem is data collection. The data we use are those obtained from the data registries and hospitals that keep cancer records. But when you look at them, you will discover that for every cancer patient in the hospital, hundreds are out there that are undiagnosed.  So the statistics may not be a true reflection of what is on the ground.

“On the other hand, for example, last year, within three months, we recorded over 10,000 new cancer cases. This is an indication that though it seems as if the cancer cases are rising, the actual case might be that there is an improvement in awareness rate and mechanism employed by advocates.

“There may equally be an improvement in the diagnostic modality for detecting cancers early. So when we have a rise in cancer cases, it doesn’t scare us because we look at it that more people are coming forward to be diagnosed,” he said.

Umar, who is also a public health physician, stated that cancers of the breast, cervix and prostate were the leading cancers in Nigeria and that the economic crisis was worsening the plight of patients.

“Even when the rate of the naira to the dollar was affordable and drugs were available, access to medicines by most Nigerians, especially for cancer patients was a herculean task. It is something that the ordinary Nigerian can’t afford.

“The current inflation, dynamics of the exchange rate and general situation of things in the country further go to show that there are compounding factors that made sure Nigerians don’t get access to the right medicines.

This is why there is the need for the Universal Health Coverage. In the National Health Insurance Act, cancer is covered but not holistically.

“Cancer care is financially consuming and with the way things are in the country, cancer patients are suffering and people are dying because they can’t afford care,” the NCS president lamented.

He added that low literacy levels, especially among individuals in rural areas, and the misconceptions associated with cancers were responsible for late hospital presentation and access to care.

The NCS president, however, said there has been increased cancer awareness in the rural areas to ensure early detection and hospital presentation.

Umar further noted that although childhood cancers are on the increase, data on the three common cancers were still higher and constituted over 70 per cent of cancer cases.

“With improved diagnostic modalities and awareness, we have more cases of childhood cancers coming up and rare forms of cancer as cancer of the blood. It is not that these cancers were not in existence before now; it is just that there has been progress in diagnostic modalities in the country, such that we now have sophisticated and world-standard facilities and tools. So, there is an increase in the number of new cancer cases and improvement in care,” Umar added.

The public health physician concluded by advocating for a holistic UHC, increased budgetary allocation to healthcare, operationalisation of the vulnerable fund, and Cancer Health fund for indigent citizens to address the cancer care gap.