CAPE TOWN - The Cancer Alliance released a report outlining the cost over the next decade.
With cancer cases predicted to double by 2030, the report examines the inequitable and inefficient access to quality health care for patients with financial challenges, as well as the need for government, civil society partners and health workers in the public and private sectors to develop a roadmap that will ensure equal access to cancer care for all.
According to the report, female breast cancer, cervical cancer and prostate cancer have the highest incidence. The incidence of non-Hodgkin’s lymphoma is increasing at the highest rate, followed by prostate and then cervical cancer.
Head of the Surgical Oncology Unit in Groote Schuur, Dr Lydia Cairncross, said at a conference that cancer incidences loom over low- to middle-income countries due to the lack of funds, early detection and resources.
“The report not only sounds the alarm for the future of cancer care in South Africa, but it also highlights the current and ongoing inequities with accessing quality cancer care. Of the 200 radiation oncologists in the country, only 44 are employed in the state sector, a shocking indicator of disparities in the delivery of cancer care. The inequitable distribution of resources between public and private health sectors extends to other categories of health workers, such as lymphoedema specialists, palliative care nurses and other critical human resources.”
“Another point to highlight is the cost of a fragmented health system and a fragmented approach to cancer care because cancer care is inherently interdisciplinary and multidisciplinary; surgeons make the diagnosis, surgeons do the operations which facilitate chemotherapy and radiotherapy.”
“So in a nutshell, we need that level of education at the primary care level. We cannot be only talking about infectious diseases, diabetes and hypertension with our primary care providers. We need to talk about what the top symptoms for the top five cancers in our country are,” said Cairncross.
Chief director at the National Treasury, Dr Mark Blecher, said it was unfortunate that given the burden of chronic diseases, challenges such as backlogs and mismanagement of funds were part of the problem.
“When you start looking at big money, the National Health Insurance (NHI) could potentially be an important vehicle trajectory for the health sector if implemented properly. However, under the NIH, there needs to be a benefit package, which the current public sector does not have. Although it does have some standard treatment guidelines and an essential drug list, it doesn’t have a formal benefit package. Also, it should have a more formal health technology assessment (HTA) system. The current system proves to be fairly weak, and given the cost of cancer interventions being fairly expensive, it would be good to put some of the systems through formal HTA. But, with that, one needs to understand that the institutional capacity for this is also important.
“Additionally, because oncology is highly specialised, the national department needs to put into place clearer norms and standards.
“It is important to understand that the whole governance is under pressure. We can see this by how the GDP dropped due to Covid-19 and tax revenue reducing. One can gather that these cuts prove to be a big threat to the health budget and affordability of facilities for cancer patients. However, I think it is very important to understand that if one knows where one is heading and has a clear plan, one can address these issues over time, given the budget,” said Blecher.
Cancer Alliance chairperson, Linda Greeff, said despite the challenges, the organisation sees itself as the “voice of the cancer community”, and will not throw in the towel.
“The Cancer Alliance will remain vigilant in its effort to mobilise all stakeholders to become part of innovative think tanks that will focus on reshaping the cancer landscape in South Africa. We have to ensure that the human rights of all cancer patients are being protected.”
“Cancer services must be delivered in an ethical manner, focusing on early detection and timeous treatment. We call on all stakeholders to be part of the innovation and re-engineering of cancer services in South Africa because together, we can remain committed to being the watchdog for cancer services in South Africa,” said Greeff.
Weekend Argus