As activities to mark the 2024 World Cancer Day continue globally, a Nigerian official has rued what he described as the poor infrastructure for the management of cancer diseases in the country.
The Director General of Nigeria Nuclear Radiation Authority (NNRA), Yau Idris, who was a panelist at a symposium held in Abuja, the Federal Capital Territory (FCT) on Monday, revealed that Nigeria, with more than 200 million population, has only eight certified radiotherapy centres.
The symposium, which was themed: “Economy, Tax & Cancer Control: The Exit of Pharmaceutical Companies from Nigeria,” was organised by Project Pink Blue – a non-governmental organisation that focuses on advocacy for improved cancer care management in the country.
The panel was moderated by the Publisher of PREMIUM TIMES, Dapo Olorunyomi, and it featured the former First Lady of Kebbi State, Zainab Bagudu; the Chairman of the Senate Committee on Finance, Mohammed Musa, and the President of Healthcare Federation of Nigeria, Pamela Ajayi.
According to Mr Idris, six other existing radiotherapy centres in Nigeria are not certified, and so could not be guaranteed to be safe for use by the public. He said nine of the radiotherapy centres are owned by the government while five belong to private investors.
The official, however, did not indicate the specific facilities that are not certified and where they are located.
He said there are just two modern nuclear centres available in Nigeria for cancer care but that they are also not working.
He said: “There are 14 radiotherapy centres in the country: nine are government and five are private. Only six of these are licensed by the NNRA.
“So these 14 centres are not working properly. We also have only two nuclear modern centres and both of them are not working.”
Radiotherapy, which is described as a good alternative to surgery for the long-term management of cancers, is said to achieve a reasonable probability of “tumour control with good cosmetic results.”
According to the World Health Organisation (WHO), more than 50 per cent of cancer patients require radiotherapy as part of cancer care, particularly for the frequent treatment of the more common types including breast, cervical, colorectal, and lung cancers.
Mr Yau also noted that Nigeria has only seven linear accelerator machines for cancer treatment while South Africa with less than 60 million population has 92 of such and Egypt has 76.
He also spoke about the importance of gamma cameras which he noted are not available in the country. He said it is an imaging technique used to carry out functional scans of sensitive human organs such as the brain, lungs, liver, and gallbladder, among others.
He said: “Unfortunately, there’s no gamma camera in Nigeria that is working, whereas a country like Tunisia with a population of just about 20 million has about 14 of them working.
“If you go to the aspect of nuclear medicine, we have only two nuclear medicine centres that have gamma cameras and both of them are down at the National Hospital, Abuja, and the University College Hospital, Ibadan.”
Govt pledges intervention
Speaking at the event, the Minister of State for Health and Social Welfare, Tunji Alausa, said the Nigerian government has concluded plans to build six new cancer centres across the six geopolitical zones in the country.
Mr Alausa said the government is concerned and is proactive in actions to address the cancer burden in the country.”
He said: “These cancer centres will be built at the University of Nigeria Teaching Hospital, Enugu; Amadu Bello University Teaching Hospital, Zaria; Federal Tertiary Hospital, Katsina; University of Benin Teaching Hospital, Benin; University of Jos Teaching Hospital, Jos; and the Lagos University Teaching Hospital, Idi-Araba.”
Mr Alausa said his ministry was able to secure additional funds to the N20 billion appropriated three years ago for the building of the centres, noting that: “The amount appropriated has depreciated, so there was no way we could use the N20bn to build the cancer centres. We had to make a presentation to the President and the National Assembly to give us another budget allocation to build the six cancer centres.”
“We have gotten the additional funding that we need. The groundbreaking will happen in the next few weeks,” he said.
Also speaking, the senator, Mr Musa, said Nigerian lawmakers have passed a bill on cancer research and treatment.
He said the re-enactment of the bill on national health is a way to remedy the situation, adding that about the economy, the government is giving incentives to tackle such issues faced by these pharmaceutical industries.
“If we look at what the government is doing today, the renewed hope agenda of the president is far-fetched, especially in areas of tax. The new tax bill that will soon be administered will look into multiple taxation,” he said.
On exit of pharmaceutical companies from Nigeria
Speaking at the event, the Vice President of the African HealthCare Federation, Clare Omatseye, raised concern over the hike in the prices of cancer drugs as manufacturing companies of chemotherapy drugs exit the country.
Mrs Omatseye noted that the lack of chemotherapy drugs in Nigeria has led to a shortage, with prices skyrocketing two to three times in the last six months, thereby making it difficult for an average Nigerian.
As of 2022, she noted, the treatment of breast cancer costs between N2.1 million and N18.2 million but today, it costs between N5 and N40 million. “Prostate cancer was between N1.3 million to N4.5 million and now it is over N5 million in federal institutions.”
She added that cervical cancer was N1.1 million to N3.3 million, but that it now costs about N4 million naira.
In August 2023, GlaxoSmithKline (GSK) Consumer Nigeria Plc, the second-biggest drug producer in Nigeria, exited the country by terminating its marketing and distribution agreement and appointed third-party distributors to sell their medications and vaccines.
GSK is the producer of vaccines such as Ambirix for hepatitis A & B, Cervarix for human papillomavirus bivalent 16 & 18, cancer drugs such as Zejula and other general medicines such as Amoxil, and Augmentin.
Sanofi and many other foreign pharmaceutical companies have also announced leaving Nigeria.
According to the Global Cancer Observatory (Globocan), cancer causes an estimated 78,000 deaths in Nigeria annually, with breast cancer and cervical cancer being the most common cancers among women in Nigeria.
The World Health Organisation (WHO) recently disclosed that over 500,000 Africans died of cancer in the year 2022 and it called for urgent interventions to avert a projected one million annual deaths by 2030.
Implications for cancer control
Speaking on the implications, the former Kebbi State First Lady, Mrs Bagudu, who doubles as the Founder and CEO of Medicaid Cancer Care Foundation, regretted the exit of the pharmaceuticals from Nigeria, noting that the implication will be increased cancer patients in the country.
She said: “There will be an increase in cancer patients. WHO’s report on World Cancer Day was that in high-income countries a woman’s chance of being diagnosed with breast cancer is one in 25 and the chance of dying is one in 70.
“And if you flip it to low index countries those figures are reversed. The chance of being diagnosed is about one in 70 and the chance of dying is much higher, which is one in 48.”
According to Mrs Omatseye, some pharmaceutical companies exited Nigeria due to challenges such as foreign exchange, ease of doing business, importation bureaucracy, multiple taxation, and malpractice within the industry.
She said: “We lost one of our biggest injection companies, syringe companies called Jubilee. They also divested in their business on 31 December and many other companies,” she said.
“So with all these challenges, President Bola Tinubu actually appealed to many of the other manufacturers, and multinationals to please remain in the country under the renewed hope agenda.
“Affordable and effective treatment is a shared responsibility that involves both the public and the private sector.”
Mrs Omatseye also suggested the expansion of the Cancer Access Partnership (CAP) programme to include more pharmaceutical companies and hospitals, and partnership with the private sector to provide affordable pharmaceuticals and treatment.
The panelists also advised that local manufacturers should be encouraged and stressed the need for people to enroll with the National Health Insurance Authority (NHIA).
Meanwhile, the Minister, Mr Alausa, also hinted at increased collaborations between the Nigerian government and various pharmaceutical companies to review the cost of chemotherapy with some international non-governmental organisations, such as the Clinton Health Access Initiative, the American Cancer Society, Pfizer, Roche, and Johnson & Johnson.
“These pharmaceutical companies are providing 50 per cent discount in some of our cancer chemotherapy,” he said.
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