" ITREALMS: Nigeria @60: Nation without independent cancer care - ITREALMS

Wednesday, September 30, 2020

Nigeria @60: Nation without independent cancer care - ITREALMS

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October 2020 is a landmark month for Nigeria, as the nation turns 60. However, the entire month of October is also the International Cancer Awareness Month (ICAM) with particular emphasis on breast cancer. 

Apart from being the Independence Day of Nigeria, the First of October is also the International Day for Older Persons (IDO). Sixty is the cutoff age for the WHO definition of “old”. If Nigeria were a person, she now qualifies to be called an “older person”. But has Nigeria grown in the wisdom and sense of responsibility that should come with age?
Nigeria is a celebratory culture, which explains why it is the second fastest-growing champagne market, after France. Total consumption of champagne in Nigeria reached 752,879 bottles in 2011 and the nation spends over 41 billion naira (£159m) on the drink annually. No doubt many would want to “roll out the drums” to celebrate Nigeria’s diamond jubilee. However, if we use healthcare and life expectancy as a yardstick, Nigeria has nothing to celebrate. 

Nigeria is growing old, but tragically, its citizens are dying young. Most Nigerians do not live up to 60. At 60, Nigeria (“the giant of Africa”) has the world’s seventh lowest life expectancy. Nigerian life expectancy is 3 years less than South Sudan (a new-born nation just coming out of fifty years of civil war), 5 years less than Togo, 7 years less than Liberia, 10 years less than Congo, 15 years less than India, 18 years less than war-torn Libya and 30 years less than Singapore. 

It is instructive to note that Singapore gained independence 5 years after Nigeria, yet its life expectancy is three decades more than Nigeria. Singapore has attained the status of a developed nation, even though it is not endowed with natural resources, like Nigeria. This remarkable achievement is attributed to Singapore’s commitment to health and education. In sad contrast, it was from these two vital areas that funds were slashed in the 2020 revised federal budget of Nigeria. 

Given Nigeria’s dismal health statistics, it is not surprising that in 2013, the Economist Intelligence Unit, EIU ranked Nigeria as the worst place to be born in the whole world. 

Nigeria is at the bottom with respect to most health indices (highest maternal mortality, highest contributor to under five mortality in Sub-Saharan region, highest number of malaria deaths, highest number of VVF, global epicenter of Schistosomiasis, highest mortality from diabetes, etc.). However, it is in the area of infrastructure for cancer care that the gap in Nigeria health infrastructure is most prominent, and the rest of this article will focus on how to bridge this gap. 

Non-Communicable Diseases (NCDs) are now responsible for over 70% of global deaths each year, with cancer being a leading cause of death and the single most important barrier to increasing life expectancy in every country of the world in the 21st century. This means that Nigeria’s low life expectancy will not change, unless we tackle cancer seriously. 

Cancer is a pandemic, with 43.8 million people worldwide, currently living with cancer, and 9.6 million annual deaths from cancer. 70% of cancer deaths occur in developing countries, like Nigeria. Every day in Nigeria 32 women die of breast cancer, 28 women die of cervical cancer, 16 men die daily from prostate cancer and 14 persons die of liver cancer. 

Most of these cancer deaths are often due to late detection and poor infrastructure. A Comprehensive Cancer Centres (CCC) is a world-class, stand-alone tertiary health institution, with all departments focused on cancer care. The CCC is the optimal infrastructure needed for cancer treatment. India has over 200 CCC - most of which are philanthropy-funded non-profit institutions, Nigeria has none. Kenya, Uganda, Tanzania and Sudan are some African nations that have CCC. Egypt has several CCC, as well as the largest children cancer centre in the world. South Africa also has several CCC 
Nigerians now spend over one billion dollars on foreign treatment annually, an amount sufficient to establish twenty (20) CCC every year. Unfortunately, most Nigerians who go abroad for treatment end up dying because of late diagnosis and delay in intervention. Moreover, unforeseen situations (such as the COVID-19 lockdown) may make it impossible to go on medical tourism, even if one could afford it. This dependence on foreign treatment is unsustainable and has to stop.

How can we be celebrating “independence”, when in fact we are so “dependent” on other nations that we are at mortal risk from cancer if they should deny us entry - as they did following the outbreak of Ebola and Corona viruses?

Dear Nigerians, year 2020 (60th) “Independence” Day, is a time for sober reflection. We must arise to redeem the time we have lost and lay a befitting legacy for the future generation. An ideal starting point would be the establishment of the first CCC; this is the immediate goal of the BIG WAR Against Cancer. The funds for the BIG WAR Against Cancer are managed through the ↓↑GivingTide Global Trust, by Corporate Trustees. With a fraction of the 41 billion naira Nigerians spend on champagne annually, a world-class CCC can be set up within a year.

The BIG WAR is operated by the National Cancer Prevention Programme (NCPP), an initiative of mass medical mission. In 2007, NCPP pioneered community-based mass cancer screening in Nigeria. Through this relentless campaign millions of Nigerians have been reached. This has contributed to a reduction in Nigeria’s cancer mortality, from 75,392 deaths in 2008 to 70,327 deaths in 2018 (WHO data).

To scale up the reach of the campaign, a system of preventive health care has been set up using Mobile Cancer Centres (a.k.a. the PinkCruise). The PinkCruise is complemented by other mobile units, including the mobile eye unit (aka PinkVISSION where “VISSION” stands for Voluntary Integrated Sight Saving Initiative Of Nigeria) and mobile dental unit (aka PinkDentist). These complementary mobile units serve to increase the impact of the PinkCruise and to tackle eye/oral cancers. The mobile units are deployed for free outreaches, targeted mainly at the under-privileged.

In addition, properties have also been acquired to serve both as base centres for the PinkCruise and as nucleuses for the proposed CCCs. These properties are located in Nigeria’s four old Regions (North, East, West and Mid-West). We must now consolidate on the strides already gained in the BIG WAR, by establishing the first CCC in Nigeria.

To this end, there are successful models around the world to inspire us. For example, Sir Dorab Tata (Chairman, Tata Group) established India’s first CCC in 1941 (six (6) years before India gained independence). His attention was drawn to the problem when his wife, Lady Meherbai Tata had blood cancer, for which she was treated in UK. Tata determined to establish similar facilities in India. Today, the Tata Centre treats 70% of its patients free of charge.

Another role model is Mrs. Kiran Mazumdar-Shaw, the main sponsor of the largest CCC world-wide, opened in 2009. The Mazumdar Shaw Cancer Centre (MSCC), Bangalore, named in her honour cost $150 million. It is the fourth cancer centre in Bangalore, a city of 8 million people. Mrs. Shaw was motivated by the experience of her husband - John Shaw, who was diagnosed of renal cell carcinoma in 2007 and her best friend who died of breast cancer. The MSCC treats poor patients for free in the evenings, so they could continue to work and care for their families during the day. Mrs. Shaw’s mother was later treated for cancer at the MSCC.

As the whole world marks the International Cancer Awareness Month and the International Day for Older Persons, ↑↓GivingTide International hereby calls on all Nigerians at home and in the diaspora to mark our country’s Independence Day (October 1) by supporting the drive to establish our nation’s first Comprehensive Cancer Centre.

Nigeria at 60 needs heroes and heroines like Tata and Shaw, to liberate Nigerians from dependence on medical tourism. That is the true essence of Independence. Any Nigerian philanthropists who rises to this clarion call, will have his or her name written in gold not only on the CCC buildings, but also in the hearts of generations yet unborn.

Let’s ACT! (Attack Cancer Today! Attack Cancer Together!! Attack Cancer Totally).

“Goodness is the only investment that never fails. Those who bring sunshine cannot keep it from themselves." - Thor.

Dr. Abia Nzelu (Executive Secretary, ↑↓GivingTide international); info@givingtide.org

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