National and Regional Strategies Supporting Cancer Care for Women under UHC Frameworks

Article Summary:
Governments across Africa provide a pre-specified set of healthcare services to a distinct population using a pool of funds as part of a “benefits package.” However, comprehensive cancer services are not provided by any country in the region, and effective health promotion, prevention, early detection, treatment, and palliative and survivorship care are frequently unavailable. For individuals, especially women, diagnosed with cancer, high out-of-pocket payments and the indirect costs of treatment often result in financial hardship, impoverishment, loss of income due to limitations in or inability to work, and worsened health for that individual and their family. To realize UHC, it is important that frameworks and policies facilitate the prevention, early detection, and effective and quality treatment of cancer for women across the continent.
Globally, cancer is the second leading cause of mortality, morbidity and disability. Highlighting a growing burden, in 2018, there were approximately 18mn new cancer cases globally , of these 8.2mn cases were in women. In wealthy nations, lower smoking rates, personalised medicine, more screening, better diagnostics, and novel treatments like immunotherapy are reducing cancer rates and improving survival, even among aging populations. Much of that progress, however, is not reaching sub-Saharan Africa.
Cancer deaths in sub-Saharan Africa now kills more than a half a million people each year. The rise of cancer in sub-Saharan Africa has hit women especially hard. Breast cancer deaths in the region have increased 70% over the last two decades and combined with cervical cancer now cause one out of every five cancer deaths in sub-Saharan Africa. In contrast, breast cancer mortality rates have fallen in high-income countries. Cervical cancer, which is completely preventable with HPV vaccine, is increasing becoming a health threat only experienced by poor women in poor nations.

Cancer and UHC

The WHO African Region adopted the Brazzaville Declaration on NCD prevention and control in 2011, whereby member states signed to confirm their political will to direct resources and strategies to control NCDs including cancer. As of now two-thirds of African nations have National Cancer Control Plans (NCCPs) compared to 46% in 2011. Senegal recently recorded universal coverage for breast and cervical cancer services (2019), a big step towards curbing the disease.
Additionally, a growing number of African counties have started recognising the need to address cancer by including it under their UHC plans or through standalone/specific cancer policies. There is increasing sense of realisation that UHC commitments can only be achieved by mapping out frameworks and policies that facilitate the prevention, early detection, and effective and quality treatment of cancer.
However, to enable the creation of policies and frameworks that are not only disease specific but also gender specific, it is vital that governments work with stakeholders across the healthcare spectrum, including the private sector. Public Private Partnerships (PPPs) allow for the spread of risk across multiple stakeholders, facilitate economies of scale principally in service provision, procurement and knowledge sharing system integrators. With a focus on women, the private sector can further UHC for cancer by facilitating :

1) Understanding the national context and identifying inequities
– National high-burden cancers
– Underserved population groups
– National health goals
2) Identifying interventions
– Availability of interventions
– Evidence of effectiveness and cost-effectiveness
– Impacts on health equity
– Understanding acceptability and demand
3) Implementation planning
– Policy and legislation needs
– Demands on health systems
– Investment needs
4) Monitoring and evaluating impacts
– Developing targets and indicator
– Identifying data sources
– Multistakeholder evaluations

Kenya

Kenya, for example has a National Cancer Control Strategy 2017-2022 which highlights the role of partners including the responsibility of the private sector to engage in various activities such as surveillance mechanisms to ensure affordable cancer commodities and resource allocation.
Highlighting the government’s partnership with the private sector, in January 2015, GE Healthcare was selected by the Ministry of Health as part of Kenya’s progressive ~USD420mn Managed Equipment Services (MES), to provide radiology infrastructure in 98 hospitals across 47 counties. Under MES, GE has deployed 585 units of diagnostic imaging equipment including digital mammography, x-ray and ultrasound systems across all 98 hospitals. In October 2018, GE Healthcare successfully installed Positron Emission Tomography–Computed Tomography (PET-CT) scanner and Cyclotron – the first in sub-Saharan Africa, excluding South Africa – at Aga Khan University Hospital (AKUH) in Nairobi. The technology will improve the diagnosis and treatment of cancer, heart disease and other diseases .
This public private partnership model has had many benefits including, patients having access to a fee for service plan. Additionally, the government has been able to spread the budget of financing the equipment across multiple years and as a result more than 30% of level 5 hospitals have increased their capacity of breast cancer screening through inhouse mammography.

A Focus on Women and Cancer

Kenya, for example has a National Cancer Control Strategy 2017-2022 which highlights the role of partners including the responsibility of the private sector to engage in various activities such as surveillance mechanisms to ensure affordable cancer commodities and resource allocation.
There have been a few successful PPPs that have made a large impact in cancer care across African nations. National and regional guidelines need to be crafted with a woman in mind as their needs and circumstances are affected by a plethora of factors including, level of education, geographic location, social and economic constrains, among others. Furthermore, it is vital that governments leverage private sector strengths in order to shape sustainable policies that support UHC and chronic diseases such as cancer with a focus on women’s health.
In sub-Saharan Africa (SSA), breast cancer was the most common cancer diagnosed in women in 2018. A key breast cancer control priority in this region is to improve survival rates which are now among world’s lowest. To do this, as per the Breast Health Global Initiative’s recommended phased implementation approach, SSA countries need to develop and strengthen programs to ensure the early diagnosis of symptomatic breast cancer, in parallel with improvements in timely access to appropriate treatment.
References

1. World Cancer Research Fund, “Worldwide cancer data | World Cancer Research Fund International”, WCRF International, 2021. [Online]. Available: Reference link [Accessed: 02- Sep- 2021].

2.UICC Report Universal-Health Coverage [online] Available at: Reference link [Accessed 30 September 2021].

4. Foerster, M., Anderson, B.O., McKenzie, F. et al. Inequities in breast cancer treatment in sub-Saharan Africa: findings from a prospective multi-country observational study. Breast Cancer Res 21, 93 (2019). Reference link

We are excited to announce that AHB is curating the next in-person AHBS event under the theme: The role of the private sector in advancing women’s health in Africa, with the objective to prioritise, explore and strengthen the role of the private sector in advancing women’s health in Africa. AHBS VII will be a full-day highly interactive hybrid event, in Nairobi, on February 24th, 2022, allowing both in-person and virtual participation, welcoming eminent health experts, business leaders, government officials and development partners to discuss, share information and provide lessons learned on key areas that affect women’s health in Africa. Stimulating content will be delivered in an engaging way – through sponsored plenary knowledge sessions, collaborative exclusive roundtable sessions, networking sessions, exhibition areas, side breakfast, lunch, and dinner meetings – helping ensure key messages are retained and commitments are actioned.

AHBS VII will be a full-day highly interactive hybrid event, in Nairobi, on February 24th, 2022, allowing both in-person and virtual participation, welcoming eminent health experts, business leaders, government officials and development partners to discuss, share information and provide lessons learned on key areas that affect women’s health in Africa.

Stimulating content will be delivered in an engaging way – through sponsored plenary knowledge sessions, collaborative exclusive roundtable sessions, networking sessions, exhibition areas, side breakfast, lunch, and dinner meetings – helping ensure key messages are retained and commitments are actioned.
AHBS-2-program

Please click below to download the session concept notes:

Session 1: Reducing the cancer threat for women Session
Session 2: Women’s empowerment through RMNCH Session
Session 3: Solutions towards aging women’s health challenges Session
Session 4: Recognising African leaders in advancing women’s health on the continent

We have a range of sponsorship packages ranging from Platinum, Gold, Silver, Bronze, Premium Exhibition, Regular Exhibition, Poster Placement and Exclusive Thematic Arrangements (Breakfast, Lunch and Dinner Sessions). Download the brochure to learn more and contact us on info@ahb.co.ke to discuss partnership opportunities.

By Alisha Crasto Project Associate, AHB and Kaushal Shah, Head of Corporate Communication, AHB

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