• Cancer care in the country at both national and county government levels has in the past years suffered from inadequate financing
• The annual incidence of cancer increased from 37,000 cases in 2012 to 47,887 in 2018.
Image: MAGDALINE SAYA
The Ministry of Health estimates that Sh53 billion will be required over the next five years for comprehensive cancer prevention and control in Kenya.
New cancer cases are expected to rise by about 70 per cent in the next two decades, with significant and rising economic effects.
Cancer care in the country at both national and county government levels has in the past years suffered from inadequate financing.
The ministry, in the cancer policy launched on Friday, targets an increase in cancer budgetary allocation from the total health budget to five per cent in 2024 and 10 per cent in 2030.
About 0.4 per cent of the health budget was allocated for cancer in 2019, in contrast to the resource needs of about Sh10.4 billion annually.
According to the ministry, another challenge is that NHIF coverage does not support the evidence-based standard of care for all cancers from prevention to survivorship care.
The policy was launched to provide a framework for interventions for prevention, screening, timely diagnosis, treatment, survivorship and palliative care, financing, monitoring and research.
Data from the ministry shows that cancer is the third leading cause of death in the country.
The annual incidence of cancer increased from 37,000 cases in 2012 to 47,887 in 2018. Similarly, the annual mortality rose to 32,987 in 2018, from 28,500 in 2012.
"The socioeconomic impact of cancer, including the loss of productivity, cost of care, and premature deaths, continues to threaten the achievement of the nation's development goals and aspirations," Health CS Mutahi Kagwe said.
"This policy will provide guidance to all stakeholders in cancer management to accelerate the efforts geared towards cancer prevention and control by averting preventable cancer deaths, increasing screening, enhancing cure rates and improving the quality of life of cancer patients."
It is further estimated that there are 3,200 new cancer cases among children below 18 years, with the top five commonest cancers being leukaemia, Non-Hodgkin's lymphoma, kidney cancer, brain cancers and cancer of the nasopharynx.
Even though up to 40 per cent of cancers can be prevented, Kenya continues to grapple with a high burden of risk factors. For instance, about 27.9 per cent of Kenyans are overweight and obese, while 94 per cent do not consume adequate fruits and vegetables.
Tobacco use among adults is about 13.3 per cent, while alcohol use is at 19.3 per cent.
Image: MAGDALINE SAYA
The proportion of women estimated to have cervical HPV-16/18 infection at a given time and those with invasive cervical cancers attributed to HPVs 16 or 18 in Kenya are 9.1 per cent and 63.1 per cent respectively.
"Cancer has been slowly and quietly consuming our people. It is one of the most impacting diseases on our people and the health facilities in recent times," the CS said.
In addition, a study in rural Kenya showed low awareness levels, revealing that although more than 80 per cent of respondents had heard of breast cancer, fewer than 10 per cent of women and male heads of households had knowledge of two or more of its risk factors.
The ministry has also decried tobacco industry interference and resistance that continues to hamper full implementation of legislation aimed at controlling cancer risk factors such as the implementation of tobacco control regulations.
Another challenge in combating cancer in the country has been low uptake of cancer screening services.
For instance, in 2018 to 2019, only 369,380 eligible women were screened for cervical cancer, translating into coverage of 10.8 per cent for that year, while only one per cent of eligible women were screened for breast cancer using mammography.
“To all our women, I want to remind you that cervical cancer screening services remain available in our health facilities, and I want to appeal to all eligible women to visit their nearest health facilities for screening at least once a year."
According to the ministry, pathology and radiology services are weak in the country and only a few county hospitals have the capacity to offer histopathology services contributing to diagnostic delays.
Late diagnosis remains a key challenge. Data from Kenyatta National Hospital shows that about 64 per cent of cancer patients are diagnosed at advanced stages when treatment is difficult to achieve.
The cancer treatment infrastructure is inadequate and most of the available centres are located in urban areas.
Currently, Kenya has only 14 radiotherapy machines mostly within the private sector. The referral systems for cancer are also inadequate. In addition, the availability and affordability of cancer commodities continue to impede access for patients.
The prices of cancer medical devices and drugs, especially those under intellectual property rights, are high and there is inadequate regulation of the importation, quality and pricing.
Moreover, drug authority market approval and procurement processes are long and complex leading to frequent stock-outs. The importation of new therapies and drugs for clinical trials is also a challenge.
Edited F'Orieny