The Guardian
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Cancer costs soar leaving patients indebted, treatment machines not working


Minister of Health, Prof. Isaac Adewole

Minister of Health, Prof. Isaac Adewole

Nigeria does not have enough cancer treatment machines, linear accelerator (LINAC), and the few in public, government-owned, hospitals are not working optimally even as the centres do not have back-up plans.

Also, cancer patients are ending up in debt because they have to cover the costs of treatment as well as other care related expenses. It was found that more than half of cancer patients spend at least a third of their yearly household income on treatment, as well as on costs such as transport to hospital and childcare. They have to pay for cancer drugs because treatment for cancer is not included in the National Health Insurance Scheme (NHIS) and government does not fund patients’ care.

These were confirmed to The Guardian by the Minister of Health, Prof. Isaac Adewole; President of the Nigerian Medical Association (NMA), Dr. Mike Ozovehe Ogirima; Chief Medical Director of one of the teaching hospitals with LINAC, Lagos University Teaching Hospital (LUTH), Idi-Araba, Prof. Chris Bode; and a European Society for Medical Oncology (ESMO) report.

A LINAC is the device most commonly used for external beam radiation treatments for patients with cancer. The linear accelerator is used to treat all parts/organs of the body. It delivers high-energy x-rays to the region of the patient’s tumour.

Also, The Guardian investigation revealed that a LINAC costs about $5 million (about N15 billion) and the six that the Federal Government procured for six teaching hospitals under FG/Vamed Engineering Teaching Hospital Refurbishing project in 2007 have packed up.

It was discovered that unlike Algeria with less than 30 million people, which has over 40 linear accelerators, Nigeria with a population of over 170 million people has only six LINAC in public hospitals and not more than ten in private centres nationwide.

Investigation also showed that the cost of treatment with the machines is so high that most cancer patients cannot afford and even those that can are in debt because they have to sell possessions.

It was gathered that a cancer patient, depending on the stage of the disease, spends at least N200,000 monthly on radiotherapy treatment from the LINAC machines and chemotherapy (drugs). But the cost is much higher in private hospitals where patients spend over N500,000 monthly.

Investigation also revealed that most of the centres have only one machine which breaks down frequently forcing patients with the means to travel abroad, especially to India, Germany and South Africa for further treatment.

Those who cannot afford it patronize quacks, traditional medicine practitioners, and spiritual homes or simply wait to die.

Bode, told The Guardian: “Most treatment machines, linear accelerator, in Nigeria are not functioning. The cost of procuring and maintaining the machine is so high and therefore the treatment cannot come cheap. The machine costs about $5million.

“The Federal Government tried to address the issue under President Olusegun Obasanjo but the medical equipment acquired under FG/Vamed project has packed up. But our LINAC is working now. It used to breakdown but we now have a Private Public Partnership (PPP) that helps sustain it.

“The centre at LUTH attends to 100 patients daily and we charge less than half of what is obtained in private settings. But we need more machines. In LUTH we need at least three LINACs.”

The ministry of health recently confirmed to journalist that almost all cancer treatment machines, linear accelerators, have broken down and most patients are stranded. Health Minister, Prof. Adewole, however, said there are plans to refurbish seven teaching hospitals in 2017.

The ESMO report also corroborated The Guardian’s findings. Researchers reported last week at the ESMO Asia 2016 Congress in Singapore that cancer patients are ending up in debt because they have to cover the costs of treatment as well as other care related expenses.

Previous studies have demonstrated that cancer patients face financial difficulties even in countries where the national public health system covers most of the expense. The economic hardship experienced by patients and survivors is often referred to as the “financial toxicity” of cancer. The research presented at ESMO Asia 2016 shows new aspects of the burden of cancer care on patients.

Lead author Nirmala Bhoo Pathy, a clinical epidemiologist at the Faculty of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia, said: “The scope of cancer care and drugs offered free through the public health services is limited in Malaysia.

“The current system of funding for cancer healthcare needs to be reviewed. The government must increase financial risk protection especially for the poor. Early cancer detection must also be improved through policy changes.”

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