Whither National Cancer Centre?

Tomorrow, Malawi joins the rest of the world in commemorating World Cancer Day. But where does the country stand in diagnosis, treatment and cure of the disease? What has become of the National Cancer Centre that was commissioned by government a  few years ago? EPHRAIM NYONDO writes.

Cancer has been described as a silent killer. Most people in the country die of the disease without knowing it—they hardly get diagnosed to access treatment.

Spokesperson for the Ministry of Health, Henry Chimbali, understands why cancer is still a silent killer.

“Cancer is better treated with early diagnosis. We are, therefore, strengthening our diagnosis and public education [for people] to understand the causes, which can be prevented,” he says.

According to College of Medicine pathologist Dr. Charles Dzamalala, the ten most common cancers in Malawi are: Kaposi’s sarcoma, cervical, oesophagus, lymphoma, urinary bladder, breast, liver, conjunctive, prostate and stomach being registered at the cancer registry by 2005.

Kaposi’s sarcoma, cervix, oesophagus and lymphoma are among the highest recorded, with Kaposi’s sarcoma accounting for the 38 percent of cancers registered in 2005.

There are over 200 types of cancer, and the shift towards poor countries such as Malawi is mainly attributed to lifestyle changes including smoking, which is not regulated and also for many, exposure to smoking fumes in tobacco production areas.

The Malawi Cancer Registry data base indicates that between 1985 and 2005, there were 38 232 cancer cases but only 130 were recorded as having lung cancer. These figures, however, might not be a true reflection of the reality, as hundreds others do not have access to cancer diagnostic experts.

The challenge of cancer is not just for Malawi.

According to the World Health Organisation (WHO), cancer is a leading cause of death around the world. WHO estimates that 84 million people will die of cancer between 2005 and 2015 without intervention.

However, low-income and medium-income countries such as Malawi are the hardest hit by cancer compared to high-resource countries.

But how can these low-income countries offset such challenges?

Currently, Malawi has no facilities to treat and palliate cancer. It does not even have a national cancer control plan. Millions of kwacha are spent to refer patients to neighbouring countries such as Zimbabwe, South Africa and Tanzania, which have facilities to treat cancer..

The challenge, however, is that the majority of Malawians live below the poverty line. As such, they cannot afford access to cancer treatment through foreign and private medical insurance.

As noted by Dr Leo Vigna, a surgeon at Mwaiwathu Hospital, Blantyre, such patients are sent home where they die a painful death.

To offset the challenge, in 2007, President Bingu wa Mutharika officiated the launch of fundraising efforts to mobilise resources for building Malawi’s first and only radiotherapy centre. The idea gave birth to the dream of building a national cancer centre in the country.

In an interview with Weekend Nation in April 2011, Chimbali underscored the importance of why Malawi needs the centre.

“It will reduce the costs that we are currently incurring in sending patients to South Africa for treatment,” he said, adding that the centre will also provide a good working environment for the country’s oncologist and other specialists, including a good treatment place for patients.”

But how far has the project gone?

In the 2009/10 national budget, Parliament allocated K20 million to the Ministry of Health towards construction of the centre. According to the budget (output based) document, the K20 million allocation was meant to, among others, prepare drawings for the cancer centre and process bills of quantities and tender documents.

The funds were also meant to ensure the ministry prepares a report for the project’s Environmental Impact Assessment.

Though some of the paperwork made progress, the project is still in its infancy, and hardly looks promising.

There is no allocation towards the project in the 2010/11 national budget under the Ministry of Health, according to the 2010/11 national budget (output based) document.

So is there hope that the project will takeoff  in the near future?

Martha Kwataine, chairperson of Malawi Health Equity and Network (Mhen), says not much has been done on the project.

“You know there are quite a number of issues revolving around finances in the country. In fact, we cannot expect much given the situation we are in,” she says.

She adds: “I think we need to raise awareness among people to start demanding this service, because more cancer patients continue to suffer in the country.”

Despite this, Chimbali says government expects to have a cancer operational centre by 2014.

“Currently, we are doing designs. And I can confirm to you that the site has been found. The centre will be at Kamuzu Central Hospital in Lilongwe,” he says.

Chimbali also says after the designs government will embark on mobilising resources to speed the process of having the centre.

Surely, the project at hand needs a collective effort among Malawians. And as Malawi joins the rest of the world tomorrow to commemorate World Cancer Day under the theme ‘Together it is Possible’, the day revokes a national call for all to join the cause for the National Cancer Centre in the country.

This year’s theme calls on people, organisations and government to do their part so that by 2025 the world is able to reduce premature deaths from cancer and other non-communicable diseases by 25 percent.

Johnny Kasalika