African Region (AFR)
Increased awareness of cancer as a health crisis facing less developed healthcare systems has led to recent calls for increased investment in cancer care infrastructure in low resource settings. However, operational descriptions of well-functioning cancer care systems in resource-constrained settings are limited. AMPATH-Oncology is the result of collaboration between North American, European, and Kenyan partners to develop a comprehensive cancer care model that supports screening services, cancer treatment, and palliative care. This article describes the approach taken by the AMPATH-Oncology program to deliver cancer care in a resource-constrained setting. A review of other ‘high-income – low-income’ collaborative models identifies successful strategies to implement cancer care in low resource environments.
Keywords: Africa, Cancer, Kenya, International, Health care, Treatment, HIV/AIDS, Program development, Research, Chemotherapy
Noncommunicable diseases (NCDs) have traditionally been associated with affluent of
lifestyles in developed nations. However, at the dawn of the new millennium, NCDs now
pose a huge health challenge in Africa, and Swaziland is no exception. It calls for urgent
action from both the Government of Swaziland and non-state actors to address the risk
factors for NCDs and their determinants. While Swaziland finds itself facing an increase
in NCDs, maternal and child morbidity and mortality, HIV and AIDS, TB and malaria also
remain a huge public health concern.
A social determinant of health approach reveals that the health outcomes of individuals,
families and communities are influenced by the social and economic conditions in which
people are born, grow, live, work and age, and the systems put in place to deal with illness,
disability and premature death. This case study was conducted to identify how actions of
various sectors could be harnessed to address key determinants of noncommunicable
diseases including their risk factors.
A secondary analysis of government policy papers, strategic plans and WHO guidelines
was conducted in addition to key informant interviews. The study examined the presence
of intersectoral actions across progragrammes and sectors namely, health in all policies,
good governance for health, leadership and stewardship roles, adequate financing,
health literacy and community empowerment. The key findings are that there is an
unnoticed, unrecorded and unabated increase of noncommunicable conditions mainly
diabetes mellitus, cardiovascular disease, hypertension, respiratory problems and HIVrelated
cancers like Kaposi’s sarcoma. The associated major risk factors are alcohol and
tobacco consumption, physical inactivity and unhealthy diet. It is concluded that a rise in
noncommunicable conditions in Swaziland requires an intersectoral approach to ensure
effective and sustainable prevention and control.
Cancer research in Africa will have a pivotal role in cancer control planning in this continent. However, environments (such as those in academic or clinical settings) with limited research infrastructure (laboratories, biorespositories, databases) coupled with inadequate funding and other resources have hampered African scientists from carrying out rigorous research. In September 2012, over 100 scientists with expertise in cancer research in Africa met in London to discuss the challenges in performing high-quality research, and to formulate the next steps for building sustainable, comprehensive and multi-disciplinary programmes relevant to Africa. This was the first meeting among five major organizations: the African Organisation for Research and Training in Africa (AORTIC), the Africa Oxford Cancer Foundation (AfrOx), and the National Cancer Institutes (NCI) of Brazil, France and the USA. This article summarizes the discussions and recommendations of this meeting, including the next steps required to create sustainable and impactful research programmes that will enable evidenced-based cancer control approaches and planning at the local, regional and national levels.
The African Breast Cancer - Disparities in Outcomes (ABC-DO) study is a multi-country sub-Saharan African study of determinants of breast cancer outcomes. The number of women diagnosed with breast cancer per year is rising rapidly in Africa, and the consequences of poor survival are worsened by the young age of women affected. ABC-DO will recruit women from four public hospitals in Nigeria, Uganda, South Africa, and Namibia and examine the full journey of breast cancer patients, both pre- and post-diagnosis, in order to identify modifiable determinants of survival, to be able to prevent avoidable deaths from breast cancer in African women.