17 December 2012

Shining a Light on Cancer in the Developing World

The impact of cancer in low- and middle-income countries is rapidly taking hold with fewer children dying and more people living longer. In fact, more people die from cancer each year than of AIDS, TB and malaria combined. Meanwhile, cancer spending by aid donors is a fraction of what is spent when compared to other health challenges.

"I think cancer and other noncommunicable diseases have been under-recognized and they have been neglected, but that’s not a malicious neglect," explained Lancet editor Richard Horton to Public Radio International's The World. "It’s because there’s just been this overwhelming burden of other problems." 

"In many parts of the developing world, particularly in sub-Saharan Africa, the overwhelming burden for many decades has been preventable maternal and child deaths, malaria, tuberculosis, and, over recent decades, HIV/AIDS. And that burden has been so overwhelming to families and to governments that it’s been very hard to see anything else through that very thick fog of death," continued Horton.

The World put together a special six-part series this month that profiled cancer in the developing world. Seattle-based freelance reporter Joanne Silberner led the series that covered a range of issues regarding cancer from prevention to its lack of attention. As a part of the series, I reported on the way that Rwandan is taking on cancer through its HPV vaccination campaign and the establishment of East Africa's first rural cancer referral center.

One segment features the director of the Uganda Cancer Institute, Dr. Jackson Orem. Uganda is facing a series of challenges in regards to cancer with the majority of patients who are seen by the institute dying each year. “People are dying because they don’t have a system,” Orem says in the interview. “They don’t have early diagnosis. They don’t actually even know that they have cancer.” Some steps are being taken to remedy the nation's challenges, including the construction of a modern 200-bed cancer hospital, but the story of Dr Orem is illustrative of the challenges that remain in both preventing and treating cancer within developing countries.

One of the interesting facts I learned was in regards to access to morphine. 93% of the world's morphine supply is consumed by people in high-income countries while 70% of cancer deaths occur in low- and middle-income countries. This infographic really drives home the disparity when considering the fact that Asia and Africa all but disappear off the size-adjusted map.

The whole series is worth a look.The reporting by Silberner covers a wide range of countries and an array of challenges faced by countries trying to mount a response to the increasing problem of cancer. If anything, there is the interview with the Richard Horton, someone who you can count on to push the envelope when it comes to global health issues.