My talk today had two sections, the first one focussed on challenges and opportunities for palliative care in Africa where we highlighted the areas that are not covered, especially in terms of palliative care financing, training of health workers, policies in countries as well as the issue of implementation of services. Then the opportunities included inclusion of palliative care into universal health coverage schemes that governments are developing as well as the implementation of the World Health Assembly resolutions on palliative care and cancer and the fact that we have countries that have developed models for palliative care from which other countries can learn.
What were your conclusions?
Countries still have a challenge of ensuring that the models that have been piloted and are being implemented are somehow adapted to the needs of each country and then implemented. Of course we have to push African governments to ensure that they increase healthcare funding that should in turn result into better funding for palliative care.
The second presentation focussed on collaborations for cancer in Africa. We have in-country collaborations where you have different stakeholders working together to ensure that national cancer control plans are in place and that those national cancer control plans are implemented. But also working with stakeholders from outside the countries to ensure that best models are implemented in the various countries in terms of creation of awareness, early detection, diagnosis, treatment, rehabilitation, palliative care, and ensuring that countries have viable national systems for cancer care.
What are the main challenges in achieving this?
There are quite a number of challenges to achieving robust cancer care systems in Africa. The first one is first of all countries setting up national cancer control plans that are evidence based and cover all aspects of cancer care. The second one is dedication of resources to cancer care. Cancer prevention and management in general requires a lot of investment and countries to have to invest into systems that ensure that awareness, early detection and diagnosis, treatment, palliative care and rehabilitation are in place and that these systems cover both the urban and the rural patient together. That can be quite a challenge for most of the countries given the fact that percentages of budgets for health in Africa are not wholly covered by the national budgets but they have to depend on donors as well until countries devise mechanisms of improving budgetary allocations to health and cancer in particular.
How do conferences like BGICC aid this process?
A conference like this in Egypt is important because of the sharing of evidence that has been documented in various countries in and outside Africa. Secondly, there is the issue of networking to learn from each other and then, thirdly, to meet the guys with the technology because for us to effectively manage cancer in Africa we need to import technology that we don’t have. So this conference has provided an opportunity to do all three at once in addition to south to south learning. Because if you are from Uganda and you have better access to oral morphine and then you meet people in Egypt who don’t have access to oral morphine then you can discuss how you can make it work. If you are from Tanzania where you don’t have adequate access to radiotherapy and then Egypt has better access to radiotherapy then you can discuss how best you can improve access to radiotherapy in your country.
What developments do you hope to see in the future?
Moving forward, especially in the cancer fight, we need to ensure that there is investment in the whole continuum, right from awareness, cancer detection and diagnosis. We need to invest into proven treatment options to ensure that they are accessible for patients. We need to ensure that rehabilitation and accompanying assistive devices are availed and that palliative care services are available both in institutions where patients are seen but also within the community and patients’ homes. We also need to ensure that technology is imported into the countries where it is not.
On top of that, Africa needs to ensure that as the individual countries set up universal health coverage schemes that cancer and palliative care are not left out of those schemes because these disciplines that are very expensive for families, they are financially toxic to patients and families, and therefore they should be part of the universal health coverage schemes that countries are putting up.
