October is an International Cancer Awareness Month (ICAM), with special emphasis on breast cancer, the commonest cancer among women globally. The ICAM is an annual international campaign against the cancer pandemic. The symbolic colour for the month of October is pink.
The Committee Encouraging Corporate Philanthropy (CECP-Nigeria) has designated the 18th of October, every year as the National Pink Day (NPD). It is a day to mobilize Nigerians from all walks of life, including diasporans, to join as advocates, donors and volunteers in the fight for better health for Nigerians, with emphasis on cancer. The day is observed by adding a touch of pink to one’s dressing, décor, website, social media, etc.
The colour pink is not only used in relation to breast cancer, but also refers to health in general, hence the phrase ‘in the pink of health.’ Reference may be made to the healthily glowing pink cheeks of new-born babies or energetic sportsmen/sportswomen and the like. In this regard, we may note that Nigeria has one of the lowest life expectancies in the world. Most Nigerians do not live to retire, to attend their children’s graduations or weddings, to see their grandchildren, or to enjoy the fruits of their labour. Cancer is a major cause of untimely death in Nigeria.
The NPD (October 18) is a day to remind all Nigerians to take an active role in ensuring that they remain in excellent health (the pink of health), by going for regular health screening, and supporting initiatives aimed at improving the health of society at large.
The Committee Encouraging Corporate Philanthropy (CECP-Nigeria) hereby invites all Nigerians to support the special project aimed at “taking cancer prevention to the grassroots”.
The CECP-Nigeria is an initiative co-promoted by six of the core bodies of the Organized Private Sector in Nigeria, namely: the Institute of Directors (IoD), the Lagos Chamber of Commerce and industry (LCCI), the Nigeria Employers’ Consultative Association (NECA), the Nigerian Association of Chambers of Commerce, Industry, Mines and Agriculture (NACCIMA), the Nigerian Institute of Management (NIM) and the Nigerian Stock Exchange (NSE).
The purpose of the committee is to unite Nigerians to jointly tackle major societal problems. The Committee Encouraging Corporate Philanthropy (CECP) was first established in the United States of America, where the committee has become a formidable force for supporting the non-profit sector through sustainable public – private – social partnership.
Each year the CECP will take advantage of the opportunity provided by the International Corporate Philanthropy Day (ICPD) to mobilize Nigerians to unite in accomplishing one major community project. The focus for ICPD 2013 is “Taking cancer prevention to the grassroots.” The specific goal is the acquisition of 37 Mobile Cancer Centres (MCCs) for the screening and early treatment of cancer in all parts of Nigeria.
The choice of cancer as the flagship cause for the CECP initiative is strategic, given the fact that cancer is not just a health issue. Cancer affects every ramification of life, all age groups and every social class. It should therefore, be a major concern to the private sector; since it has cut short the lives and careers of many gifted and talented professionals. Cancer is a catastrophic illness; a catastrophic illness is any disease that takes away more than 30% of the income of the family. Tackling cancer indirectly prevents other related social problems like school, drop-out, poverty, marital breakdown, etc.
Cancer is a global epidemic. In 2010, cancer took over from heart disease as THE No. 1 KILLER OF MANKIND. Cancer kills more people than HIV/AIDS, malaria and tuberculosis combined. It is now being diagnosed in one out of every three persons alive.
As if this were not bad enough, the projections for the future point to a geometric rise in the incidence of cancer. According to the International Agency for Research on Cancer (IARC), globally, there will be 21 million new cases of cancer every year and 13 million cancer deaths by the year 2030, while deaths from infectious diseases will reduce by 7 million every year.
Sadly, 80% of cancer deaths worldwide occur in developing countries like Nigeria. The key factors are the lack of access to information, late presentation, and inadequate treatment due to inadequate public health infrastructure. Cancer is the most expensive disease afflicting mankind, with an economic toll in 2008 of 895 billion USD, so that most people with cancer in developing countries cannot afford the treatment and do not survive.
Cancer is a major contributor to untimely death in Nigeria. Every year, over 100, 000 new cases of cancer are diagnosed in Nigeria out of which 80, 000 die i.e. at least 10 deaths every hour and 240 deaths every day. The gravity of this statistics can be illustrated by comparing the loss of lives from cancer to other better publicized occurrences, for example air traffic accidents. The 3rd of June, 2012, was a very sad day in Nigeria, because of the plane crash that took about 150 precious lives. However, this incident rightly precipitated a series of remedial actions and reactions at all levels of society. In contrast, scarcely any attention is paid to the fact that on that same day more than 240 Nigerians died from cancer. Most of these preventable deaths from cancer are preceded by untold suffering which the cancer victims endure for months or even years, before finally succumbing to the disease.
In Nigeria, the commonest cancers in women are breast and cervical cancer while prostate cancer is the commonest in men. Liver and colorectal cancers are common in both sexes. The commonest cancer in children is Burkit’s lymphoma. Leukaemia (blood cancer) is also a common cancer in children. The death rate of some of the common cancers in Nigeria is alarming: thirty (30) Nigerian women die every day from breast cancer; a Nigerian woman dies every hour from cervical cancer; 8900 Nigerians die from liver cancer every year; prostate cancer kills 14 Nigerian men every day; and every two hours a Nigerian dies from colorectal cancer.
Although the cancer epidemic is a global phenomenon, the situation in Nigeria is particularly sad because of the high death ratio - out of every five (5) Nigerians who have cancer, only one survives. This is the most unfavorable death ratio worldwide. The outcome of cancer today in Nigeria is worse than the situation in the United States of America sixty years ago, when, out of every three (3) Americans that had cancer, one survived. Today the survival rate of cancer in the USA has further improved to two (2) in three (3). Furthermore, the stated target of the American Cancer Society is to improve the survival rate of cancer to 100%, thus making this the last century for cancer in the United States.
The cancer situation in Nigeria is even worse when you consider specific cancers. For instance, out of every 30 Nigerians that have leukaemia, only one (1) survives. This is very unfortunate because leukaemia, a common cancer in children and young adults, is now curable. At the Tata Cancer Centre in India, out of every 100 cases of leukemia, 99 survive.
The Tata survival rate with leukaemia illustrates the fact that given our current level of medical knowledge most deaths from cancer are easily preventable. According to the World Health Organization (WHO), one-third of cancers are preventable, another one-third is curable and the last third can have good quality of life with appropriate care. For example, cervical cancer is virtually 100% preventable; and yet it kills one Nigerian woman every hour. Death from prostate cancer is easily preventable if detected early; and yet it kills 14 Nigerian men every day.
There are countless cancer survivors all over the world that can testify to the fact that cancer is not a death sentence. For example, there are currently nearly 14 million cancer survivors living in the United States. Two factors are responsible for their survival: early detection and access to first-class treatment.
Some well-known examples of cancer survivors include Banky W. (Olubankole Wellington), Colin Powell, Nelson Mandela, Desmond Tutu, and Martina Navratilova. Ronald Reagan survived colon, skin and prostate cancers sequentially; after he was treated for the prostate cancer, he declared that he had never felt better in his life. Ruth Ginsburg, the only female judge on the bench of the US Supreme Court, survived pancreatic cancer; during her treatment, she never missed a day on the bench.
One may ask, what other countries are doing right that Nigeria could emulate. The answer is that many countries are investing a lot of funds in cancer research, screening programmes and treatment. Every sector of the society is involved in the fight against cancer in these countries.
Some developing countries that have Comprehensive Cancer Centres include India, Egypt, Zambia, Mauritania, Pakistan, South Africa etc. A Comprehensive Cancer Centre is a tertiary health institution focused exclusively on cancer care. India has over 120 Comprehensive Cancer Centres (CCCs), mostly established with the support of the private sector. Bangalore, an Indian city with a population of 8 million has four Comprehensive Cancer Centres whilst Nigeria with a population of 167 million neither has a CCC nor a full-fledged Mobile Cancer Centres (MCCs).
India’s progress is a result of innovative philanthropy by leaders of the private sector. The first Indian cancer centre was sponsored by the late Sir Dorab Tata (Chairman of the Tata Group). His wife, Lady Meherbai Tata had leukaemia (blood cancer), for which she was treated in England. Sir Dorab then determined to establish similar facilities for the treatment of Cancer in India. He successfully initiated the project and the Tata Cancer Centre, Mumbai, was commissioned in 1941. Today, the Centre treats over 70% of its patients almost entirely free of charge.
The largest cancer centre world-wide was opened in 2010. Mrs Kiran Mazumdar-Shaw is the main sponsor of the Mazumdar Shaw Cancer Centre (MSCC), Bangalore, named in her honour. It has 1,400 beds and cost 150 million USD. It is the fourth cancer centre in Bangalore, a city of 8 million people. At the age of 25, Mrs Shaw created a biotech company in her garage. Today that start-up, Biocon Ltd, is a 1 billion USD operation. The MSCC treats poor patients for free in the evenings so that they can continue to work and care for their families during the day. Where are the Tatas and Mazumdars of Nigeria?
We need to borrow a leaf from other countries like India which has become a major destination for medical tourism for the teeming Nigerian cancer patients. According to the Nigerian Minister of Finance, Nigerians spend over 200 million USD on such overseas treatment. Meanwhile, it would cost 63 million USD to set up a Comprehensive Cancer Centre in Nigeria.
Already, there have been efforts to combat the cancer epidemic in Nigeria. For instance, the National Cancer Prevention Programme (NCPP), a non-governmental initiative, was launched in 2008 and became the first major national effort towards the control of cancer in Nigeria.
In spite of its limited resources, the NCPP has been carrying out nation-wide awareness/ screening/ treatment campaigns. Over 100,000 Nigerians have been directly screened/ treated so far, and through the awareness being created, the NCPP is helping to protect millions of Nigerians from the cancer scourge. These life-saving campaigns would be facilitated by using Mobile Cancer Centres, which is the focus of CECP-Nigeria for 2013/ 2014.
Ideally, we need at least one Comprehensive Cancer Centre in each of the 6 geopolitical zones of Nigeria, as well as Mobile Cancer Centres (MCCs) to take advantage of all levels of cancer care. However, given the fact that Nigeria does not have the adequate structure on ground to take full advantage of the second and third levels of cancer care (cure and care), it is important to focus first and foremost on the first level (prevention), which is better and cheaper. For this we need 37 of MCCs, one for each State and the FCT, Abuja.
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MOBILE CANCER CENTRE - exterior[/caption]A Mobile Cancer Centre (MCC) is a clinic on wheels, in which screening, follow-up and several forms of treatment (including surgeries), can take place. It includes facilities for mammography, sonology, colonoscopy. It will also contain colposcope and cryotherapy equipment for follow-up and treatment, and a side laboratory for Prostate and colorectal cancer screening and other basic tests for hepatitis, malaria, HIV/AIDS and diabetes. Thus the MCC takes care of the double burden of disease (Communicable & Non-Communicable Diseases). A surgical theatre is incorporated into the MCC, as well as facilities for telemedicine.
There are so many advantages of mobile over fixed centres; only a few can be highlighted here, namely:
•Accessibility: The mobile cancer centres will enable easier access to the remote areas of Nigeria. They are tropicalized and customized to operate in our difficult terrains.
•Equity: Unlike a fixed centre which will be utilized mainly by those in its locality, the use of mobile centres will help to ensure that no community is left out.
•Cost-Effectiveness: According to a study by the Harvard Medical School the estimated savings of mobile clinics is staggering. The study found that for every dollar invested in the operation of the mobile clinic, 36 USD was saved in terms of management of chronic illnesses, avoided hospital visits, and prevention of diseases.
•Accuracy of data and statistics: The data and statistics gathered through the MCCs will be superior to the hospital-based data available at the fixed centres.
•Tried and Tested model: The use of mobile units has been successfully tried and tested in numerous countries. There are over 2,000 mobile health clinics across the United States of America.
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MOBILE CANCER CENTRE - interior[/caption]Each MCC costs ninety-five (95) million naira. Two platforms have been established for fund raising towards this project. The Nigerian Communication Commission (NCC) facilitated the formation of a special short code (44777) which is common to all networks. Interswitch Nigeria Ltd also established a common code (777526) for electronic donation
Anyone may contribute towards the project by sending the word ‘ACT’ to ‘44777’ (N100/sms); or via ATM or online at www.quickteller.com using the code ‘777526’. We request all Nigerians to join in publicizing these two codes – 44777 and 777526 within their spheres of influence. We need volunteers (‘Connectors’) to support this cause. Further information is available at www.cecpng.org. Let’s ACT! Attack Cancer Together! Together we can!!
