Cancer is one of the leading causes of death worldwide, including in South Africa1. However, the insurgence of the COVID-19 pandemic has meant that cancer patients are facing a further increased risk of mortality2. As such, in light of the pandemic, cancer patients are treated as high-risk in South Africa due to them presenting underlying comorbidities and being immunosuppressed3. Historically, however, there has been limited access to oncology treatment in the country’s public hospitals due to increasing cancer numbers. This was further exacerbated by the pandemic as associated services were reduced4.
Along with this, there is a shortage of doctors and specialists who can treat the most pressing diseases in the country5, including those that are oncology-related6. Furthermore, it has been reported that broken or limited equipment and facilities, and extensive waiting times have negatively impacted timeous access to care and in turn, may have resulted in deaths that could have been prevented6. As such, healthcare inefficiencies have been noted as one of the reasons that patients living with cancers such as breast and cervical cancer are still being diagnosed at a late stage7.
Another setback for South Africans living with cancer is that affordability of treatment remains a key challenge as local healthcare providers currently utilise the traditional fee-for-service model that focuses on the volume of treatment rather than the value. As a result, patients are often faced with exorbitant payments for newer and more targeted treatments8.
As we acknowledge World Cancer Day on 4 February 20219, it is important to emphasise that considering the aforementioned challenges, the quality and access to cancer care in South Africa needs to be drastically improved – particularly as it is predicted that cancer cases in the country will only increase in the coming years10. Although the public and private sectors have implemented the below-listed initiatives, more can be done through proactive stakeholder collaboration.
Cancer treatment is improving
Cancer is a complex disease11 with more than 100 types and biology that constantly evolves12. Traditionally, chemotherapy and radiation have been and remain important treatments for cancer13, however, scientists worldwide have been working through the pandemic to develop new ways to treat cancer more effectively14. At Pfizer, we are aiming to bring as many as 25 breakthroughs to patients by 2025 with more than 60% in the pipeline solely for treating cancer15.
We are also working towards establishing oncology patient access programmes with Patient Advocacy Groups, Government and healthcare professionals in the country, with particular emphasis on breast cancer. These programmes aim to provide women in rural or peri-urban populations with the necessary education and navigation tools to promote the early screening and diagnosis of breast cancer as well as to support better beast cancer-focused disease management.
Affordability is key
While there continues to be challenges across both the public and private healthcare sectors when it comes to the costs associated with the treatment of cancer16, at Pfizer we believe that the pricing regulation for the private market does not allow for alternative reimbursement mechanisms which could significantly improve patient access. As such, we are committed to engage with stakeholders in this regard to help develop practical solutions to address the country’s health care challenges including developing reimbursement schemes.
Introducing more doctors into the system
There is a shortage of doctors in South Africa, with less than one doctor per 1000 people having been recorded17. To remedy this, Pfizer South Africa is working with key partners across industry and government through the Public Health Enhancement Fund (PHEF). The PHEF has since produced 60 medical students, 20 PhD studies, and 7 MSc studies18.
These are just a few steps in the journey towards providing better access and treatments that are affordable to South Africans. We, therefore, look forward to working together with Government and other private stakeholders to improve the lives of those living with cancer in 2021 and beyond.
Written by: Dr Bha Ndungane-Tlakula, Medical Director at Pfizer South Africa
1. Prevalence Cancer [Internet]. [cited 2021 Jan 28]. Available from: https://cansa.org.za/south-african-cancer-statistics/
2. COVID-19 and cancer [Internet]. [cited 2021 Jan 28]. Available from: https://www.medicalacademic.co.za/post-summary/?post_refered=23952
3. Okeke M, Oderinde O, Liu L, Kabula D. Oncology and COVID-19: Perspectives on cancer patients and oncologists in Africa. Ethics, Medicine, and Public Health. 2020;14:100550.
4. Cancer Treatment Challenges During COVID-19 [Internet]. [cited 2021 Jan 28]. Available from: https://cansa.org.za/cancer-treatment-challenges-during-covid-19/
5. Project 1: Expansion of Health Professionals [Internet]. [cited 2021 Jan 28]. Available from: https://phef.co.za/?page_id=96
6. Elna Schütz for Spotlight. SPOTLIGHT: Cancer care in the public sector: Things are improving — but there’s a long way to go [Internet]. 2020 [cited 2021 Jan 28]. Available from: https://www.dailymaverick.co.za/article/2020-12-08-cancer-care-in-the-public-sector-things-are-improving-but-theres-a-long-way-to-go/
7. Joffe M, Ayeni O, Norris SA, McCormack VA, Ruff P, Das I, et al. Barriers to early presentation of breast cancer among women in Soweto, South Africa. PLoS One. 2018 Feb 2;13(2):e0192071.
8. Value Based Care: Why we need it and how to get there [Internet]. [cited 2021 Jan 28]. Available from: https://www.discovery.co.za/corporate/value-based-care
9. Official website of World Cancer Day by UICC [Internet]. [cited 2021 Jan 28]. Available from: https://www.worldcancerday.org/
10. Sartorius K, Sartorius B, Govender PS, Sharma V, Sheriff A. The future cost of cancer in South Africa: An interdisciplinary cost management strategy. SAMJ, S Afr med j. 2016;106(10):949–50.
11. Knox SS. From “omics” to complex disease: a systems biology approach to gene-environment interactions in cancer. Cancer Cell Int. 2010;10:11.
12. National Institutes of Health (US), Biological Sciences Curriculum Study. Understanding Cancer. In: NIH Curriculum Supplement Series [Internet]. National Institutes of Health (US); 2007.
13. Oncology, Cancer Research and Development [Internet]. [cited 2021 Feb 4]. Available from: https://www.pfizer.com/science/oncology-cancer/research
14. Twelve cancer research breakthroughs of 2020 [Internet]. [cited 2021 Jan 28]. Available from: https://www.worldwidecancerresearch.org/stories/2020/december/twelve-cancer-research-breakthroughs-of-2020/
15. Purpose [Internet]. [cited 2021 Jan 28]. Available from: https://www.pfizer.com/science/research-development/breakthroughs
16. Waterworth T. “Pay or die”: the huge cost of cancer treatment [Internet]. IOL | News that Connects South Africans. 2019 [cited 2021 Jan 28]. Available from: https://www.iol.co.za/ios/news/pay-or-die-the-huge-cost-of-cancer-treatment-30260500
17. George A, Blaauw D, Thompson J, Green-Thompson L. Doctor retention and distribution in post-apartheid South Africa: tracking medical graduates (2007–2011) from one university. Hum Resour Health. 2019 Dec 16;17(1):1–9.
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