By Samwel Doe Ouma

Cancer warriors and caregivers are calling for a raft of interventions to address existing gaps to enhance capacity of the public health sector to better address hidden cost challenges when seeking cancer care and rehabilitation services after successful treatments.

Speaking at the National Cancer Institute of Kenya stakeholder’s media briefing a head of the Inaugural National Cancer Summit to be held from February 2nd to 4th 2023, Lucy Njeri, a cancer warrior challenged government to improve enhanced access to cancer care clinics to ease patients from non-medical expenses in terms of transport and sometimes accommodation due to long distances they have to travel which are not always covered through the national health insurance (NHIF).

“Government should establish at least one Cancer treatment center in each and every county to ease the patients burden at Kenyatta National Hospital and also ensure that patients do not undergo extra costs which are not covered under the national health insurance fund (NHIF),” Lucy said.

She also urged NHIF to cover rehabilitative care packages saying that most patients have been known to develop depression, poor coping and other psychological problems due to difficulties arising from their altered image after surgeries. This is a result of poor and or inadequate rehabilitation.

Lucy said that when she was diagnosed with breast cancer in 2017, the NHIF helped her to pay for her treatments including chemotherapy and radiotherapies but would still incur cost due to hidden costs not covered under NHIF.

While speaking at the same event, Keziah Kiseu, a cancer caregiver and palliative care volunteer, who also sits at the board of Stoma Centre Kenya- a cancer patient advocacy organization- challenged government to prioritize tax exemptions for cancer health products and technologies and rehabilitative care equipment’s used after undergoing cancer related surgery which plays an important role in their management of patients.

She asks for the government to waiver taxes and fast track approvals of imports and donations of commodities such as stoma bags, prothesis, breast molds, special brassieres, breast prosthesis and special compression arm sleeves.

“People living with colostomy, ileostomy and urostomy face a crisis, as our donors are unable to ship the stoma bags, due to not getting clearance/waiver from Kenya Revenue Authority (KRA) and Kenya Bureau of Standards (KBS),” Kezia Said.

According to Dr Alfred Kiragu, Acting Chief Executive Officer (CEO) National Cancer Institute of Kenya, the government is working with different stakeholders to address issues of diagnosis, monitoring, surveillance and research to support nationwide cancer prevention, treatment and control.

He said that “two out of every three persons diagnosed with cancer eventually die of the disease since 70 percent of cases are diagnosed in advanced stages, when cure is impossible,” adding that “Despite the high burden, only about 23 percent of Kenyans have access to cancer management services.”

Dr Kiragu said that because Cancer is caused by an interplay of multiple risk factors, there is a need for a multi-stakeholder approach to its prevention and management.

He further reiterated that available treatment modalities for cancer carry high costs that are protracted in the lifespan of the affected individual.

Peter Kamunyo, CEO NHIF said that the insurance fund has since expanded the scope of its services in line with the universal health coverage (UHC) agenda.

He said that last year alone over six percent of total claims, about 3.8 billion were paid to cancer treatments.

According to the National Cancer Institute of Kenya, the top five common cancers namely breast, cervical, prostate, esophagus and non-Hodgkins lymphoma account for nearly half 48 percent of the cancer burden in the country. Notably, cervical and breast cancers contribute to almost a quarter 23 percent of all cancer-related deaths in the country.

While Dr Andrew Mulwa who represented health Cabinet secretary Susan Wafula at the event said that government has and is still investing a lot in the cancer ecosystem to enhance access to cancer care.

He said that the government recently launched regional cancer treatment centers in Garissa, Mombasa and Nakuru to ease burden of existing treatment centers.

The new developments he said, have seen many people seeking care locally.

“We now have PETSCAN at Agha Khan university hospital and the Integrated Molecular Imaging Services at Kenyatta University Teaching Referral and Research Hospital (KUTRRH) for cancer diagnosis and management which has propelled the country’s capacity to detect, treat and manage cancer to a whole new level and seen significant drop of people seeking care a broad,” Dr Mulwa said.

“The KUTRRH facility, an ultra-modern and the first-ever public Integrated Molecular Imaging Centre (IMIC) not only in Kenya but also in the region is expected to boost medical tourism since it is targeting patients from all over East Africa region. The IMIC center has a commercial Cyclotron, 2 PET-CTs, a SPECT-C machine, 256 Slice CT, and a 3.0 Tesla MRI.”