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Local approaches to cancer in Africa

September - October, 2008  |  Volume 7, Issue 5

Guest Opinion by Twalib Ngoma

One reason that the challenge of cancer in Africa is underappreciated is the lack of population-based incidence and mortality data. Too much reliance is placed on data from the West. These data are often not useful when trying to generate compelling evidence-based guidance on how cancer in African countries can be addressed.

Recruiting, training and retaining healthcare professionals are another problem. The situation is exacerbated when healthcare professionals migrate from rural to urban areas, move from public to private health sectors, and emigrate from Africa to richer countries.

Three types of research--basic, epidemiologic and interventional--are relevant to caring for cancer patients, and each can, at least in principle, be carried out in Africa. Yet research is still considered a luxury in many African countries.

For epidemiological research, Africa needs cancer data registries, whether these are broad regional and national cancer registries, or more limited study-specific registries intended to measure the outcomes and effects of specific interventions.

Africa also requires better needs assessments for tailoring treatment to specific health care settings. Most cancers seen in Africa have different causes, epidemiology and biological behavior compared with those seen in the western world. So Africa cannot just extrapolate knowledge and experience from the West.

Instead, Africa needs local, effective and sustainable research. If this research is not relevant to rich countries, it may be unrealistic to expect them to finance it.

Researchers must also remember that, since African countries have different levels of resources, populations, prevalence of disease and other factors, each country will require different solutions for the same cancer problems.

The good news is that the commonest cancers in Africa are caused by viruses, against which new interventions--namely vaccines--are being developed. But the high costs of these vaccines mean that most African countries cannot afford to buy them.

Africa needs concerted efforts by the donor and international community to make these vaccines accessible to those Africans who need them most.

Twalib Ngoma is Executive Director of the Ocean Road Cancer Institute, Dar es Salaam, Tanzania. The views expressed here are not necessarily those of the Fogarty Center, NIH or the Department of Health and Human Services.

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