Special Report-UMTH: Looking at the Cancer Center Under Professor Ahidjo’s Led Management Team (3)

By: James Bwala

As a way to wrap up this piece, let me mention that the management team of Professor Ahmed Ahidjo is actively working to provide Nigerians seeking assistance with cancer treatment with the greatest possible care. The CMD has taken concrete action and made public statements to support the training of doctors who specialize in clinical oncology and related fields. If only to find water, the CMD might go anywhere and crack the rock. An official count of oncology or general surgeons in Africa could not be located after searching through reports on cancer-related topics. In 2010, a thorough analysis of the literature from sub-Saharan Africa (except from South Africa) on the state of surgery in the region indicated that there were just under two surgeons for every 100,000 people living there. For comparison, there were more than 35 surgeons in the same number in England.

As a result, surgery and anesthesia were performed—and are still performed—in many district hospitals by non-physicians who received special training for the job. The majority of oncologic surgery was carried out by general surgeons in referral hospitals. According to the study, the large-scale emigration of medical school graduates and the lack of surgically specialized programs in many African nations were the main causes of the low number of surgeons in the region.

Many Nigerians are now wondering how Professor Ahmed Ahidjo was able to reach the ground under his leadership in hospital management at the University of Maiduguri Teaching Hospital, which prides itself as the “Centre of Excellence”. We also made inquiries. How many radiation facilities are currently operating in Africa? Are these covering the need for cancer therapy sufficiently? How many additional units will be necessary? And so on. Radiotherapy plays a major role in the curative arsenal of a cancer unit.

When examining the primary therapeutic approaches utilized to treat cancer patients, it was discovered that surgery was the primary approach in 49% of cases, radiation was the primary approach in 40% of cases, and chemotherapy was the primary approach in the remaining 11% of cases. According to a survey conducted in the high-income nation of Australia, little more than 52% of cancer patients required radiotherapy as part of their treatment regimen. However, it is believed that up to 60% to 70% of new patients in low-income countries require radiotherapy due to a lack of surgical treatments and the high proportion of advanced-stage tumors that call for palliative care.

In light of this, only 277 external-beam radiation devices were registered for the African continent in the IAEA’s Directory of Radiation Centers in 2010. Of them, two nations—South Africa and Egypt—accounted for 60%. In addition, of the 52 nations surveyed, 29 African nations did not offer radiotherapy to cancer patients. According to the IAEA, more than 700 additional teletherapy machines would be needed on the continent given the estimated 713,206 cancer cases per year in Africa (according to GLOBOCAN 2008) and the fact that one teletherapy machine can treat 450 new cases of cancer annually.

There are currently no specific statistics available on the accessibility of chemotherapy drugs across the continent of Africa. In 2012 and 2018, an assessment of the situation in sub-Saharan Africa was made, which revealed a number of issues. All 22 of the chemotherapeutic medications on the WHO essential list are probably imported into the region, most of them as generics, but not all of the medications are always available. It is assumed that there is a severe scarcity of systemic anticancer drugs based on extrapolating the status of other critical medications on the WHO list, whose availability was proven to cover barely half of the demand. The scientists also discovered that, on average, the prices of pharmaceuticals in Africa were between 2.7 and 6.1 times higher than the prices used as international benchmarks. Finally, they calculated that there aren’t enough certified medical professionals available to give chemotherapy.

The situation is best illustrated by a review of the pharmaceuticals accessible for cancer therapy at a cancer center in Tanzania; over the time period studied, only about 50% of the specified medicines were available, which resulted in more than 70% of patients not receiving adequate therapy. The expense of purchasing the medications privately ranged from 1 to 7 months’ worth of income. Only a few patients were able to pay because the majority of them lacked insurance. Services in anatomic and clinical pathology are essential for cancer prevention. Pathology studies provide evidence for each stage of the diagnostic process, including the detection of malignant disease, diagnosis, staging, planning the surgical procedure, assessing management complications, and monitoring the outcome of treatment.

Furthermore, pathologic confirmation of the diagnoses is required for the cancer registry data to be taken seriously. For realistic planning of cancer control measures, this final input is crucial. Although there are no official statistics on the state of pathology services in Africa, the information that is currently available indicates a serious shortage in both quantity and quality. According to a 2012–20 informal assessment of pathology capacity in sub-Saharan Africa, the number of pathologists in the region was roughly 10% lower than that of specialists in fields equivalent to pathology in high-income nations.

The African Pathologists Summit, held in 2013 in Dakar, also noted the lack of pathologists and technicians, the poor state of the equipment, the inadequate infrastructure, and the difficulties in getting laboratory supplies. An extensive assessment of cancer prevention in Africa was just released. The analysis reiterates that most malignancies in Africa with the highest incidence rates can be prevented. For instance, human papillomavirus vaccination and other population screening techniques can prevent cervical cancer; hepatitis B vaccination can prevent liver cancer; eliminating malaria and HIV infections can lower the risk of Burkitt lymphoma (HIV is also the primary cause of the high incidence of Kaposi’s sarcoma); and limiting sun exposure can prevent skin cancer.

The investigation did discover that the region’s preventative measures are insufficient. According to the literature, not enough people are aware that cancer exists as a disease, that it has risk factors and manifestations, and that there are methods for preventing and treating it. Additionally, a number of cultural aspects make it difficult to use preventative strategies developed for other sociocultural contexts. The infrastructure and staff in place to enable mass prevention efforts in the health sector are insufficient. Although vaccination programs against the human papillomavirus and the hepatitis B virus are conducted on the continent, they are mostly supported by funding from outside organizations like the United Nations or the Global Alliance for Vaccines and Immunizations.

Governments lack the motivation to fully commit to the fight against cancer, and the majority of nations lack national cancer registries, which would provide accurate information on the scope and character of the issue. In a 2009 analysis of the global burden of cancer, the Economist Intelligence Unit discovered a significant gap between the cancer costs on the African continent, which accounted for just 0.3% of the global costs, and the continent’s share of the world’s new cases of cancer, which accounted for 6.4% of the world’s annual total. The amount spent on cancer treatment is disproportionately low in Africa since the majority of cancer costs are represented by medical expenditures (medications, medical procedures, charges for hospitalization, and outpatient visits).

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We were able to see the wider picture of the efforts being made by Professor Ahmed Ahidjo, Chief Medical Director of the University of Maiduguri Teaching Hospital, and his management team to find a solution to a more significant issue the world is currently facing thanks to his high-level explanation, study results, and real-world data. The newly opened Cancer Center at the University of Maiduguri Teaching Hospital (UMTH) would go a long way toward reducing the amount of regular medical travel that Nigerians engage in. The Cancer Center is the only facility in Nigeria with four bunkers and cutting-edge medical equipment to ensure that cancer patients receive top-notch care.

Recalls that Alh. Mamman Mamuda, the Permanent Secretary of the Federal Ministry of Health, said of the UMTH during the inspection of projects completed in the hospital that other cancer centers across the nation “are not up to the standard” of the UMTH Cancer Center and lack the capacity. From what I have observed on the ground, I can conclude that the UMTH is prepared to put an end to medical tourism in Nigeria, he claimed. We have already begun planning ways to make the UMTH a recipient of the Federal Government of Nigeria’s Cancer Support Fund.

The Cancer Center, which cost more than N5 billion to build, has the newest medical facilities in Sub-Saharan Africa, according to the Chief Medical Director (CMD) of the UMTH, Prof. Ahmed Ahidjo. He also noted that the goal of the UMTH is to prevent any medical issues from being referred to outside facilities, such as the Epic Hospital in the North East Region. We have two linear accelerators, two brachytherapists, and four bunkers here. We are bringing the first linear accelerators into Nigeria with the Nectar Infinite. The second one, HD Versa, for which the Federal Ministry of Health recently completed the purchase procedure for us, is the first to enter sub-Saharan Africa and the most recent method used globally.

Alongside the Permanent Secretary, Director of Hospital Services Dr. Adebinpe Adebiyi praised the Cancer Center as one of the greatest in the nation and claimed that “it is beating the trends” set by other centers before it. Dr. Adebiyi disclosed that the management of UMTH has given the issue of staffing the new cancer center great priority, noting that the capacity building of professionals to staff the center has been completed. “When Nigerians travel overseas and encounter other Nigerians, they are treated with respect. Why are they not able to treat Nigerians here? It was her.

In Borno State, the CMD is being praised for the several initiatives he is putting in place to make Maiduguri a tourism hub for health in Nigeria, especially with the country’s largest cancer center and cutting-edge medical technology. The move and encouragement needed from the previous administration to the current one, under President Bola Ahmed Tinubu, is to have more federal presence at the University of Maiduguri Teaching Hospital through activities that would promote bigger dreams for a better health solution in Nigeria.

Special Report-UMTH: Looking at the Cancer Center Under Professor Ahidjo’s Led Management Team (3)