Nigeria's Radiotherapy Capacity: '10 Machines Inadequate for Over 200 Million People'

The President of the Nigerian Cancer Society, Abidemi Omonisi, has provided an assessment of the cancer landscape in Nigeria, discussing government funding, service delivery challenges, healthcare worker migration, and the role of private and philanthropic support.

Omonisi noted that while cancer care in Nigeria has historically faced numerous hurdles, the federal government has made substantial progress over the past decade, particularly in enhancing infrastructure, diagnostic capabilities, and treatment services nationwide.

The federal government has established dedicated centres of excellence for cancer management across the country's six geopolitical zones. These facilities are being equipped to provide comprehensive care. Specific examples include cancer centres at the University of Benin Teaching Hospital, Maiduguri, Lagos, and Abakaliki. The National Hospital in Abuja has also seen upgrades to its existing cancer services, with plans for further development in other regions. The Federal Medical Centre in Birnin Kebbi is being transformed into an Oncological Centre of Excellence, and discussions are underway for similar developments in other federal hospitals. A key aspect of these upgrades is the installation of radiotherapy equipment, with ongoing efforts to enhance existing facilities.

Regarding the availability of radiotherapy machines, Omonisi indicated that Nigeria currently operates approximately ten functional radiotherapy machines, accounting for both public and private healthcare facilities. While some centres possess multiple linear accelerators, this number is considered critically low for a nation with a population exceeding 200 million. There is a pressing demand for additional machines.

Beyond equipment, Omonisi identified several other significant challenges in the fight against cancer in Nigeria. The high cost of treatment remains a major barrier, particularly for immunohistochemistry testing, which is often unaffordable for many Nigerians, even with improved access through public- private partnerships. The cost and accessibility of chemotherapy drugs are even more problematic, exacerbated by foreign exchange difficulties and import complications, significantly restricting patient access to vital treatments.

To address the financial burden on patients, the federal government has implemented initiatives such as the National Cancer Health Fund, which provides support for patients with breast, cervical, and prostate cancers, and the National Cancer Access Programme (NCAP) aimed at improving access to essential cancer medications. However, Omonisi pointed out that bureaucratic delays often hinder the timely availability of these drugs, forcing many patients to bear substantial out-of-pocket expenses, leading some to abandon treatment altogether.

The shortage of oncology healthcare professionals is another critical issue. Cancer care requires a multidisciplinary approach involving specialists like pathologists, surgeons, radiologists, oncology nurses, medical oncologists, and radiation oncologists working collaboratively. Nigeria faces a severe deficit in these areas, with fewer than 70 clinical oncologists and fewer than 200 pathologists nationwide, falling far short of international benchmarks. Shortages are prevalent across all cancer-related medical specialties.

The primary driver for this shortage is the migration of healthcare professionals. Inadequate remuneration, security concerns, and less-than-ideal working conditions compel many specialists to seek opportunities abroad or relocate within the country. Consequently, over half of Nigeria’s oncology workforce is concentrated in Lagos, leaving many northern states with minimal or no oncology expertise. This geographical disparity results in extended waiting periods, limited access to care, and an increase in preventable cancer-related deaths. Omonisi emphasized that while infrastructure is vital, it is insufficient without the necessary skilled personnel to operate equipment and provide patient care.

In response to these challenges, the Nigerian Cancer Society is actively collaborating with the Federal Ministry of Health and other stakeholders. The society is advocating for solutions to drug access issues and workforce shortages. Furthermore, they have initiated a new national cancer intervention fund with a target of N100 billion, intended to support cancer patients and survivors, particularly in accessing chemotherapy and radiotherapy services.

Addressing the Turai Yar'adua Cancer Care Centre, Omonisi recalled that Mrs. Yar'adua, wife of the late former president, had a strong focus on cancer care and envisioned establishing a dedicated centre in 2008. The project's continuity was significantly impacted by the late president's passing. He clarified that the initiative was a personal endeavor rather than a formal government project. Due to evolving circumstances and personal considerations, the project was not pursued further. The society acknowledges her commendable vision and intends to engage with her to express gratitude for her past contributions and explore potential avenues for reviving aspects of the project. While she is no longer in government, opportunities exist for her to mobilize support from philanthropists and private sector partners. Even if the full original centre cannot be funded, there are ways to contribute meaningfully, such as supporting cancer diagnosis, treatment services, nutrition programmes, or patient support initiatives.