Tanzania: Guidelines to Boost Cancer Treatment

A physicist administers radiotherapy treatment to a cancer patient at Mulago hospital using the old Cobalt 60 machine bought 21 years ago.

THE much awaited National Cancer Treatment Guidelines, which are envisioned to assist the government have proper forecast of cancer medicines and other services, are in their final stages.

The Ocean Road Cancer Institute (ORCI) Executive Secretary and Oncologist, Dr Julius Mwaiselage, exclusively told the 'Sunday News' that they and the Ministry of Health, Community Development, Gender, Elderly and Children, are organising a stakeholders' meeting to be held in the first week of next month, to review the guidelines.

"All hospitals involved in cancer care in the country have been involved including ORCI, Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Centre (KCMC), Bugando Medical Centre (BMC), Benjamin Mkapa Hospital (BMH), Agakhan Hospital, Mbeya Zonal Referral Hospital (MZRH) and Muhimbili University of Health and Allied Sciences (MUHAS).

"It is anticipated that when the guidelines are launched on February 4, next year, during World Cancer Day, all hospitals in Tanzania should use the same guidelines for cancer treatment," he explained.

On Wednesday, the American Society for Clinical Pathology (ASCP), Novartis from Switzerland and the American Cancer Society (ACS), announced to choose Tanzania among three Sub-Saharan countries to benefit from their programme for improvement of cancer intervention. Others are Uganda and Ethiopia.

Dr Mwaiselage said that Tanzania will be a beneficiary of several regional and international initiatives aimed at improving cancer diagnosis and treatment in Africa.

Cancer diagnosis is a challenge in most African countries, particularly on immunohistochemistry (IHC) due to absence of these services in most diagnostic centres, as a result of lack of expertise as well as availability and cost of equipment and reagents.

Most countries in Africa, including Tanzania, do not have a major challenge of convectional cancer diagnosis by studying of microscopic anatomy of cells and tissues of living organism or cytology of biopsy/tissues; in Tanzania all zonal referral hospitals namely BMC, KCMC, MZRH, MNH, ORCI and a number of big private hospitals can diagnose cancer by histology and cytology.

The only challenge in this service is longer turn-around times for the results due to few staff and equipment.

"The major challenge in many countries including Tanzania is limited capacity to do IHC, which is the basis for a targeted therapy in cancer treatment, leading to better outcome of treatment. Cancers which definitely is important to do IHC includes breast cancer, lymphoma, prostate cancer," he explained.

The Executive Secretary cited that Muhimbili National Hospital (MNH) and Ocean Road Cancer Institute are performing IHC, but to a very limited extent due to challenge of equipment and other supplies.

Thus, through Novartis, ASCP and ACS, Tanzania will be among countries that will benefit in having the capacity to perform IHC through support for equipment, supplies and staff training. This will greatly improve targeted cancer treatment which has been shown to have better outcome.

Tanzania is also among six countries which have been given access to procuring cancer medicines from manufacturers at reduced prices through initiative by Clinton Health Access Initiative (CHAI). The pharmaceutical companies which have already agreed for this initiative are Pfizer and CIPLA.

"The Medical Stores Department can procure 16 types of medicines from these manufacturers at prices which have been reduced by 50-60 per cent of what is procured now.

This implies that Tanzania will be able to procure twice the amount we are procuring now, with the same budget and hence other hospitals like Bugando Medical Centre and KCMC can access these medicines," he said.

Tanzania has seen a soaring number of cancer cases in recent years, whereby 5,529 patients reported to the country's largest facility, ORCI based in Dar es Salaam, whereas in 2015, the number stood at 5,244 while in 2014 it was at 4,195. Back in 2013, the cancer patients were 3,776.

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