Amid rising cancer rates and an expired national strategy, health experts and activists call for urgent reform. They aim to address the nation's cancer policy in South Africa and tackle the issue of late diagnoses. Improving patient care is also a priority.
With an outdated framework for cancer care, they emphasise the urgency of reforming healthcare strategies. Dealing with late-stage cancer diagnoses and patient management is crucial.
South Africa is facing a deepening cancer crisis. An alarming increase in cases, significant barriers to treatment, and a leadership vacuum resulting from expired national policies mark this situation.
While the government and health activists debate the path forward for cancer policy reform, patients continue to struggle within a fractured system. This underscories an urgent need for comprehensive reform of existing approaches.
The scale of the problem is stark. With non-communicable diseases set to rise, experts predict that cancer incidence in South Africa could double by 2030.
They estimate it could potentially reach over 121,000 new cases annually. An ageing population and a general increase in cancer risk drive this projection. Statistics already paint a grim picture. The National Cancer Registry (NCR) recorded nearly 88,000 new cases in 2023.
Experts widely consider this figure a significant undercount. For men, prostate cancer is the most common diagnosis. In women, breast and cervical cancers dominate. Cervical cancer is particularly deadly. This underscores the need for more effective cancer policies to address this growing issue and enhance cancer care in South Africa.
Systemic Failures: Why Patients Are Diagnosed Too Late
A clear pattern emerges from recent provincial health workshops. Doctors frequently diagnose cancers too late, which severely limits treatment options and survival rates. Professor Jeannette Parkes, Head of Radiation Oncology at Groote Schuur Hospital, highlighted numerous systemic barriers.
These are particularly significant for the 85% of the population who rely on the public sector. Addressing these challenges requires reforming South Africa's current cancer policy.
The referral pathway is problematic, Prof Parkes explained. She highlighted urban-rural divides and a failure to refer patients efficiently. There is also a significant issue with accessing imaging services; additionally, the costs of biopsy support and pathology services are a significant concern. A dated policy governs the current system. This needs further attention on cancer management.
This results in devastating delays. At a Johannesburg meeting, it was revealed that patients often only begin treatment on their sixth visit to a healthcare facility. Clinicians also note practical challenges, for instance, the cost of transport prevents many from seeking care until their condition is critical.
Furthermore, activists like Salomé Meyer of the Cancer Alliance argue that survivorship and palliative care are "almost absent." This leaves patients without support after treatment ends. These gaps highlight shortcomings in the existing cancer policy approach.
Cancer Policy in Limbo and a Path Forward
Compounding these systemic issues is a policy void. The National Cancer Strategic Framework for 2017-2022, which guided the country's response, has lapsed. The Ministerial Advisory Committee on Cancer also expired in early 2024, leaving a gap in expert guidance.
A new strategy is reportedly nearing finalisation, but the delay has hindered a coordinated national effort that affects cancer policy in South Africa.
In response, a collective of research organisations and the Department of Health are developing a new National Cancer Research and Innovation Strategy. They are working through a series of provincial workshops. These sessions aim to identify key challenges and set future priorities. The focus is on prevention, early detection, treatment, and survivorship. The ultimate goal is reforming South African cancer policy.
A central proposal championed by the Cancer Alliance is the establishment of a National Cancer Institute (NCI). Meyer argues that an NCI would be crucial for standardising treatment protocols. It would also assist in planning resource allocation under the future National Health Insurance (NHI) system. Additionally, decentralising care away from overwhelmed tertiary hospitals is essential. Such an institute could find a home within the proposed National Public Health Institute of South Africa (NAPHISA). However, its establishment has also been stalled. An effective cancer policy includes such ambitions.
As South Africa confronts its escalating cancer burden, these calls for structural reform are more critical than ever. We need to improve data collection and establish a robust, well-resourced national strategy. To address the lag in cancer policy updates, implementing effective structural reforms in South Africa is essential.