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Strategies for more equitable and improved cancer care in South Africa

The World Cancer Day 2024 Equity Report, just released by the Union for International Cancer Control (UICC) to mark World Cancer Day on 4 February, provides a comprehensive examination of the state of cancer prevention and treatment across the globe, as well as regional perspectives and experiences, such the inequities faced in South Africa and how to address them.

The report reveals in particular how certain populations experience barriers to accessing health services, undermining their ability to prevent and survive cancer. These barriers relate to socioeconomic factors such as gender, age, income and education levels, geographical location and ethnicity, and are also caused by prejudices and assumptions based on similar factors.

According to Ann Steyn of South Africa, President of Reach for Recovery International (RRI) and a past UICC Board Member, the healthcare system in the country shows significant disparities, despite a progressive constitution that recognises human rights.

A majority of the population of South Africa relies on public healthcare, which varies in quality and specialisation. Diagnostic and radiation equipment are in short supply, particularly in public hospitals not linked to academic institutions.

Ann Steyn says, “With 84% of the nearly 60 million population accessing public healthcare, there are enormous challenges to overcome. The treatment varies, with only five out of nine provinces offering specialised cancer care. Moreover, most cancers are diagnosed at a late stage due to lack of proper early detection and screening systems, affecting survival rates adversely.”

She further adds, “Entrenched barriers such as gender and racial equity exacerbate the situation. In South Africa, only 20% of healthcare professionals are in the public sector, with 70% of them being white males treating a majority of patients that are people of colour. This can often create challenges for diagnosis and treatment if there is not mutual language understanding or cultural background consideration.”

As modifiable behavioural factors contribute to over 40% of all cancer deaths, UICC’s World Cancer Day 2024 Equity Report emphasises overall that implementing cost-efficient and evidence-based prevention measures, such as limiting the marketing, sales and consumption of tobacco, alcohol and unhealthy foods that can lead to overweight and obesity, are crucial to reducing health inequity and the cancer burden.

Screening programmes, early detection of cancer, and timely treatment and care for people who develop cancer – regardless of their ability to pay – are also vital in reducing the burden.

Efforts are being deployed to close the gap in cancer care in South Africa. At an organisational level, the Cancer Alliance is working alongside a coalition of more than 30 not-for-profit cancer organisations and has established a partnership with the Treatment Action Campaign to improve access to quality healthcare for people with HIV, as cancers linked to HIV are increasing. “They operate on the principle of ‘five Ps: Patient, Public, Private, Partnerships, Philanthropy,’ always ensuring that patient care is at the forefront,” says Ann Steyn.

At the governmental level, the pending National Health Insurance (NHI) bill is a major step toward implementing universal healthcare in South Africa.

Ann Steyn says, “To close the cancer care gap by is an ambitious task, but there are actions we can take to make progress, in particular by establishing proper referral pathways for the top 10 cancers, implementing a robust cervical cancer elimination strategy, and drafting standardised treatment protocols.”

Cary Adams, CEO of UICC says, “Where you live, how much money you make, your age, your health, your gender, who you love or the colour of your skin shouldn’t dictate whether you have access to cancer care. But the sad reality is, it does. That’s why UICC’s World Cancer Day 2024 Equity Report is so crucial – it shines a light on the obstacles people face in getting the care they need, and suggests strategies to help overcome them.”

Download the Equity Report chapter dedicated to South Africa

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