[hifa] PLoS Med: Cancer trials in sub-Saharan Africa: Aligning research and care

We share the sentiments in this important paper about the massive burden of cancer of all types in SubSaharan Africa (SSA), and that something needs to be done. We agree that trials need to be adopted on various treatment modalities that originate from resource rich Global North countries. But perhaps the investment should go

along with elimination of ignorance and superstition that todate informs SSA communities that 'cancer is caused by withcraft / witches, is a curse for sin, is inflicted atimes by remote control by the victims enemies and / or elderly relations especially mother-in-law. The result is that victims harbour the condition for years and eventually report first to native doctors or religious houses for exorcism or divine intervention. When all these fail the victim presents to orthodox medicine practitioners to perform ' miracle' on advanced metastasized cancer .

The order challenge is that whereas in resource rich countries comprehensive approaches are adopted to manage cancer from health promotion, to prevention, before treatment, in LMICs such comprehensive approach is lacking. In LMICs it is the exception to find screening for early detection of cancer and even when there is one the follow up steps for positive screening report is lacking: take breast cancer as one example, mammograms are springing up but virtually no treatment service for the positive mammogram cases. No intervention radiologists, very few breast surgeons, lack of intra-operative frozen section service, lack of pathologists, lack of supportive and rehabilitative care service. lack of follow up. Rather than just setting up a mammogram centre, LMICs need whole breast cancer service to cover the whole cycle. The same applies to other common SSA cancers, prostate, cervix, etc. Prevention is always cheaper and better than cure!. Treatment outcomes are invariably better if cancer is detected early.

It is okay to conduct trials on treatment but effort should also be directed at cancer awareness / health promotion and prevention. Whole cancer care services are needed all over SSA.

Joseph Ana. 

Africa Center for Clin Gov Research & Patient Safety

@ HRI West Africa Group - HRI WA

Consultants in Clinical Governance Implementation

Publisher: Health and Medical Journals 

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Cross River State, Nigeria

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