MADISON, Connecticut — Cancer treatment in impoverished countries is an issue that is extremely consequential to millions of people. Although the entire world deals with cancer in some way, developing nations account for nearly two-thirds of the total 7.6 million global cancer deaths, according to the Harvard Chan School of Public Health.
Health Care Disparities
High-income countries, such as the United States, France and Japan, have the economic funding and resources to skew the fight against cancer a little more in the favor of their people. With cancer prevention initiatives, modern treatment facilities and a plethora of public health campaigns, people are able to educate themselves about cancer risk factors and schedule regular checkups to make sure that they are staying on top of their health. In contrast, according to a 2017 article published by Cancer.Net, 29 of the 52 countries in Africa do not have radiation therapy centers, hindering patients from accessing the most common form of cancer treatment.
According to the same article, the numbers are simple: higher-income regions expend five to 10 times more on individual health care than lower-income regions, and as such, in higher-income regions, more than 50% of people with cancer survive. The statistics are not as favorable in impoverished parts of the world as just 34% of these patients survive the disease.
Roberta Lombardi is a 55-year-old breast cancer survivor who resides in the U.S. state of Connecticut. After overcoming her battle with cancer almost six years ago, Lombardi founded Infinite Strength, a nonprofit organization that provides financial assistance to underserved/underinsured single mothers with metastatic breast cancer in the northeastern part of the U.S. Since starting Infinite Strength in 2018, Lombardi has worked with some of the most renowned oncologists and surgeons in the country, witnessing the unfortunate link between poverty and cancer.
Cancer is a global health issue as the World Health Organization predicts that by the year 2035, “the world could see 24 million new cancer cases and 14.5 million cancer-related deaths a year.”
The Poverty Factor
As the American Cancer Society stated as far back as 2011, poverty is “one of the most potent carcinogens” that exist. Low-quality cancer treatment in impoverished countries is largely due to the significant lack of cancer prevention programs and policies. Detections and screenings are extremely rare so, when a patient finally does go for a check-up, the disease has often already progressed too far to warrant treatment.
For example, cervical cancer is detectable and, in many cases, very curable in comparison to other forms of cancer. However, in Africa, cervical cancer is the “leading cause of cancer-related death among women,” according to a study published in 2020 by Rodney Hull and others.
In an interview with The Borgen Project, Lombardi says, “Disparities are [visible]in people from low-socioeconomic groups, certain racial/ethnic populations and those who live in geographically isolated areas.”
People living in impoverished parts of the world have a more difficult time accessing and utilizing health insurance, inhibiting many from getting treatment even if they had a good prognosis originally. Poorer people are also subjected to environmental factors that are known to cause cancer, such as air pollution, arsenic exposure and secondhand smoke from tobacco.
“Although substantial progress in cancer treatment has been made over the years,” Lombardi states, “addressing cancer health disparities, such as higher cancer death rates, less frequent use of proven screening tests and higher rates of advanced cancer diagnoses in certain populations is an area that still needs a lot of improvement.”
The Availability of Medical Professionals and Technology
Cancer treatment in every part of the world significantly depends on the quality of medical professionals who are able to diagnose and treat patients. The availability of clinical oncologists and oncological surgeons is extremely limited in impoverished countries, which is largely due to a lack of proper education and equipment. The lack of technology in poorer areas means that physicians depend primarily on experience and knowledge, whereas physicians in the U.S. can run CT scans and MRIs in order to form a diagnosis.
Lombardi acknowledges that “Socioeconomic factors (poverty and race) are major contributors to cancer health disparities as lack of education leads to lack of good employment (if any), which leads to lack of insurance and living in areas that are not in close or even in reasonable proximity to quality health care facilities.”
While the issue of cancer treatment in developing countries is not often a topic of discussion, there are organizations that are working to expand access to high-quality chemotherapy and radiation treatments around the world.
The Assistance of CHAI
Founded in 2002, the Clinton Health Access Initiative (CHAI) works with the mission of “reducing the burden of disease in low- and middle-income countries.” CHAI runs in more than 35 nations across the globe to increase access to medicines, treatments and technology to prevent and treat several diseases, including cancer.
In 2015, CHAI entered into a partnership with the American Cancer Society “to increase access to high-quality and affordable treatment, strengthen health worker capacity and help governments establish plans to comprehensively manage the disease,” the CHAI website says.
Following on, in 2017, the two partners announced “a groundbreaking agreement with pharmaceutical manufacturers,” the Cancer Access Partnership, which would allow cost-effective access to 26 critical cancer treatments across 30 nations in Asia and sub-Saharan Africa.
In 2021, the partnership expanded, increasing access to treatments in these regions for 30 types of cancers. The agreement has led to 59% savings on cancer treatment costs for countries and has doubled the number of breast cancer patients receiving treatment in Ethiopia alone.
Cancer is not just a domestic issue, but rather, a global health crisis. Furthermore, “There’s this myth that treating cancer is expensive,” Dr. Christian Rusangwa, a Rwandan doctor with Partners In Health, tells NPR. “And that’s because the data is almost all from high-income countries,” he says further. Organizations such as CHAI require the support of the international community to ensure greater access to cancer treatment for the impoverished in developing countries.
– Ava Lombardi