Cancer patients bear the brunt of drug, equipment shortages

Lazarus Sauti

Zimbabwe is not battling food famines only, but massive shortages of essential drugs at major provincial and district health institutions.

The situation is putting the lives of citizens, mostly in rural areas, at risk as most – if not all – public health institutions in the country’s remote areas, for instance, are facing drug shortages.

In fact, drug access and drug availability are major challenges at these health institutions.

Itai Rusike, executive director of the Community Working Group on Health (CWGH), a network of civic or community based organisations that aim to collectively enhance community participation in health in Zimbabwe, concurs.

“Drug supplies at rural health institutions are problematic and a constant source of client discontent seeing that the approximately 1 500 clinics in Zimbabwe are the last step in a long chain of drug procurement and distribution,” he said.

Due to drug shortages, Zimbabweans, in both rural and urban areas, are forced to buy expensive drugs at private pharmacies.

Cancer patients in the country are hit most since most public health institutions do not have cancer equipment, drugs, oncologists and adequate information to rein the disease which is claiming the lives of many Zimbabweans.

Last year provincial and district hospitals throughout the country faced an acute shortage of drugs for cancer, a situation which put the lives of many patients at risk.

A cancer patient in Macheke, who requested anonymity, says drug shortages put her in a fix as she is forced to buy expensive drugs.

“I used to buy cisplatin (cancer drug) in Harare for US$20, but of late, I was forced to travel to Bulawayo as I could not find it in any of the pharmacies in Harare. I was forced to buy the drug for US$85 in Bulawayo, thanks to drug shortages,” said the patient.

Many Zimbabweans, desolately, are dying of cancer without being diagnosed or treated due to ignorance or failure to access medication due to drug shortages and the high costs of cancer drugs and treatment, a fact supported by Makurirofa who said “statistics do not paint a true picture of the ravages of cancer as many people with cancer go undiagnosed.”

“Cancer cases are on the increase and statistics are an underestimation of the situation on the ground. It is not everyone who can afford to get screened or diagnosed and yet statistics are based on those who would have been diagnosed or screened,” he said.

In Zimbabwe, Makurirofa added, breast cancer, for example, affects one in every 10 women and one in every 100 men has to battle prostate cancer mostly affecting males above 50 years.

“Cancer, which falls under non-communicable diseases (NCDs), is the new killer as it has overtaken HIV and Aids as the leading killer in Zimbabwe,” added the World Health Organisation (WHO) Zimbabwe Report 2014.

The report added: “Cancers topped the list with 10 percent of deaths in the country followed by cardio-vascular diseases (nine percent), chronic lung diseases (three percent), and diabetes (one percent).”

A report from the Zimbabwe National Cancer Registry (ZNCR), also noted that more than 6 000 cases of cancer were recorded countrywide last year.

Of growing concern, adds Kidzcan Zimbabwe, is the emergence of childhood cancers since they accounted for more than 3 percent of the cancers recorded in 2013.

According to research done by KidzCan Children Cancer Relief Organisation Zimbabwe, the only organisation in the country dedicated to increasing the survival rate of children with cancer, in 2014, 243 new cases of cancer in children were reported and 106 children died from cancer-related illnesses.

“Although childhood cancers (age 0-14) are a rare condition worldwide, the incidence in Zimbabwe is rather high,” added ZNCR registrar, Eric Chokunonga.

Resource constraints, currency shortages, losses in supplied drugs, expiring drugs and theft of the drugs, says Rusike, affects drug availability and further complicates the lives of both adults and children.

“Theft and leakages of drugs from the public sector and sales of drugs brought onto the country for personal use are causing drug shortages and putting the lives of patients at risk,” he said, adding that some unregulated drugs are finding their way into the black or informal markets, making it difficult to ensure quality or appropriateness of drugs, avoid side effects and complications and also problems of resistance that can happen in unregulated use of drugs.

Rusike, consequently, says the government needs to do more in addressing drug and equipment shortages and ensuring the provision of basic, accessible and adequate health services throughout Zimbabwe, as per section 29 of the country Constitution.

“The government, sadly, is not doing much in addressing this sitting time bomb which requires substantial resources to make a meaningful impact,” he said.

Rusike added that the government needs to seriously work on domestic financing of cancer awareness as well as prevention so as to improve the provision of essential drugs as well as improving staff pay and training, especially for workers in preventive services, clinics and district hospitals.

“Cancer is a very expensive disease that many today do not have access to treatment, even if they do, they cannot afford the drugs or the surgery needed to remove such ailments.

“The government, therefore, needs to increase domestic funding if the country is to effectively deal with the new killer disease.

Lovemore Makurirofa of the Cancer Association of Zimbabwe (Cancer Centre), a non-profit making organisation formed in 1961 by a group of cancer survivors and volunteers in a bid to support each other morally, emotionally, spiritually and physically, says the shortage of cancer drugs as well as equipments is worrying because any disruptions in taking cancer medication might result in treatment failure.

“Cancer treatment involves killing off the harmful cells and so if treatment is stopped before the prescribed cycles, cancer might recur,” he said, urging the government to take necessary measures to arrest drug shortages and improve the livelihoods of citizens.

“This is so because section 76 of the country’s new charter recognises the right to health care of citizens and permanent residents of Zimbabwe.”