Dr Usman Malami Aliyu is the Director General of the National institute for Cancer Research and Treatment (NICRAT). Aliyu, who is also an associate professor of Radiation and Clinical Oncology in this interview, spoke on strategies to change the cancer narrative in the country through the newly established institute, and the need for increased funding for cancer research, among others.
Can you briefly tell us about the burden and impact of cancer in Nigeria?
In Nigeria, cancer caused over 78, 000 deaths in 2020 alone, (34, 200 for male and 44, 699 for female.
This number is set to increase given that there are 120, 000 new cases of cancer every year.
The estimated incidence for breast cancer is 27%, cervical cancer is 14%, liver 12%, prostate 12% and colorectum 4.1%.
Cancer has an immense socio-economic impact on individuals, families, communities and the health system.
It is often associated with a protracted course of illness and loss of productivity, resulting in significant physical, psychological and financial burden in an increasingly younger segment of the productive population.
The huge burden of cancer is compounded by a severely limited capacity of low income countries like Nigeria to provide the necessary health care.
Late stage presentation and in-accessible diagnosis and treatment are common.
It is in this regards that the former President and Commander in Chief of Nigeria, Muhammadu Buhari signed into law, an act for the establishment of the National Institute for Cancer Research and Treatment (NICRAT) in 2017, and appointed a director general who is the chief executive officer of the institute with the aim of steering leadership in cancer research, prevention, treatment and control.
What are the key objectives of the institute?
They strategic focus of the institute as enshrined in the act are as follows:
-Policy advisory in cancer prevention, treatment and control.
-Regulate and enhance access to cancer care in Nigeria.
– Research and development in cancer prevention and control.
-Establish and maintain a cancer registry.
-Public education and awareness creation in cancer.
-Capacity development in cancer prevention and control.
Considering the magnitude of cancer, how much was budgeted for your institute in the 2023 budget?
My appointment vis a vis the institute came into being in January this year, that is about six months ago. So, we have already missed inclusion in the 2023 budget. To be included in the 2023 budget, you have to be in existence before January 2023. We don’t have anything now but we are hoping to be in the 2024 budget.
What are your plans for collaboration with international organisations for funding and cancer research?
There are a lot of international organisations and agencies that are waiting to partner with the institute. The institute is a replica of the National Cancer Institute in America, Canada and some other places. We have waited a long time for this institute. They have actually been supporting a lot of cancer activities within the country before now.
We intend to unveil our strategic plan very soon. It will set a road map that will make it very visible to the donors; that this is what we intend to do and it is only then, we hope to catch the full attention of the donors.
So, we are currently in communication with a lot of them. And they have shown interest to collaborate in at least 60 to 70% of our activities.
The institute has also started some research. We had an interaction recently with the National Institutes of Health in America. We are assured of funding for that research. It is in the area of mapping.
Before you do anything you have to know the baseline. So, the first research the institute wants to do is mapping of the resources in the cancer space.
Be it human resource, let us know the workforce, the manpower that we have, the specialists that we have, the surgeons, cutting across surgical oncologists, medical oncologists, radiation clinical oncologists, and the community health people that are working in cancer, even the advocates.
So we intend to carry out general mapping on the burden of cancer in the country and it will tell us the prevalence, and incidence.
This is because most of the problems we have, these projections on the cancer burden that we have currently are purely hospital based and they are just a tip of the iceberg.
Mapping will also help us to grade the cancer centres and know those that are qualified to be called cancer centres in the first place, and the best place for the treatment of certain kinds of cancers.
What are the challenges of the institute so far?
There are some hurdles. The first one is that of the lack of information that I have mentioned. Though we have started our activities, the major one that we are banking on that will give us focus and direction is the mapping that we intend to do.
So it will give us the information we need.
Some programmes were also already on ground before we came in so, we are trying to integrate them. We are also working with the National Cancer Control Programme (NCCP). The Cancer Health Fund is there and some people have been operating it before we came, so we have to follow due process to get it and others within our mandate.
Then the most important one. It is actually just an appeal to the federal government. This institute needs a lot of funding so that we can embark on a lot of research because research is the answer to the problems that we have in the cancer space in the country.
It is through research that you can identify the best preventive mechanisms likewise diagnosis.
We are still evolving in the area of diagnosis, so it is through research that we can come up with newer modalities that we can use to make a diagnosis of cancer.
Yesterday somebody shared that an institute in the United Kingdom has started a research on a blood test to identify cancer even before the signs and symptoms appear in the body of the person. So it identifies the cancer DNA. And it is going to be a ground breaking research and game changer in the area of cancer prevention.
It is at the preliminary stage but they want to go into a full clinical trial. We intend to reach out to them to see how we can actually collaborate.
Funding research is not actually #20 billion or trillion. You can put virtually any amount into research.
So we are calling on the federal government to fund the institute adequately so that we can embark on research and change the cancer narrative in the country.
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