On 7-10th November 2017, Rwanda will host yet another major international conference. It’s not an AU or UN summit but instead a conference to talk about cancer. The International Conference on Cancer is a biennial conference organised by the African Organisation for Research and Training in Cancer (AORTIC) and is hosted by different Africa countries. Rwanda will be privileged to host the 11th AORTIC Conference. As a Rwandese physician involved in the provision of cancer care, research and advocacy I am very excited to welcome colleagues from other African countries and around the globe to my home country. The conference, over five days, will feature a variety of sessions with topics ranging from cancer biology, treatment, economics and control, pain management and many others. This meeting on cancer in Africa will attract around 1,000 cancer specialists, pathologists, nurses, public health specialists, cancer patients, and survivors. Rwanda, like many of the Sub Saharan Africa, has seen a tremendous increase in cancer incidence in recent years. The required medical personnel, infrastructure and awareness of the disease have not even come close to matching this huge and increasing burden. However despite these challenges, Rwanda has shown the political will to move things in the right direction. Rwanda is among only a few countries throughout Africa that allocated more than 15% of its total budget to health care, in accordance with the 2001 Abuja Declaration by African Union countries. With this allocation and other efforts, over the last five years, we have seen significant progress in cancer care, advocacy, policy, training and research. Hosting this conference in Kigali is a testament to the achievements of Rwanda and the trust that the oncology community across both the continent and globe has for our country. In reflecting on the previous status of cancer care and hosting the largest African cancer conference, one has to acknowledge the efforts and contributions of many that have brought Rwanda to where we are now. As a medical student, in 2012, I attended this little girl who had a very curable cancer type called Hodgkin’s Lymphoma (named after the scientist who first described it). This disease attacks the lymph nodes and can affect both children and adults. This disease is commonly treated with a concoction of four drugs given several times every few weeks (cycles). These drugs, however, are expensive and not every ordinary Rwanda can afford the 6-8 cycles that can lead to cure. The family of my patient sold properties and their cows to make sure their child received good treatment. During this time there was no pharmacy in the country that sold these drugs and while occasionally, good Samaritans would bring these drugs, this supply was unpredictable. The family would travel to Uganda or Kenya to buy drugs and bring them to our hospital via buses - but no one knew if these drugs were good quality, safe, or counterfeit. Sometimes we were only able to give her one drug out of the four required and other times she would spend two months without any drugs despite being scheduled for a cycle every 3 weeks. This story is not only typical of Rwanda but many other low-income countries across Africa and this persists even today. Despite all these challenges, this child managed to finish treatment and six years later, she is a happy adolescent girl in high school and doing well in class. I talk to her on occasion and not only am I grateful for her health but it reminds me where, as a country, we have come from in cancer care but also of the many lives we have lost due to unaffordable drugs and inaccessible care. Why this story? And why does it matter? -That was the state of oncology in 2012. Despite the happy ending for this child, the family had to bear a huge financial and travel burden coupled with anxiety and uncertainty about the consistency and availability of care. Right now any child in Rwanda with a similar condition can get a full treatment course free of charge and when needed, some are even referred for radiotherapy thanks to partners in this cancer fight. We have achieved huge strides in universal access to care and families need not sell their cows and jeopardize their livelihood to get treatment for their children. In 2012, Rwanda had no trained oncologists but now we have three practicing oncologists (radiation, pediatric and gynecological) and five in training in different fields. Just years ago, we had only a few surgeons who could operate on the different types of cancer, no Rwandan pathologists and a handful of radiologists. Today, the top referral hospitals are all able to offer pathological and imaging diagnostic capacities and there are many private laboratories and diagnostic imaging centers as well. While then we had no pharmacy that could provide chemotherapeutics, currently, several pharmacies are selling many of these cancer medicine and insurance companies have added these drugs on their premiums. Different oncology care services from diagnostic, management and palliative care are offered at tertiary hospitals throughout the country. Radiotherapy treatment the only service not yet offered in Rwanda, but plans are in progress to get started in few months. Cancer care is complex and requires a national health system approach. As such, Rwanda now has cancer policies and plans generated and executed by a dedicated cancer unit the Rwanda Biomedical Center under the Ministry of Health. We have come a long way! All these are achievements we must celebrate and build on. Given the trajectory of cancer care in Rwanda, it is indeed excellent timing that we are hosting the biggest event in cancer in Africa: the AORTIC conference. Hopefully by the end of this conference more strides in cancer care will be made and solutions created. Murakaza neza! The writer is an oncologist by training and Founder & Board Chair, Rwanda Children’s Cancer Relief. The views expressed in this article are of the author and do not necessarily represent those of The New Times.
