Co-authored by Dr. Fidel Rubagumya, Oncologist in training and Founder & Board Chair, Rwanda Children's Cancer Relief
Last week, the CEO of pharma giant AstraZeneca, Pascal Soriot, went on record stating that, when it comes to cancer in “Africa, we could give our products away and it would make no difference.”
As cancer advocates fighting for equitable treatment for cancer, one of us as a doctor from Rwanda who is training to be a clinical oncologist in Africa, we find Mr. Soriot’s statement absurd and saddening. Across a continent with over 645,000 new cancer cases diagnosed and 456,000 cancer deaths reported in 2012 alone, unacceptable arguments that ‘it’s just too complicated to try’ are holding us back from saving thousands of lives from cancers for which effective treatments currently exist.
Affordable medicines for cancer matter across Africa and other developing countries, just like they do in North America or Europe.
While we agree that trained doctors and adequate infrastructure are paramount to provide necessary treatment for cancer patients, we simply cannot wait another 10 years to train more Oncologists and build cancer centers before AstraZeneca and other multinational pharmaceutical companies reduce their impoverishing cancer drug prices.
Mr. Soriot has never sat with a breast cancer patient, who can’t even afford two meals a day, to tell them that the drug they need to survive costs USD 1000. The patient literally laughs at you, despite the excruciating cancer and the heartbreaking reality of the situation.
Oncologists and non-oncologists in Africa treating cancer are too often hamstrung when it comes to providing care for their cancer patients, because there are no affordable treatments available. For example, far too many HER2-positive breast cancer patients are not treated as we know they should be, simply because patients can’t afford trastuzumab, the lifesaving medicine required for this type of cancer.
Would you want to know that you had cancer, if you could not afford the treatment to save your life?
In 2012, the Government of Rwanda, together with partners like Partners in Health, the Dana Farber Cancer Institute, the Clinton Foundation and others, opened the Butaro Cancer Center in the rural north of the country. To start, the center had no oncologists and physicians had never treated a cancer patient. But Rwandan doctors refused to let their brothers, sisters, parents, relatives and fellow countrymen die of treatable cancers. With immense dedication to learning, as well as Government and international partner support, Rwandan doctors have saved the lives of countless cancer patients who would otherwise be dead. The Butaro Cancer Center partnership has believed in and delivered solutions. An important part of this was to provide cancer drugs to patients free of charge. As an example, a patient diagnosed with Chronic Myeloid Leukemia is now treated at the Butaro Cancer Center in Rwanda just as they’d be treated at the Dana Farber Cancer Institute in the United States.
Essential medicines are a basic human right, period.
Health advocates have been fighting for affordable medicines, mostly for infectious diseases in the global south for about two decades. Increasingly, this battle is including medicines for cancer and other chronic diseases. Last year, the World Health Organization added 16 new lifesaving medicines for cancer to their Model List of Essential Medicines. This list guides drug procurement, reimbursement and donations worldwide. The message WHO has sent is that cancer medicines, just like lifesaving medicines for infectious diseases, should be made available and affordable to all people who need them, regardless of where they live. Patients who’ve been able to afford essential cancer medicines across Africa have been treated by doctors and are alive to testify to this.
Mr. Soriot’s comments echo a statement made by the CEO of the pharma company Bayer in 2014, that the company’s cancer medicines were made for “Western patients who can afford it”. The AstraZeneca CEO further declared that the implementation and infrastructure challenges to deliver the necessary healthcare in Africa are too great. This is an old and disproven argument that kept HIV/AIDS medicines out of the hands of patients in low resource countries prior to 2002. We will not accept arguments that serve to distract from unsustainable medicine prices, particularly in the face of cancer drug prices that are increasingly breaking the bank for even the wealthiest nations.
While the challenges to cancer care across Africa are real, they are not insurmountable. The Butaro Cancer Center is but one testament to this.