Burden of cancer morbidity and mortality in Tanzania to be reduced

Dar es Salaam, Tanzania, 16 December 2019 - To combat the rise in cancers and enhance comprehensive cancer care in Tanzania, the Government of Tanzania, the Aga Khan Health Services (AKHS), and the French Development Agency (AFD) today signed a grant agreement and memoranda of understanding related to an innovative Public Private Partnership project of 38 billion shillings (approximately €13.3 million).

With the global rise in the prevalence of non-communicable diseases, cancer is becoming an increasingly important public health issue. Tanzania and other developing countries are disproportionately affected by cancer, where a dramatic rise in cancer incidence and mortality is seen.

The rise in cancer places an enormous burden on the Dar es Salaam-based Ocean Road Cancer Institute (ORCI), which until 2014 was the only public cancer hospital responsible for serving the country’s 55 million inhabitants. Despite the addition of oncology services at Bugando Medical Center (BMC) in Mwanza, the number of cancer cases, usually presenting at late stages, continues to rise. Significant investments into each component of the cancer continuum from prevention, screening and early detection, continuing into diagnostics, treatment as well as palliative care and survivorship are needed to strengthen the quality of cancer care in Tanzania.

To address challenges facing cancer care in the country, Tanzania Comprehensive Cancer Project (TCCP) was aimed at strengthening and expanding the quality of access and the capacity of cancer care services through an innovative public private partnership (PPP) initiative.

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Mr. Frederic Clavier, Ambassador of France, and Dr. Gijs Walraven, Director of AKDN Health Services, are seen after signing the Grant Agreement for the Tanzania Comprehensive Cancer Project.

Copyright: 

AKDN / Venance Nestory

This project, funded by a €10 million grant from AFD and €3.3 million contribution from Aga Khan Foundation Geneva, builds on the long history of successful cooperation between AFD and AKHS-T in the health sector in Tanzania, including the recent inauguration of the Aga Khan Hospital’s expansion in Dar es Salaam on 9 March 2019.

On behalf of Chief Guest Hon. Ummy Mwalimu, Minister of Health, Community Development, Gender, Elderly and Children, government of Tanzania, the Deputy Minister Dr. Faustine Ndugulile said, “This project will directly benefit approximately 1.7 million people. The project will build the capacity of health personnel and community social workers at all partner institutions and participating communities. Expanding the range of cancer services using outreach programmes is to result in increased demand for quality primary health care services and improved referral mechanisms to secondary and tertiary centres. The project is also intended to contribute to improved knowledge, practices, and health seeking behaviours of the target groups and their communities. The public private partnership will not only increase the probability to achieve better access to quality cancer services, but also result in knowledge sharing and identification of good practices through establishing Memoranda of Understanding and service agreements signed today."

Hon. Dr. Faustine Ndugulile added, “In the four years of this project, the government expects to have major impacts: at least 60% of the country population to be reached by awareness campaigns via blends of communications channels; and increased access to oncology services from prevention, screening, diagnosis, treatment to survivorship especially to the under-served rural population. Currently, only 10% of cancer patients in the country reach hospitals. We expect to increase this number to at least 20% by the end of the project, reducing the rate of advanced stage presentation. Today 75% of cancer patients present at late stage 3 and 4. This is expected to be less than 50% by the end of the project.

“The government is also expecting increase Human Papilloma Virus (HPV) vaccination uptake and establishment of the first molecular and digital pathology laboratory in the country that will serve the whole country to better characterise tumours and offer personalised treatment, roll out the 1st ever mobile cancer screening unit that expects to direct serve at least 1.7m clients, at least 100 community health facilities will be trained and capacitated to offer basic oncology care including screening, diagnosis, early referral, palliative care and survivorship and 330 healthcare workers from tertiary up to dispensary level will be trained by the project hence reduction of treatment costs by establishing cancer consortium in collaboration with MSD that will be able to do group purchases, hence leverage better prices/deals for anticancer drugs, pathology reagents and other consumables including collaborative research and statistics for cancer together with National Institute for Medical Research (NIMR)."

Dr. Harrison Chuwa, Consultant Oncologist at The Aga Khan Hospital and Director for TCCP said, “The Comprehensive Cancer Project is a four-year plan and is a high-quality, evidence-based initiative designed to reduce the burden of cancer morbidity and mortality in two target regions of Dar es Salaam and Mwanza in Tanzania. This will be achieved through a strategy that focuses on the enhanced performance and expanded outreach of the Tanzanian-based implementing partners, including Aga Khan Health Service, Tanzania (AKHS-T), Ocean Road Cancer Institute (ORCI), Muhimbili National Hospital (MNH), Bugando Medical Centre (BMC), Dar es Salaam and Mwanza regional secretariats under the President office regional and local government (PO-RALG), and Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) with technical support from Institut Curie in France in delivering the full range of cancer services in the two-targeted regions in Tanzania."

Dr. Chuwa added that “TCCP will adapt a health system strengthening approach focusing on addressing leadership and governance, health information systems, essential medical products and technologies, human resources, health financing, service delivery and partnerships to ensure the comprehensiveness of the project. The development of a partnership between government and private institutions is to contribute to the creation of a strong, integrated cancer care network in targeted regions. The partner institutions have a long presence in Dar es Salaam and Mwanza with a strong understanding of the cancer landscape in the local communities, including functioning and requirements of local health systems. AKHS-T and partners are well equipped to enhance the quality cancer care provision and to address the large health challenges of cancer in Tanzania. The approach will create an integrated health care network at local and hospital levels to accelerate performance in cancer care and expand to underserved areas and low-income target groups.”

Addressing the objectives of this project Ms. Stéphanie Mouen, the Country Director of French Development Agency in Tanzania said, “TCCP is an innovative initiative of 38 billion and is aimed at enhancing comprehensive cancer care in Tanzania“. She added that this project would have very strong social and financial commitments that have been agreed with the implementing agencies on creating greater access for the vulnerable population. Social contributions through care subsidisation will lead to needy cancer patients and those holding the National Health Insurance from NHIF receiving support in different medical programmes of oncology, at both primary to tertiary level care.

The financial contribution from the Aga Khan Foundation is intended for the supervision and management of the project and to build the capacity of staff, at all institutions, in the full spectrum of cancer care (in collaboration with various French and international referral training institutions such as Institut Curie). She further stressed, “these commitments have been decisive in AFD’s decision to indeed participate in the financing of the project. They are aligned with the objectives pursued by AFD to ensure such projects, which are intended to maximise the desired impact for target populations."

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Professor Lawrence Museru, Executive Director, Muhimbili National Hospital, and Mr. Sisawo Konteh, COO, Aga Khan Health Service, Tanzania are seen here together after signing of the MOUs for the Tanzania Comprehensive Cancer Project.

Copyright: 

AKDN / Benazir Karim

For more information:

Olayce S. Lotha
olayce.lotha@akhst.org
+255 717 516 650

Mrs. Bérénice OREYO-PIERRONNET
oreyopierronnetb@afd.fr
+255 683 68 19 88/ +255 769 18 45 02