CANCER IN POOR COUNTRIES

Henry Miller Hoover Institute Stanford University

Post Courier 8 August 2011

a comprehensive and professional report

Cancer is sometimes thought of as a disease of wealthier countries but it is a major cause of mortality in poorer ones as well.

By the end of this decade, about 150 million people worldwide will have cancer with about 60 residing in developing countries.

Fewer people in developing countries live to an age at which cancer is prevalent but inadequate nutrition and exposure to viruses and toxins combined with a paucity of diagnostic and treatment options, increase the incidence and lethality of cancer.

Many people from poor countries die from cancers that are treatable in wealthier societies, but they often succumb to other scourges as well such as infectious diseases.

Most countries lack the funds, equipment and qualified personnel needed to provide basic care for cancer patients. Thirty countries – half in Africa – do not have a single radiotherapy machine.

And these countries certainly do not have the financial resources, facilities, equipment, technology, infrastructure staff or training to cope with long-term demands of cancer care.

As the United Nations own data makes clear, infectious diseases many of them preventable and treatable remain the scourge of poorer populations.

In 2008, about 250 million cases of malaria caused almost a million deaths. In all poor countries, there is inadequate access to anti-malarial medicines, especially artemisin based combination therapy.

The incidence of malaria could be reduced drastically by application of mosquito-killing DDT but the UN and national regulators have curtailed its availability owing to misguided notions about its toxicity.

Hundreds of millions suffer from other neglected tropical diseases, including lymphatic filariasis and cholera.

Although new HIV infections worldwide have declined slightly in the past decade, 2.7 million people contracted the virus in 2008 and there were 2 million HIV related deaths.

By the end of that year, 4 million people were receiving antiretroviral therapy, but more than 5 million who were HIV positive remained untreated.

The number of new cases of tuberculosis worldwide is increasing and the growing emergence of multi-drug resistant strains of bacteria is very worrying.

According to the UN statistics, about 15% of the world’s population lacks access to safe drinking water. IN 2008, about 2.6 billion had no access to an hygienic toilet while 1.1 billion were defaecating in the open.

Primitive approaches to managing sewage continue to spread infections such as schistosomiasis, trachoma, viral hepatitis and cholera.

Many cancers are likely caused by chronic viral infections, another reason why it is surely more sensible to attack the viral infections by improving access to clean water, basic sanitation, antibiotics and vaccines rather than build a radiotherapy facility.

Many poor countries do not have a single medical school. When their citizens study abroad they stay there. Or they are ill equipped for working back home.

Public health efforts to curb air pollution and smoking could reduce the prevalence of lung cancer in Asia and Africa.

Cervical cancer can be treated by vaccines against human papilloma virus. Acetic acid can be used to visualize cervical cancers that can be treated with cryotherapy.

The bottom line is that in a world of limited health-care resources, we need to make hard decisions that will deliver high impact outcomes for the most people at the least cost.

COMMENT: As a lay person, I find this to be an amazing report that sets out the issues in a comprehensive and valid way in relation to cancer in poor countries.  It comes back to eradicating viruses and the implementation of basic health procedures.

On the issue of the reduction in HIV infection across the world, there seem to be logical reasons. We have already seen reports from UNAIDS and Burnett (PNG) in which they allude to the fact that the reduction in PNG is due to their policies and strategies. Not true.

It is suggested that the reduction is caused by the world community starting to understand the causes of HIV infection. Blood transfusion testing has improved.

Drug addicts may not be sharing needles as they did. Families are keeping closer watch on the children. The message of HIV infection is making the world careful.

At the same time, men are seeking sex with virgins. Gays, lesbians and paedophiles want virgin girls and boys rather than older people who may have HIV infection. Hence their strategy to break up families to get access to their junior sex fodder. There are millions of kids out there.

Men may be more careful in their adultery and polygamous relationships. More men and women may be using condoms, male and female.

The world infection rate is dropping. But the world gay infection rate is rising. Gays are not being careful either with HIV or gut parasite infections. Perhaps they know they are doomed by their own sexual practices of anal sex, rimming and fisting.

The sad news is that 5 million people do not have access to ARV drugs. That means that they will go through the classic symptoms unto death.

They will suffer chronic diarrhoea, loss of weight, destruction of the gut wall, loss of finger and toe nails, loss of hair, onset of dementia, loss of memory, paranoia, incontinence, delusions and delirium.