The cancer crisis in South Africa is becoming insurmountable, where access to cancer treatment and care is disproportionately associated with socio-economic status, access to health insurance, and geographic location.
With high costs, many standard-of-care treatments are unaffordable for partially insured or uninsured patients. The situation is made worse by long waiting lists, inadequate human resources, and infrastructure weaknesses.
These inequities are something that radiation oncologist Dr Sudeshen Naidoo hopes to correct. He established the Johnson-Rose Cancer Foundation, which was named after his father and aunt, and is addressing the human rights situation using a bold, multifaceted strategy.
His plan is simple. Get private oncologists and treatment providers with the capacity to step up to alleviate the burden on a health system under pressure and help those patients who cannot afford to wait for treatment.
“One of the objectives of the foundation is to increase the number of oncologists in South Africa by funding doctors to specialise in the field and to try and retain them in the state sector.
“Secondly, equitable access to cancer care for partially insured and uninsured people of this country. By directly funding treatment with curative intent, we can prevent many avoidable deaths. The third objective of the Johnson Rose Cancer Foundation is to support families and communities that have been affected by cancer through access to counselling and other support services.”
Dr Naidoo is no stranger to tragedy. He disclosed that in 2019 his father, Dr Johnson Naidoo, was diagnosed with stomach cancer that was aggressive and ultimately fatal. He underwent a successful surgical resection, but because of the adverse effects and his advanced age, he was unable to complete his chemotherapy and radiation treatment.
He firmly believes his life experiences have shaped his understanding of the complexities involved in enabling access to treatment in South Africa.
Dr Naidoo further asserts that the cancer crisis in South Africa will continue for one simple reason – 85% of the population is serviced by only 15% of the oncologists in the state sector, while 85% of the oncologists are currently in the private sector, servicing only 15% of the population who are insured. There are simply not enough oncologists, which eventually results in inefficiencies in the state sector.
“We know the current public health care system is under immense pressure and in crisis. However, cancer is a time-sensitive disease; the sooner a patient receives evidence-based treatment the better the outcome for them. Unfortunately, in some geographical areas, a fair number of cancer patients need to wait months for treatment to start. Even if they receive surgery and chemotherapy, the waiting lists at radiation oncology units are months-long.”
Naidoo says radiation must be given within a specified window period, which is either two to four weeks after chemotherapy or four to seven weeks after surgery, depending on the stage of the disease. All of those patients are anxiously expecting care and recovery, but he notes that because patients may have waited for too long, their condition may return.
This negatively affects families, and cancer treatment results in the loss of economic resources and opportunities for patients, their families, communities, and society overall. Children are at particular risk of dropping out of school especially when the sole breadwinner is sick.
The foundation understands these complexities and will take a multi-disciplinary approach that integrates services to focus on the patient and their families. The aim is to partner with the government, other NGOs and organisations, and refer patients and their families for additional services when required. This includes support services for transport and accommodation to access treatment and care, and referral to services in the community, including palliative care and counselling.
Co-founders Dr Keo Tabane and Dr Omondi Ogude are part of a team of committed cancer care experts that run the Johnson-Rose Cancer Foundation. A group of professionals from the South African oncology community, including oncologists, business and managed health care professionals, patient advocates, and social workers, make up its board of directors. Importantly, the foundation is also creating an academic advisory committee, which will provide policy and process recommendations. This committee is open to all government oncology heads of department.
“We can only close the gap in cancer care if we have your support and your investment in the people with no voice who need our help.”
To learn more about the foundation and how you can help uninsured South Africans to receive cancer treatment and care, visit www.johnsonrosecancer.org.