October is International Cancer Awareness Month (ICAM) with special emphasis on breast cancer. It is an important month to once again draw the attention of all, to the waste of precious lives and resources as a result of the huge gap in Nigeria’s health infrastructure especially the infrastructure for cancer care, and how we could bridge this gap.

Cancer is the single most important barrier to increasing life expectancy in every country of the world. Therefore, Nigeria’s low life expectancy which is the seventh lowest globally will not improve unless we tackle cancer seriously.

According to the International Agency for Research on Cancer (IARC), in 2019, cancer was the first or second leading cause of death before the age of 70 years in 112 of 183 countries. Globally, there were 19.3 million new cases in 2020, with over 120,000 occurring in Nigeria alone. There were 10 million global cancer deaths in 2020, with 70% of the deaths occurring in developing nations like Nigeria.

In 2020, breast cancer overtook lung cancer to become the most common cancer in the world. There were about 685,000 deaths from breast cancer worldwide in 2020 (IARC statistics). Like cancer in general, the global burden of breast cancer mortality is marked by inequality; 75% of global deaths from the breast cancer occur in developing countries. In Nigeria, 40 women now die daily from breast cancer (up from 32 in 2018).

Most of these cancer deaths are often due to late detection and poor infrastructure. For instance, whilst India has over 200 Comprehensive Cancer Centres (CCC) - most of which are philanthropy-funded non-profit institutions, Nigeria has none. Some African nations that have CCC include Egypt, Uganda, Tanzania, South Africa, Kenya and Sudan.

Nigerians now spend over $1 billion dollars on foreign treatment annually, an amount sufficient to establish twenty (20) CCC every year. Unfortunately, most Nigerians who go abroad for treatment end up dying because of late diagnosis and delay in intervention. Moreover, unforeseen situations (such as the COVID-19 lockdown) may make it impossible to go on medical tourism, even if one could afford it.

A recent sad example of the futility of dependence on medical tourism is the case of the billionaire, Captain Idahosa Wells Okunbo, who died of pancreatic cancer in London. The 63-year-old moved to the UK for treatment after the diagnosis, where his doctors predicted that he would live for just nine months. He managed to survive for 12 months before he eventually died on the 8th of August, 2021.

On his death, Captain Okunbo joined a growing list of prominent Nigerians of Edo extraction who have succumbed to the cancer carnage. These are people who were capable of mobilizing support towards the establishment of a CCC in Nigeria including: two former Military Vice-Presidents; a former First Lady, a former chairman of NADECO, the wife of the Paramount Ruler, the wife of the elder statesman who moved the motion for Nigerian Independence; the former DG, Centre for Democracy, two Ex-Goalkeepers of National Team; and the renowned Musician – Evangelist Sunny Okosun, among others. All from Edo State alone!

Most of these cancer deaths are preventable. According to World Health Organization (WJO), one-third of cancers can be prevented, one-third can be cured and the last third can have good quality of life with appropriate care.

Dear Nigerians, ICAM 2021 provides another impetus for us to arise and halt the waste of lives, starting with the establishment of the first CCC, which is the immediate goal of the BIG WAR. A CCC is the only institution that can optimally tackle all stages and types of cancer. The CCC is NOT a hospital with a radiotherapy machine. Rather, it is a world-class, stand-alone tertiary health institution, with all its units focused solely on cancer care. The CCC houses first-class cancer research, preventive, curative and palliative care in one place resulting in better outcomes across a range of measures – including, most importantly, cancer survival. Establishing the CCCs will honour the memory of our loved ones who have died from cancer.

We may look at other nations for inspiration. The case of Ruth Ginsburg who died at the age of 87 years illustrates how the positive step we take today can transform the situation for us and future generations. Ginsburg was the second female Justice of the US Supreme Court. Ruth’s mother died from cervical cancer (one of the easiest cancers to prevent) at the age of 48 years, a day before Ruth graduated from high school. In contrast, Ruth Ginsburg survived colon cancer as well as one of the deadliest cancers - pancreatic cancer (the same cancer that killed Captain Okunbor). While being treated for these two cancers, she did not miss a single day at work.

Justice Ginsburg was a beneficiary of the legacy of some American philanthropists whose generosity transformed the US health system between her mum’s generation and her own. These philanthropists rose to the challenge of establishing world-class CCCs in the USA, long before the US government became involved. Largely due to such philanthropic efforts, USA now has over 1,500 CCCs.

The first CCC in USA is the Memorial Sloan Kettering Cancer Center (MSKCC), New York, where Ruth received treatment. This was also where Admiral Mike Akhigbe (one of the cancer victims from Edo State) was treated for throat cancer following his late diagnosis.

Before the establishment of MSKCC in 1884, cancer was a death sentence in the US. John Jacob Astor III (a philanthropist) sponsored the first wing of the MSKCC, named the “Astor Pavilion”. His attention was drawn to the need by his wife Charlotte who was on the board of the Women's Hospital, New York, an institution that was then rejecting cancer patients. Over the years, the MSKCC went through various stages of advancement through the continuous support of more philanthropists. Today, the legacy that was left behind by these philanthropic persons of goodwill is one of the top cancer centres in USA; saving tens of thousands of lives from all over the world, annually.

Another role model is Mrs. Kiran Mazumdar-Shaw, the main sponsor of one of the largest CCC world-wide, opened in 2009. The Mazumdar Shaw Cancer Centre (MSCC), Bangalore, named in her honour cost $150 million. It is the fourth cancer centre in Bangalore, a city of 8 million people! Mrs. Shaw was motivated by the experience of her husband - John Shaw, who was diagnosed of renal cell carcinoma in 2007 and that of her best friend who died of breast cancer. The MSCC treats poor patients for free in the evenings, so they could continue to work and care for their families during the day. Mrs. Shaw’s mother was later successfully treated for cancer at the MSCC.

Similarly, in Pakistan, it was a sportsman, Imran Khan (then a professional cricketer) who led the efforts towards that nation’s first CCC – after he lost his mother to Colon Cancer. At this centre, 75% of patients are treated free. To raise the funds needed to set up the CCC, Imran organized over 50 fundraisers. Imran himself later underwent emergency surgery at the same Centre he had helped to establish; that operation saved his life. Imran’s story demonstrates that it is in our enlightened self-interest to support the BIG WAR - we never know whose life could be saved! For while it may be our privilege today to give, it may be our necessity to receive tomorrow.

↓↑GivingTide is an initiative to promote concerted and catalytic philanthropy. To this end, ↓↑GivingTide has established the ↓↑GivingTide Global Trust, which is managed by FBNQuest Trustees, a subsidiary of FBN holdings. The current focal cause of ↓↑GivingTide is the BIG WAR Against Cancer, which is operated by the National Cancer Prevention Programme (NCPP), a nongovernmental initiative of mass medical mission. Since 2007, NCPP has spearheaded community-based cancer prevention across Nigeria. In 2017, a fleet of Mobile Cancer Centres (MCC) was acquired and deployed, to great effect. The project is now at the phase of establishing Nigeria’s first CCC.

As we mark the International Cancer Awareness Month, ↓↑GivingTide calls on all to support the efforts towards establishing Nigeria’s first CCC in record time.

IF ONE IN SEVEN NIGERIANS DONATED ONLY N1,000 (ONE THOUSAND NAIRA) EACH TO THE ↓↑GIVINGTIDE GLOBAL TRUST, NIGERIA’S FIRST CCC WOULD BE READY WITHIN SEVEN MONTHS. Therefore, there is no reason for the holocaust of preventable deaths from cancer. Together, it is possible!

Let’s ACT! (Attack Cancer Today! Attack Cancer Together!! Attack Cancer Totally).

•Dr. Abia Nzelu, Executive Secretary, ↓↑GivingTide International); can be reached via info@givingtide.org

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