Modon Holding posts AED 2.1bn net profit in H1 2025    Egypt's Electricity Ministry says new power cable for Giza area operational    Egypt exports first high-tech potato seeds to Uzbekistan after opening market    Egypt's Al-Sisi, Italian defence minister discuss Gaza, security cooperation    Egypt's FM discusses Gaza, Nile dam with US senators    Aid airdrops intensify as famine deepens in Gaza amid mounting international criticism    Health minister showcases AI's impact on healthcare at Huawei Cloud Summit    On anti-trafficking day, Egypt's PM calls fight a 'moral and humanitarian duty'    Federal Reserve maintains interest rates    Egypt strengthens healthcare partnerships to enhance maternity, multiple sclerosis, and stroke care    Egypt keeps Gaza aid flowing, total tops 533,000 tons: minister    Indian Embassy to launch cultural festival in Assiut, film fest in Cairo    Egyptian aid convoy heads toward Gaza as humanitarian crisis deepens    Culture minister launches national plan to revive film industry, modernise cinematic assets    Sudan's ambassador to Egypt holds reconstruction talks on with Arab League    I won't trade my identity to please market: Douzi    Sisi calls for boosting oil & gas investment to ease import burden    Egypt welcomes 25-nation statement urging end to Gaza war    Sisi sends letter to Nigerian president affirming strategic ties    Egypt, Senegal sign pharma MoU to unify regulatory standards    Two militants killed in foiled plot to revive 'Hasm' operations: Interior ministry    Egypt, Somalia discuss closer environmental cooperation    58 days that exposed IMF's contradictions on Egypt    Egypt's EHA, Huawei discuss enhanced digital health    Foreign, housing ministers discuss Egypt's role in African development push    Egypt reveals heritage e-training portal    Three ancient rock-cut tombs discovered in Aswan    Sisi launches new support initiative for families of war, terrorism victims    Egypt expands e-ticketing to 110 heritage sites, adds self-service kiosks at Saqqara    Egypt's Irrigation Minister urges scientific cooperation to tackle water scarcity    Palm Hills Squash Open debuts with 48 international stars, $250,000 prize pool    On Sport to broadcast Pan Arab Golf Championship for Juniors and Ladies in Egypt    Golf Festival in Cairo to mark Arab Golf Federation's 50th anniversary    Germany among EU's priciest labour markets – official data    Paris Olympic gold '24 medals hit record value    A minute of silence for Egyptian sports    Russia says it's in sync with US, China, Pakistan on Taliban    It's a bit frustrating to draw at home: Real Madrid keeper after Villarreal game    Shoukry reviews with Guterres Egypt's efforts to achieve SDGs, promote human rights    Sudan says countries must cooperate on vaccines    Johnson & Johnson: Second shot boosts antibodies and protection against COVID-19    Egypt to tax bloggers, YouTubers    Egypt's FM asserts importance of stability in Libya, holding elections as scheduled    We mustn't lose touch: Muller after Bayern win in Bundesliga    Egypt records 36 new deaths from Covid-19, highest since mid June    Egypt sells $3 bln US-dollar dominated eurobonds    Gamal Hanafy's ceramic exhibition at Gezira Arts Centre is a must go    Italian Institute Director Davide Scalmani presents activities of the Cairo Institute for ITALIANA.IT platform    







Thank you for reporting!
This image will be automatically disabled when it gets reported by several people.



Tropics of Cancer?
Published in Daily News Egypt on 05 - 08 - 2011

STANFORD: Cancer is sometimes thought of as a disease of wealthier countries, but it is a major cause of morbidity and mortality in poorer ones as well. Indeed, by the end of this decade, about 150 million people worldwide will have cancer, with approximately 60 percent of them residing in developing countries.
Although fewer people in developing countries live to the age at which cancer is most prevalent, inadequate nutrition and environmental exposures to viruses and toxins, combined with a paucity of diagnostic and treatment options, increase cancer's incidence and lethality. Many people in poor countries die from cancers that are preventable or treatable in wealthier societies, but they often succumb to other scourges as well, such as infectious diseases. So what could and should be done about this conundrum?
Margaret Chan, the head of the World Health Organization, and Yukiya Amano, director of the International Atomic Energy Agency (IAEA), noted in a recent article that most developing countries' health-care systems are designed to cope with infectious diseases rather than cancer. I find this to be a rational strategy, given the heavy toll that infections take, and that many can be prevented and treated at a relatively modest cost.
The diagnosis and treatment of most types of cancer in developing countries would require a huge and daunting investment in infrastructure. As Chan and Amano point out:
“[M]ost lack the funds, equipment, and qualified personnel needed to provide basic care for cancer patients. Thirty countries — half of them 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 the long-term demands of cancer care.”
In order to begin addressing these deficiencies, “The IAEA's work involves building countries' capacity for radiation medicine. But technology means nothing without well-trained and motivated staff to use it.”
Such an approach is, however, poorly focused and unlikely to be cost-effective. As the United Nations' own data make 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, mostly of children under five. In virtually all poor, malaria-endemic countries, there is inadequate access to antimalarial medicines (especially artemisinin-based combination therapy).
The incidence of malaria could be reduced drastically by the judicious application of the mosquito-killing chemical DDT, but 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 declined slightly during the past decade, 2.7 million people contracted the virus in 2008, and there were two million HIV/AIDS-related deaths. By the end of that year, more than four million people in low- and middle-income countries were receiving anti-retroviral therapy, but more than five million who were HIV-positive remained untreated. The number of new cases of tuberculosis cases worldwide is increasing, and the growing emergence of multidrug-resistant strains of the bacteria is especially worrisome.
According to UN statistics, about 15 percent of the world's population lacks access to safe drinking water, and “in 2008, 2.6 billion people had no access to a hygienic toilet or latrine,” while “1.1 billion were defecating 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 that it is surely more sensible to attack infectious diseases by improving access to clean water, basic sanitation, antibiotics, and vaccines than it is to build radiotherapy facilities. In some technology-poor but oil-rich Middle East countries, state-of-the-art radiotherapy (and cardio-pulmonary bypass) equipment has been delivered, but never used, or has been damaged by electrical surges or power outages. And many poor countries do not have a single medical school, and when their citizens study abroad, they often stay there, or are ill-equipped for a low-tech milieu that is so different from where they trained.
Although the use of big-ticket equipment, expensive chemotherapy drugs, and sophisticated and complex procedures such as bone marrow transplantation would not be wise, this is not to say that we should give up entirely on cancer treatment in developing countries. Sometimes, prevention, diagnosis, and treatment are cost-effective. Vaccines to prevent hepatitis A and B (and C, when one becomes available) reduce the incidence not only of the viral infections, but also of sequelae such as cirrhosis and hepatic carcinoma. And public-health efforts to curb air pollution and smoking could reduce the prevalence of lung cancer in Asia and Africa.
Another example is cervical cancers, many of which can be prevented by vaccines against human papilloma virus. And acetic acid can be used to visualize cervical cancers, which can then be treated with cryotherapy (freezing).
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.
Henry I. Miller is Fellow in Scientific Philosophy and Public Policy at Stanford University's Hoover Institution, and was an official at the US National Institutes of Health and the US Food and Drug Administration. This commentary is published by Daily News Egypt in collaboration with Project Syndicate, www.project-syndicate.org.


Clic here to read the story from its source.