How COVID-19 exposed pre-existing roadblocks for cancer control in Africa: strategies, lessons and recommendations from the 2019-2020 Africa Cancer Research and Control ECHO

Annet Nakaganda; Nwamaka Lasebikan; Elise M Garton; Benda Kithaka; Eunice Garanganga; Alicia A Livinski; Mishka K Cira

doi:10.3332/ecancer.2022.1516

How COVID-19 exposed pre-existing roadblocks for cancer control in Africa: strategies, lessons and recommendations from the 2019-2020 Africa Cancer Research and Control ECHO

Ecancermedicalscience. 2023 Mar 6:17:1516. doi: 10.3332/ecancer.2022.1516. eCollection 2023.

Authors

Annet Nakaganda¹, Nwamaka Lasebikan², Elise M Garton³, Benda Kithaka⁴, Eunice Garanganga⁵, Alicia A Livinski⁶, Mishka K Cira³

Affiliations

¹ Uganda Cancer Institute, PO Box 3935, Kampala, Uganda.
² University of Nigeria Teaching Hospital, 8F26+HQ2, Enugu 402109, Nigeria.
³ Center for Global Health, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rockville, MD 20850, USA.
⁴ KILELE Health Association, PO Box 1627, Nairobi, Kenya.
⁵ Hospice and Palliative Care Association of Zimbabwe, 13 Lezard Avenue, Milton Park, Harare, Zimbabwe.
⁶ National Institutes of Health Library, Office of Research Services, NIH, 10 Center Drive Building 10, Room 1L-25, MSC 1150, Bethesda, MD 20892, USA.

Abstract

Background: The COVID-19 related mitigation measures adversely affected various cancer control activities in Africa, with cancer prevention and screening activities amongst the most significantly impacted. When the COVID-19 pandemic struck, the Africa Cancer Research and Control ECHO utilised their virtual platform to share experiences and knowledge of how to continue cancer service delivery during the pandemic. This analysis describes the evolved strategies, dilemmas, and recommendations to strengthen the health systems for cancer control in Africa.

Methods: Eleven 1-hour-long sessions about the then newly emerging coronavirus infection and its impact on cancer control in Africa were held from April 2020 to August 2020, using Zoom®. An average of 39 participants attended the sessions including scientists, clinicians, policymakers and global partners. Sessions were analysed thematically.

Results: Most strategies to maintain cancer services during the COVID-19 pandemic centred around cancer treatment, with few strategies on maintaining cancer prevention services, early detection, palliative care and research services. The most mentioned challenge during the pandemic was fear of exposure to COVID-19 infection at the health facility during diagnosis, treatment or follow-up for cancer care. Other challenges were disruptions to service delivery, inaccessibility of cancer treatment, disruption of research activities and a lack of psychosocial support for COVID-19 related fear/anxiety. Significantly, this analysis shows that the COVID-19 related mitigation measures exacerbated existing predicaments in Africa, such as inadequate attention to cancer prevention strategies, psychosocial and palliative services and cancer research. The Africa Cancer ECHO recommends African countries to leverage the infrastructure developed in response to COVID-19 pandemic to strengthen the health system along the entire cancer control continuum. This calls for urgent action to develop and implement evidence-based frameworks and comprehensive National Cancer Control Plans that will withstand any future disruptions.

Keywords: Africa; COVID-19; cancer; control; lessons; pandemic; recommendations; strategies.