Tanzania's government, which has been criticised for its handling of the pandemic, has no plans to rollout Covid vaccines, the health minister says.
The comments come days after President John Magufuli warned officials against acquiring vaccines saying they could harm people, without giving evidence.
Critics have accused him of playing down the threat posed by the virus.
Millions of people have already been inoculated in many countries after the vaccines were given emergency approval.
Vaccines are rigorously tested in trials involving thousands of people before being assessed by health regulators. They look at all the data on the safety and effectiveness of vaccines before approving them for use on a wider population.
Last month, the World Health Organization (WHO) urged Tanzania to consider inoculating its population.
Tanzania is one of the few countries in the world to not publish any data on Covid-19 cases. It last did so in May, when about 500 cases and 20 deaths were recorded. The following month, Magufuli declared Tanzania "coronavirus-free".
Last month, the president said some Tanzanians had travelled abroad to take the vaccine but "ended up bringing us a strange coronavirus". The comments were seen as an apparent admission that the virus may be circulating in the country.
At a news conference on Monday, Health Minister Dorothy Gwajima said: "For now the government has no plans to receive the Covid vaccine being distributed in other countries."
The minister urged Tanzanians to take precautions and to use traditional medicine as a way of dealing with coronavirus, although their efficacy to combat the virus has not been scientifically confirmed.
A blogger shared photos of Dr Gwajima and other officials inhaling steam and taking a herbal concoction.
Dr Gwajima also warned media outlets not to report unofficial information on coronavirus or any disease. The warning comes after the Catholic Church said it had observed an increase in requiem masses, blaming funerals on a spike in coronavirus infections.
The US Centers for Diseases Control and Prevention (CDC) has advised against all travel to Tanzania and updated its alert to level four, meaning transmission of coronavirus in the country is "high or rising rapidly".
Many African states are buying vaccines through an international scheme called Covax, but some are also planning to negotiate directly from pharmaceutical companies.
The Covax scheme aims to make it easier for poorer countries to buy vaccines amid growing concerns that wealthier nations are snapping them up and practising "vaccine nationalism".
South Africa, which has the highest number of Covid-19 cases and deaths on the continent, received its first shipment of vaccines on Monday the AstraZeneca vaccine from a manufacturer in India.
About 1.2 million front-line health workers would be the first to be inoculated, President Cyril Ramaphosa said.
More than 1.4 million people in South Africa have contracted the virus and 44,164 are known to have died, according to Johns Hopkins University research.
African states that have started rolling out vaccines include Egypt, Guinea, Morocco and Seychelles. - BBC/Bulawayo24
8% of all Kenyan households experienced catastrophic health expenditures, with out-of-pocket payments pushing more than 1 million Kenyans into poverty annually. Photo Sarah Farhat/World Bank
In 2017, Grace, a 45-year-old single mother of five children in Kenya, discovered a painless mass in her right breast. So she trekked 80 kilometers from her home to the nearest hospital, where doctors called for surgical removal of the mass – without explaining it could be cancerous. Not realizing the full extent of her risk and lacking accurate information, Grace declined to have the procedure.
A few months later, Grace experienced growing pain that became incapacitating. When finally diagnosed with stage II breast cancer, the cost of treatment was financially beyond the reach of the family. Fortunately, through support from a local NGO and late registration with the national insurance fund, Grace was able to access treatment.
A growing burden
Grace’s plight is sadly familiar.
Cancer is the second leading cause of deaths due to non-communicable diseases (or NCDs) in Kenya, and the number of cases is rising rapidly. The illness affects Kenyans of all ages and socio-economic backgrounds but has a disproportionate impact on the most vulnerable groups. Cervical cancer makes up the largest portion of cancer cases (nearly 12%) followed by breast cancer, Kaposi’s sarcoma, and oesophageal and prostate cancer.
In 2020, according to the World Health Organization’s International Agency for Research on Cancer (IARC), new cases of all types of cancers increased to nearly 20 million worldwide, and there were 10 million cancer deaths (up from about 17 million and 9.5 million, respectively, in 2018). Current IARC projections suggest that one in 5 people worldwide will develop cancer during their lifetime and that the global cancer burden is projected to rise by about 50% over the next 20 years. The growing cancer burden is driven by aging populations, as well as several risk factors, such as sedentary lifestyles, obesity and smoking.
As in many low- and middle-income countries, most cancer cases in Kenya are diagnosed at an advanced stage, when treatment options are limited and families make huge sacrifices, often with poor results. Households not covered by health insurance frequently grasp for dire financial fixes – borrowing, selling assets – that can plunge them further into insolvency.
According to a 2018 household survey, 8% of all Kenyan households experienced catastrophic health expenditures, with out-of-pocket payments pushing more than 1 million Kenyans into poverty annually. With less than 20% of the population enrolled in the national health insurance scheme, financial barriers to accessing care remains problematic as many Kenyans only enroll once they become ill.
The Kenyan government has stepped up its response to the mounting threat of cancer , but much more needs to be done. Efforts are underway to boost the capacity of health providers through in-service training on early cancer screening and expand pre-service training to increase the availability of specialized personnel.
The World Bank is partnering with Access Accelerated, a private sector collaboration, to provide technical and financial support to countries to tackle NCDs, including cancer. This partnership funds innovative pilot projects, analytical work and knowledge sharing that will help developing countries deepen and expand access to NCD services.
In the case of Kenya, the partnership is supporting the non-profit AMPATH’s Primary Integrated Care For 4 Chronic Diseases (PIC4C) initiative, an innovative model of care that involves raising awareness, promoting early detection and screening and initial care for several NCDs, including breast and cervical cancer. While COVID-19 resulted in disruptions of these services, the team has managed to adopt the model of care by expanding telephone-based consultations, providing medications for longer durations, and enhancing triaging of patients to minimize the need to visit health facilities.
What have we learned so far?
While these efforts are laudable, much more needs to be done. And as we observe World Cancer Day, Grace’s story, which is also featured in a recent World Bank study about the Economic and Social Consequences of Cancer in Kenya: Case Studies of Selected Households, exemplifies the hurdles countries across the globe must navigate to reduce the threat of cancer.
The report highlights four priorities for strengthening the national cancer response in Kenya:
Improve health seeking behavior by raising awareness and knowledge of cancer, lowering barriers to care, strengthening the quality of care, ensuring access to supportive counselling, and urging households to enroll early in Kenya’s National Hospital Insurance Fund.
Continue to promote financial protection by progressively expanding the benefit package to cover more interventions and more people over time and identifying ways to cover non-medical costs which can be considerable.
Strengthen the capacity of the primary health system to prevent, detect, and promptly treat most of these cancers, as this will ultimately save lives and minimize health care costs.
Empower cancer survivors and family members to play a critical role in the cancer journey, advocating for patients, and establishing support groups to mitigate fears and foster solidarity.
How the World Bank supports cancer prevention
The World Bank plays an important role by supporting developing countries’ efforts to strengthen health systems. The Bank’s overriding strategy is to help countries accelerate progress towards Universal Health Coverage through three pillars: expanding financial protection, so that no one is tipped into poverty because of catastrophic health spending; increasing coverage of quality health services for the poorest 40 percent of the population; and fostering a healthy society, including through investments that reduce risk factors. Cancer cuts across all three pillars.
The World Bank’s portfolio of about $US 1.5 billion (as of 2019) for health systems and health services operations is aimed at addressing non-communicable diseases. The World Bank provides financial support, policy advice, and technical assistance to reduce key risk factors for NCDs, including cancer. World Bank also helps countries strengthen early detection and screening, promote risk reduction, revamp health systems, and facilitate reforms to shift attention from costly secondary care to primary health.
For example, in Tamil Nadu, the sixth most populous state in India, the Bank has supported the state’s work to strengthen the management of NCDs, with cancer being one of the main priorities. Similarly, in Argentina, the Bank has assisted the country’s efforts to improve and expand its health services to tackle cancer and other NCDs, especially among the most vulnerable.
World Cancer Day is a reminder that, both individually and collectively, we must provide universal access to primary care and expand financial and social protection to all against the deadly plight of cancer. Failure to do so, will have devastating impact on families and society at large. - Miriam Schneidman/Renzo Sotomayor, World Bank
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