Burundi poised to strengthen its national cancer control capacities

12 May 2017

The Government of Burundi seeks to strengthen its national cancer control programme, while taking into account recommendations made during a recent joint assessment mission by the International Atomic Energy Agency (IAEA), the World Health Organisation (WHO) and the International Agency for Research on Cancer (IARC).

"Our priorities are to establish a national, multi-sectoral committee to review our strategic cancer control plan and to mobilise the human and financial resources necessary to provide adequate cancer care," said Dr Innocent Nkurunziza, the National Programme Director for the Integrated Fight Against Non-Communicable Diseases and President of the Thematic Group on Cancer at the Ministry of Public Health.

Burundi is one of Africa's smallest and most densely populated countries, and cancer increasingly affects the population. According to IARC, each year, over 7,000 Burundians develop the disease and almost 6,000 die from it. Both figures are projected to rise by around 85% by 2030. At the same time, public awareness about cancer remains low and the majority of patients seek medical attention when their illness is already too advanced to be cured.

To better understand the country's cancer situation, the Government of Burundi requested an assessment of its national capacities to control cancer through an "imPACT Review" conducted by the IAEA in cooperation with WHO and IARC. A team of international experts nominated by the participating Agencies visited public and private health care facilities, medical schools and non-governmental organisations (NGO) working on cancer in the capital Bujumbura and the cities of Kayanza and Mpanda. The experts appraised the status of cancer prevention, early diagnosis, treatment and palliative care, as well as of the national cancer planning and cancer registration system. In addition, the levels of safety and security of radiation medicine for health care workers and patients were evaluated.

Out of the more frequent cancers in Burundi, cervical and oesophageal cancers and Kaposi Sarcoma are highly preventable, while effective control of breast cancer and non-Hodgkin lymphoma predominantly depends on the early detection and appropriate treatment of the relevant tumors. In Burundi, the limited access to effective prevention measures as well as early detection and treatment services significantly reduces patients' chances of survival.

While the Government is gearing up to address the growing needs, several NGOs have been undertaking prevention or screening activities for years. For example, the Association Burundaise pour le Bien-être Familial (ABUBEF) runs 7 clinics nationwide offering breast and cervical cancer screening, and referring women screened positive to gynaecologists for confirmation of the diagnosis and treatment, if needed. "We have been running a cervical cancer screening programme here since 2014. During a recent campaign, we screened 189 women in one week and trained 17 medical doctors in screening and treatment of pre-cancer lesions with cryotherapy," said Donavine Uwimana, ABUBEF's Executive Director.

The Government plans to establish radiotherapy and nuclear medicine facilities with the support of the IAEA in the coming years. The imPACT experts recommended that Burundi builds and strengthens the corresponding health care workforce as a matter of priority, particularly in relation to cancer prevention, early detection and palliative care.

The experts observed further that a National Cancer Control Programme 2016 to 2020 is in place. Its implementation is challenged though by competing health priorities, such as HIV/AIDS, tuberculosis and malaria. The team also highlighted the need for strengthened cancer data to support prioritisation and informed decision-making.

"There is a need for continuous action to counter the suffering and economic hardship caused by cancer. The recommendations of the imPACT review mission will greatly enhance the ability of Burundi's health system to take a comprehensive approach in delivering cancer services" said Dr Nkurunziza.

Programme of Action for Cancer Therapy (PACT)

PACT was established as part of the International Atomic Energy Agency (IAEA) to help fight the growing cancer crisis in the developing world. The IAEA has over 40 years experience in supporting countries in applying nuclear technologies for health and prosperity. PACT works to improve IAEA Member States' capacities to address the growing cancer burden through promoting the integration of radiotherapy technologies within a comprehensive national cancer control programme. PACT builds strong strategic partnerships, particularly with the World Health Organization, to provide equitable, affordable and quality access to cancer care for all cancer patients to the highest standards, everywhere. cancer.iaea.org