Algeria: Stepping up cancer care
The government is boosting spending on cancer prevention and treatment as part of a wider investment plan to increase services in health care, with a number of new specialised hospitals and oncology centres on the way.
The Ministry of Health, Population and Hospital Reform (MoHPHR) has budgeted AD21bn (€211.9m) for cancer care in 2012 and will prioritise increasing patients’ access to services, particularly in more remote regions. Ministry authorities hope to increase the number of specialised cancer centres from four to 22 by 2014, as well as open a diagnostic centre in each wilaya (province) and daïra (county).
Spending on cancer this year will complement a broader investment in health care currently under way. Algeria’s overarching five-year public investment plan that runs until 2014 includes financing for the establishment of 45 new specialised health care centres, 15 of which will be devoted to oncology. Six centres, including facilities in Algiers, Constantine and Sétif, began operations in early 2011, and feasibility studies were launched for the remaining facilities.
A regional cancer centre is also being established in the eastern city of Batna. The centre’s day hospital, which should be able to accommodate 90 patients per day for consultations, is expected to open this winter. The radiology department should open in July, and additional services will come online gradually. The 240-bed facility will ultimately provide diagnostic services, radiotherapy and surgery. And Djamel Ould Abbes, the minister of MoHPHR, indicated in the local press that the ministry intends to boost the number of facilities with radiology equipment from 13 to 70 by 2014.
This focus on tackling incidences of cancer is part of the government’s increasing attention to the provision of health services and more broadly, the treatment of long-term care issues. The government dominates medical spending, with an estimated 82% share of expenditures, which is considerably higher than in Tunisia and Morocco, where the state accounts for an estimated 50%. The private sector, although smaller, has experienced sustained growth since its authorisation in 1988 and now contributes 16% to overall health expenditure.
While the public sector is the largest provider of health financing, increased private sector investment in specialised health care infrastructure could go a long way toward making cancer treatment more accessible to the population.
Due largely to changing lifestyle choices, increasing purchasing power and urbanisation, Algeria is a country in epidemiological transition, where non-communicable diseases have surpassed the morbidity rates of infectious diseases. The impact of infectious diseases has nearly been eradicated; the only significant challenge that remains in this regard is tuberculosis, of which approximately 20,000 new cases are registered annually.
Non-communicable diseases, including cancer, diabetes, respiratory disorders and neuropsychiatric disorders, represent 70% of mortalities and 55% of the overall burden of disease, compared to 34% for infectious diseases and 12% for trauma, according to the World Health Organisation (WHO). Cardiovascular disease is the primary cause of death, with an average of 25,000 mortalities per year.
Cancer is the second leading cause of death, with the MoHPHR reporting the number of cancer cases at 43,000 in early 2012. Lung cancer is the most common among men, and breast cancer among women. A report by the American Cancer Society showed that Algeria’s cancer survival rate, measured five years after the original diagnosis, was 39% in 2008, which is low when compared with the 89% in the US and 80% in Spain.
Despite these bleak statistics, Algeria is not new to the cancer fight: it became one of the first countries in Northern Africa to develop a national programme to fight the disease and other non-communicable diseases in 2003. The country’s cancer plan focuses on prevention, the promotion of healthy lifestyles, increasing the quality of care, ensuring adequate human and material resources, and cooperation with organisations such as the WHO and the International Atomic Energy Agency (IAEA).
A short-term priority for the MoHPHR is the creation of a national cancer register to better understand the footprint of non-communicable diseases nationwide. A February 2012 conference on health care indicators also emphasised the need to develop a national information system, including censuses and studies, to create more effective, better-informed policies and prevention programmes. Algeria’s Sétif region already has an effective cancer register in place, but much work remains to be done to replicate this system nationwide.
The new spending plans are an important step toward expanding access to oncology services, however, plans for additional treatment and diagnostic centres could be hampered in the short term by the lack of trained personnel. A shortage of doctors and specialists in southern regions especially could hold back plans for new facilities. A project to establish a medical school in one of the southern districts is currently under review, and more news is expected by the middle of 2012. If this obstacle can be overcome, Algeria’s investment programmes should significantly increase access to quality cancer care in the coming years.