Tobacco industry: A question of corporate social irresponsibility

by-Akin Owoeye

I have in recent times observed through newspaper articles the generous activities of tobacco companies, particularly the British American Tobacco (BAT) which claims to be social responsible. Tobacco companies make so much noise about what they do, despite the laid-down rules and procedures on Corporate Social Responsibility (CSR) programmes. But the truth is, it is normal for any responsible company to engage in CSR.
CSR is an effort to bring corporate values more in line with society's expectations and values. That is, a way for companies to develop a code of conduct and provide accountability to society. It is however my view that legally enforceable mechanisms based on internationally agreed standards in the areas of human, social and environmental rights are necessary to reverse the unsustainable impacts of tobacco companies' activities.
The tobacco companies, through their CSR efforts, attempt to gain credibility and public trust, but their CSR efforts have not demonstrated any positive impact on public health. They give little to host communities and take so much out of them. The industry claims to help tobacco farmers by giving loans, while in actual fact it forces them to grow tobacco for buyers who will provide all inputs. When the cost is deducted from the farmers' earnings, the leftover can hardly be used for anything. Moreover, they sign contracts which they know nothing about, a situation which has kept them mired in abject poverty.
Health threats to tobacco farmers include bladder cancer, allergies or skin disorder (eczema), pesticide exposure, etc. They engage children and women in tobacco farming and expose them to Green tobacco sickness, which involves nicotine poisoning through the skin during cultivation and harvesting. It also causes vomiting or nausea and dizziness or headaches during or after exposure.
While tobacco companies' public advertising has been restricted, much of their CSR is actually indirect advertising. They carry out all sorts of promotions and sponsorships, even when research has shown that industry-sponsored programmes do not work. Tobacco industry youth programmes, for instance, do more harm than good for tobacco control, and should not be allowed to run or be directly funded by tobacco companies. In the same vein, research has also shown that industry-sponsored TV programmes increase exposure to tobacco products.
Several tobacco companies state that they have developed less harmful tobacco products as part of their CSR efforts. However, there is no scientific evidence to prove that these products are less hazardous. Profit continues to be a motivator of all they do.
The truth is that tobacco industry objectives and goals will always remain incompatible with what public health wants. Contrary to standard ways of doing CSR according to Indication Protocols (IP), a product responsibility indicator, organisations are expected to exercise due care in the design of their products and services. This is to ensure they do not pose unintended hazards to health and safety.
In addition, protection of health and safety is a recognised goal of many national and international regulations. So failure to comply with legal requirements indicates either inadequate internal management systems and procedures, or lack of implementation.
BAT's CSR claims to subscribe to the international reporting system, but cannot report on customer health and safety indicators, given that its products kill one-half of its users. Tobacco industry and health promotion goals are also mutually exclusive; hence partnership is impossible.
All told, economic actors (the government, transnational companies) have a huge role to play in protecting, promoting and respecting human, social and environmental rights. Tobacco companies often exercise enormous influence over decision-making in the country, and are rarely held accountable for damaging the environment, harming local communities and forcing workers and tobacco farmers to accept unfair conditions and/or salaries. It is time for companies to be responsible and accountable!

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Don't Smoke Away Your Future

Newborns of smokers have abnormal blood pressure

By Agency Reporter

Babies of women who smoked during pregnancy have blood pressure problems at birth that persisted through the first year of life, a new study finds.
''What is of concern is that the problems are present at birth and get worse over time,” said Gary Cohen, a senior research scientist in the department of women and child health at the Karolinska Institute in Stockholm, and lead author of a report in the Jan. 25 online edition of Hypertension. ”They‘re not going away, they‘re getting worse.”
The study led by Cohen compared 19 infants of nonsmoking couples with 17 infants born to women who smoked an average of 15 cigarettes a day during pregnancy. At one week of age, the infants of nonsmoking mothers experienced a 2 percent increase in blood pressure when tilted upright, with a 10 percent increase at one year. The pattern for the children of smoking mothers was reversed: a 10 percent blood pressure increase at one week, a 4 percent increase at one year.
And the heart rate response to tilting of the children of mothers who smoked was abnormal and exaggerated, the report said.
It‘s not possible to say whether the abnormalities seen in the babies will lead to trouble later in life, Cohen said. But, he noted, ”the extent of the condition at one year suggests that it is not going to disappear quickly.”
The reason why exposure to tobacco in the womb affects blood pressure is not clear, Cohen said. A leading possibility is that ”smoking might damage the structure and function of blood vessels,” he said, mainly by damaging the endothelium, the delicate layer of cells that line the interior of blood vessels.
Whether that damage will persist is not known. ”We‘re only up to 12 months at the moment,” he said. ”We plan to follow them.”
The damage seen in the Karolinska study is similar to that observed in babies born to mothers whose pregnancies were marked by such abuses as drug use, said Barry M. Lester, a professor of psychiatry and pediatrics at Brown Medical School, and director of the Brown Center for the Study of Children at Risk.
”Early kinds of natal insults can cause reprogramming of brain circuitry,” Lester explained. He has led studies of the long-term effects of cocaine and amphetamine use during pregnancy. Many women who take such drugs also smoke, Lester added.
”When we isolated tobacco effects, we showed that there are inborn neural effects of tobacco exposure similar to what we see in cocaine and methamphetamine abuse,” he said.
Some research has connected such problems to overproduction of cortisol, a ”stress hormone” that plays an important role in regulation of blood pressure and the immune system, Lester said. ”Cortisol overexposure is one hypothesis,” he said. ”There is a lot of evidence showing that too much cortisol is damaging.”
It is a reasonable hypothesis, Cohen said. Babies born preterm have problems with blood pressure that have been linked to overproduction of cortisol by the adrenal glands, he noted, ”and there are some parallels between tobacco smoke exposure and preterm babies of the same age.”
Whatever the mechanism of damage, treatment to eliminate the problems after birth does not seem possible, Cohen added.

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ACS to spend $7m grant in Africa over 5 years

In an unprecedented effort to reduce tobacco related deaths in Africa the American Cancer Society (ACS) is set to fund tobacco control activities on the continent with a $7million grant spread over five years. The grant will be channelled through the Africa Tobacco Control Consortium (ATCC).

The consortium coordinated by the America Cancer Society (ACS), includes the Africa Tobacco Control Alliance (ATCA), Africa Tobacco Control Regional Initiative (ATCRI) , Framework Convention Alliance (FCA), Campaign for Tobacco-Free Kids (CTFK), and the International Union Against Tuberculosis and Lung Disease (The Union). ATCC’s s goal is to promote evidence-based tobacco control in Sub-Saharan Africa (SSA) in order to prevent an epidemic of tobacco-caused death and disease in the region.

The $7 million grant, will provide financial and technical support for in-country implementation of the FCTC, implementation of a region wide advocacy campaign to prioritise tobacco control within the broader health and development agenda in Africa, targeted rapid response research to influence policy development and the monitoring of the implementation of the FCTC in Sub Saharan Africa (SSA).

Ban of cigarette in Abuja: FCTA’s clarion call to the media

NIGERIAN COMPASS

“Who is the next journalist we are going to lose to smokingrelated disease?” We lost Steve Kadiri, we lost Yinka Craig, and we lost Kubanji Momoh. Why is it that NUJ secretariats across the country are like smoking dens unlike the secretariats of other professional bodies? said Akinbode Oluwafemi, a former journalist with the Guardian Newspaper, and an activist against cigarette smoking in the countr .
Oluwafemi equally expressed worry that despite their exposure and knowledge, the late journalists, Dr. Beko Ransome Kuti, as well as the late songstress, Tina Onwudiwe who were chain smokers during their life time shared the same fate as they all died of tobacco related diseases.

According to him, Tina Onwudiwe who reportedly died of cancer started smoking cigarette at the age of 16.

The Programme Manager for Environmental Rights Action/Friends of the Earth, Nigeria, who was in Abuja for a one day workshop on ‘Tobacco and the Media’ queried journalists on how long they would remain silent while tobacco smoking continues to take away some of the nation’s valuable ones. The workshop which was aimed at getting the mass media on the driver’s seat of the campaign against smoking of cigarette in public places in the Federal Capital Territory (FCT), Abuja, was designed to continue the enforcement of the ban of cigarette smoking in public places in Abuja introduced in 2008 by the then FCT Minister, Dr. Aliyu Modibbo Umar.

More than any of his predecessors, former FCT Minister, Dr. Moddibo , has etched his name in the book of history as the first minister to ban smoking of cigarette in public places in Abuja. It was in view of this feat that he was given an award by the World Health Organisation (WHO) even after the expiration of his tenure.

In the same vein, Modibbo, also won accolades from those who have been kicking against the sales and consumption of tobacco products in the country.

Modibbo indeed invoked the provision of Tobacco Control Act of 1990 on August 31, 2008 to make public smoking of cigarette within the FCT a criminal act, no matter how highly placed a person might be. Ever since, there have been repeated calls from anti-smoking groups to have smoking of cigarette banned in all the 39 states of the federation.

Most of the calls against tobacco smoking in the country also include heavy taxation of the product to discourage consumers as cigarette according to anti-smoking activists and health practitioners, remains a product in which consumers do not derive any benefit.

To ensure that tobacco and cigarette are totally eliminated from the country, most of the agitators have also been looking forward to how the tobacco companies in the country would eventually be flushed out.However, in all their campaigns against smoking of cigarette, a missing link has been identified which is said to be a key factor in ensuring that all efforts at shutting down tobacco factories in the country become successful. Still perturbed by the tobacco situation in the country especially among men of the pen pushing profession, who according to him have huge capacity for creating mass awareness on any issue, Oluwafemi asked: “ Is a writer that guy with a cigarette in one hand and writing with the other hand”?

The media, he explained, are trusted by the public and policy makers as they (media) connect the political agenda with policy agenda. He noted that Nigerian media has an history of advocacy journalism and should not fail in this regard to make the public see the evil in the production and consumption of cigarette.

He revealed that contrary to belief in some parts of the country, especially in Oke Ogun area of Oyo State where the British America Tobacco Company (BAT) has tobacco plantations, a recent report by the UN and the World Bank has indicated that tobacco business or cultivation is not a sustainable business anywhere across the world.

It is against this realisation that he said that both the UN and the World Bank have stopped sponsoring investment in tobacco related production or business.

But what is role for the media in the campaign? The anti-tobacco smoking exponent noted that though the failure of the federal government to impose heavy tax on the products has continued to encourage more patronage from the public, the mass media is feared greatly by the tobacco industry.

“The media is the only medium through which tobacco advocates can communicate with both members of the public and policy makers at the same time,” he said, adding “the use of mass media for effective tobacco control gained momentum in the 1990s in countries such as the United States, United Kingdom, Canada and Australia.”

Again, he stressed that mass media campaigns are an effective tobacco control strategy as they increase knowledge of the health risks of tobacco use, encourage quitting and motivate change in both smokers and non-smokers.

The former journalist, convinced that media can help win the war against cigarette in the country, advocated that media houses should create one ‘tobacco journalist’ per media house. This, he explained could be done when such journalists capacity is boosted to report tobacco issues.

Although he argued that tobacco to some journalists is not as attractive as other issues such as AIDS, malaria, poverty, corruption and bad governance, Oluwafemi opined that media can be used to advocate tighter tobacco control laws and implementation of the WHO Framework Convention on Tobacco Control (FCTC) which Nigeria is a signatory.

Why the war against tobacco smoking? The anti-smoking activist explained that the adult smoking rate in Nigeria is put at 17 per cent which translate to mean that there are over 13 million active smokers in the country.

“Since half of smokers die of tobacco related diseases, it also goes to show that over 6.5 million Nigerians are on death row due to tobacco addiction. Tobacco kills, it kills over 5 million people every year,” he said.

He added: “Tobacco is a major risk factor for cardiovascular diseases, a major risk factor for cancers as well as a major risk factor for about 44 different kinds of diseases. There are over 4000 carcinogens in tobacco smoke.”

While corroborating this, the FCT administration Secretary for Social Development Secretariat, Barrister Habiba Sani Kalgo, said the media has a great role to play in the process of sensitising the public and should not be left out in the chain of reaction if all the efforts at making members of the public appreciating the ‘stop smoking in public places campaign’ must be successful.

Barrister Kalgo who spoke at the workshop organised by her secretariat in partnership with the Nigeria Tobacco Situation Analysis (NTSA) for FCT Press Corps stressed that the job of sensitising the public on the hazard of smoking cigarette would be made easier with mass media incorporated into the FCTA’s campaign against the habit.

“The workshop we are having today with the media is in recognition of your importance in the success of the campaign. Indeed, the power of the media in effective communication cannot be over-emphasised. We have brought our friends from the Nigeria Tobacco Situation Analysis (NTSA) to properly educate us on this very significant health issue.”

Currying the support of the mass media in the FCT administration’s war against smoking of cigarette in public places in Abuja, the Social Development Secretary said: “Our beautiful city of Abuja as you know has put its name in history books as one of the few cities in the world to have officially banned smoking in public places. We therefore urge you to join the FCT administration in our noble course of promoting healthy living and public health safety of Abuja residents.”

At the end of the workshop in which journalists from media houses like the Nigerian Compass, the Nation, Leadership, Vanguard, NTA, News Agency of Nigeria (NAN) Hot FM, Rhythm FM, Daily Trust, People’s Daily, AIT, ITV, DBN, The Champion among others, were present, there was an atmosphere of conviction among journalists that the war is worth fighting as at least tobacco smoking has claimed some of their loved ones. Hence, they cannot wait to see another one stolen away by a preventable habit.

SOURCE

Blame Poor Taxation For Increase In Smoking – Expert

by Catherine Agbo

The ever growing rate of active smokers in the country has been linked to the inability of the federal government to impose heavy taxes on tobacco products, which have consequently made the price of the products easily affordable for all.

This was the position of an expert on Tobacco Control, Akinbode Oluwafemi who was speaking at a one-day workshop organised for journalists on the role of the media in the campaign against smoking of cigarette in public places in FCT held in Abuja.

Akinbode posited that if heavy taxation could be imposed on tobacco by the federal government, the cost of production will increase and this will invariably lead to the increase in the price of the products thereby discouraging youths from smoking.

He said, "A pack of cigarette that sells for N200 in Nigeria goes for about $5 in the United States of America due to the heavy taxation placed on the manufacturing companies and I can assure you that smoking is a sure gateway to drug addiction.

Akinbode who described smoking as a major risk factor for different cancers and other tobacco related ailments said it was also linked to about fifteen various cases of cancer in the human body saying "apart from the high cost of treatment, infrastructural challenges, smoking related cancers accounts for 30 per cent of cancer related deaths" . The expert who is the Programme Manager, Environmental Rights Action/friends of the Earth Nigeria disclosed that studies had revealed that cigarette contains about 4,000 toxic and cancer causing chemicals and is responsible for more than 85 per cent cases of lung cancer. This, he added, can also lead to cancer of the mouth, pharynx, larynx, oesophagus, stomach, pancreas, uterine, cervix, kidney, ureter, bladder and the colon.

While urging the National Assembly to hasten the process of passage of bill on the ban on tobacco smoking in the country, he urged Nigerians to support the passage of the National Tobacco control bill as it was in the interest of all especially second hand smokers who are more at risk of infection arising from inhaling tobacco smoke.

The Secretary of Social Development of the FCDA, Habiba Kalgo while declaring the workshop open said the decision to ban smoking in public places in the FCT was necessitated by the increase in the number of deaths arising from cancer cases in the FCT.

She, however, urged FCT residents to support the ban since they were the second hand smokers who are also affected by the fumes of the products.

SOURCE

Nigeria: Smoking - 6.5 Million Risk Death in 2010

By Ben Ukeji

Abuja — No fewer than 6.5 million Nigerian smokers may die this year from tobacco-related sickness.

An international expert, Akinbode Oluwafemi, who said this also said about 65 million Nigerians smoke cigarette.

Olwafemi said that inability of government to tax tobacco producing companies heavily was responsible for the cheap prices of cigarette making it easily available to low income earners.

According to him, increased taxation will lead to increase price of the product thereby, discouraging the youths who were the most vulnerable group from smoking cigarette.

He said a pack of cigarette that sells for N200 in Nigeria goes for about $5 in the United States of America (USA) due to the heavy taxation placed on the manufacturing companies saying "smoking is a sure gateway to drug addiction."

While describing smoking as a major risk factor for different cancer cases, Akinbode said it is also linked to about fifteen various cases of cancer in human body saying "apart from the high cost of treatment, infrastructural challenges, smoking related cancers accounts for 30 per cent of cancer related deaths."

The expert who is the Programme Manager, Environmental Rights Action/Friends of the Earth Nigeria said that cigarette contains about 4000 toxic and cancer causing chemicals and is responsible for more than 85 per cent cases of lung cancer.

He said that smoking causes cancer of the mouth, pharynx, larynx, oesophagus, stomach, pancreas, uterine, cervix, kidney, ureter, bladder and the colon.

While urging the National Assembly to hasten the process of passage of bill on the ban on tobacco smoking in the country, Oluwafemi urged Nigerians to support the passage of the National Tobacco Control Bill.

The Secretary for Social Development of the FCDA, Habiba Kalgo while declaring the workshop open said the decision to ban smoking in public places in FCT was necessitated by the increase in the number of deaths arising from cancer cases in the FCT.

She, however, urged FCT residents to support the ban since they were the secondhand smokers were also affected by the fumes of the product.

SOURCE

Green tea cuts a smokers' lung cancer risk...but damage from smoking is permanent!

Green tea cuts a smokers' lung cancer risk....

...but damage from smoking is permanent!

SMOKERS AT RISK FROM OWN 'SECOND-HAND' SMOKE

Group wants ban on sale of cigarettes near schools

By Ayodeji Moradeyo

The federal government should ban the sale of cigarettes near institutions of learning in the country, a non- governmental group, Campaign for Tobacco Free Youths, has said.
“It is highly wrong for cigarettes to be sold near school environment; government must do everything to ensure that our students are not exposed to seeing cigarettes being sold like biscuits,” the coordinator of the group, Gbenga Adejuwon, said.
Mr. Adejuwon, who spoke at a workshop organised in Akure, on Wednesday, also appealed to the governors of the 36 states of the federation to implement the article 8 of the Frame Work Convention on Tobacco Control of the World Health Organisation.
“The article, according to him, will also restrict the exposure to tobacco smoke to prevent hazards from second hand smoke,” he said.
Mr. Adejuwon also urged all states to set up tobacco control committees which will comprise government officials and tobacco control organizations.
The committee, he said, would be empowered by law to prosecute people who smoke cigarettes in public places.
The anti-tobacco activists present at the event also raised alarm over what they said was the attitude of tobacco companies to slow down the hearing of public health cases filed against them in courts by various anti tobacco groups.
“Most of these companies, through their counsels, asked for unnecessary adjournments to deliberately slow down the pace of judgement and frustrate the trials,” Mr. Adejuwon said.
The workshop was organized to inform students about the harmful effects of cigarette.

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Cancer: Cost and causes of a killer ailment

By NIYI ODEBODE

Until 2007 when she was admitted to the Lagos University Teaching Hospital, Idi-Araba, Comfort Adio was hale and hearty. Before December that year, the 46-year-old woman had never been hospitalised. But what she thought was an ordinary sore on her right breast later became fatal. She was forced to consult a doctor, when the sore did not heal after two months of self-medication.
Her husband, Martin, said, ”We did not suspect that it was a serious illness. We thought that it was a sore that we could treat with an antibiotic.”
The woman was diagnosed with breast cancer at LUTH. According to her husband, the cancerous cells had spread to other organs. In September 2007, she decided to go to India for treatment. The 46-year-old teacher required N4m for surgery and other treatments in India. She died early 2008, while her husband and other relations were making efforts to raise the fund.
While Comfort lost the battle of her life to breast cancer, another patient, Adeola, has been bed-ridden by the ailment. She was diagnosed with it in 2008. Adeola initially took a lump in her left breast for granted because it was painless. When the lump persisted, she strolled to a hospital, where she was diagnosed with the cancer. She has been living in pain since 2009, when she began cancer treatment.
The women‘s cases typify the problems associated with cancer in Nigeria. Besides the two, the ailment, which was hitherto thought to be foreign, had claimed lives of prominent Nigerians. Such people included a Lagos-based lawyer, Chief Gani Fawehinmi; a broadcaster, Mr. Yinka Craig; a popular musician, Mr. Sunny Okosuns and recently, the wife of a former military president, Mrs. Mariam Babangida, who died of ovarian cancer in a United States hospital.
These eminent Nigerians died abroad after unsuccessful treatments. Some of them, particularly, Fawehinmi, were forced to seek foreign treatments, when their conditions were misdiagnosed in the country.
Cancer patients are a pitiful sight to watch when they are in agony. A consultant oncologist at LUTH, Dr. Remi Ajekigbe, said, ”There is no pain as worse as cancer pain. It is the worst pain anybody can have.”
The World Health Organisation estimated that 7.6 million people died of cancer in 2005 globally. It stated that there were 100,000 new cases annually. The world body predicted that the figure would increase to 500,000 as from 2015.
Currently, Nigeria does not have a national cancer registry. There are no reliable data on the prevalent rate of the ailment. What the country relies on are hospital-based statistics. There are, however, indications that hospitals are seeing more cases of different types of cancer.
Ajekigbe, who confirmed this, said, ”There are increasing cases of cancer all over the world. As Nigeria is also part of the world, there is increase in the country. Here in LUTH, if we compare what we are seeing now to what we used to see in 1980s, there has been a 25 per cent increase.”
Also, studies in Ibadan showed that there had been an annual incidence of 10,000 cervical cancer cases in the South-Western part of the country.
What are the reasons for the increasing cases of cancer? One of the reasons is the increase in the level of awareness. More Nigerians, particularly, the educated, now go to hospitals for treatment rather than dying at home.
Medical experts, including Ajekigbe, said that there had been an increase in the level of awareness. Ajekigbe also said, ”We are getting more westernised. We are doing everything the Western way. We are changing our diet and importing virtually everything, including foreign diseases.”
In spite of the increase, cases in hospital may be a tip of the iceberg as cancer screening centres are not in many parts of the country.
While the Federal Government in 2009 directed its tertiary hospitals to set up screening services for breast, cervix and prostate cancers, these are not available in many secondary and primary health facilities. Where facilities are available, only a few Nigeria go for check-ups.
The Coordinator of the National Cervical Control Prevention Programme, Dr. Kin Egwunomwu, at the inauguration of the organisation in Lagos, said that some groups that were offered opportunities of screening rejected them.
Narrating his experience, he said that a church did not allow its members to undergo free cervical cancer screening, when his organisation went there. ”What we often hear from such organisations is ‘God forbid. It is not our portion,” said Egwunonwu, who is also a reverend.
Corroborating the cleric, Ajekigbe said that most cases of cancer in Nigeria were presented late. He said, ”Cancer of the inner parts of the body may not be detected early because it affects parts that are not seen. But the cancer of the outer part can be detected early. Our people report late. They say they are bewitched. They go to native doctors and pastors. They come to hospitals as a last resort.”
Also, the Coordinator of Cancer Control Programme of the Federal Ministry, Dr. Patience Osinubi, stated, ”30 per cent of cancer cases are preventable and 40 per cent are easily detectable in the pre -malignant stages.”
She, however, noted, ”Many cases of cancer are presented to hospitals at advanced stages when effective intervention is not possible. This has been one of the major reasons for the high mortality rate.”
Even when cases are diagnosed, does Nigeria have enough facilities to treat the ailment. Investigations show that currently, Nigeria has five radiography machines to serve a population of 140 million people. A radiotherapy machine is a major instrument for the treatment of cancer. A linear accelerator, an advanced form of radiography, costs N1bn, including the funds for the building and accessories.
The hospitals that have functioning radiotherapy machines include, LUTH; the University College Hospital, Ibadan; Eko Hospital, Lagos; Ahmadu Bello University Teaching Hospital, Zaria and the National Hospital, Abuja.
The five radiotherapy machines are not evenly spread in all the six s zones of the country. Three are in the South West, while one each is in the Federal Capital Territory and North Central.
Osinubi, ”In Nigeria, an average of one linear accelerator per 20 million is available when compared to 3.4 and 8.2 radiotherapy machines per million population in the United Kingdom and the United States of America respectively.
Besides radiotherapy, other treatment options available for cancer patients in Nigeria include, surgery, chemotherapy, and hormone therapy.
Management of cancer is multi-disciplinary. This, a consultant radiation oncologist at the UCH, Dr. Atara Ntekim, in an interview in Lagos, said was one of the reasons why the treatment was expensive.
Explaining treatment options in Nigeria, Ajekigbe said, ”Before anybody can be said to have cancer, the growth in any part of the body is taken by a surgeon and passed to a pathologist, who examines it under a microscope and give a written conclusion on the type of cancer the person has.” He added that the surgeon could remove the growth after diagnosis.
Other method of treatment is chemotherapy, which involves the use of chemicals that kills cells. ”They kill both cancer and non-cancer cells,” stated Ajekigbe.
The use of hormone therapy is common in cancer that is hormone -dependent. According to Ajekigbe, ”When we are treating any cancer that is hormone -dependent, we attack the hormone which the cancer feeds on. In breast cancer treatment, we give anti-estrogen hormone.”
With only five radiotherapy centres available in the county, it is obvious that the treatment of cancer is not accessible to Nigerians. Ajekigbe said that a cancer patients needed about N10m a year complete his or her treatment in Nigeria.
With 70 per cent of Nigerians living below $1 (N146) a day, most people cannot pay for the treatment from their incomes. This is compounded by the fact that the National Health Insurance Scheme, which currently covers about three million Nigeria, does not fund cancer treatment. It only covers cancer screening as well as mastectomies and prostatectomy for breast and prostate cancers.
The coordinator of the cancer control programme acknowledged this in an email sent to our correspondent. Osinubi said, ”Cancer treatment is expensive to treat any where in the world. In Nigeria, the challenge facing patients is the inability of the National Health Insurance Scheme to fund cancer treatment.”
A mammogram (an X-ray of breast cancer) goes for N3,000 - N5,000 in public hospitals in Nigeria, where the minimum wage still remains N9,500 a month.
Cancer patients normally undergo CT scan or a magnetic resonance imaging to detect organs that have been affected by the ailment. A CT scan costs between N30,000 and N40,000. An MRI, an advanced form of a CT scan, costs about N80,000 for just a part (chest for example). A patients may be required to do an MRI of three parts (the head, chest and abdomen).
Ajekigbe disclosed that a patient would require between N500,000 and N12m for chemotherapy ;and N2.5m for hormone therapy in a period of five years.
Cancer drugs are expensive considering the income an average Nigerian. For example Adriamycin, a breast cancer drug is N2,000 per bottle. Another breast cancer drug, Eprirubicin, meant for breast cancer patients with heart problem, costs N10,000 per bottle.
Investigations show that a mastectomy, which is the removal of a cancerous breast through surgery, costs about N50,000 in the country. A breast cancer patient that requires radiotherapy through a linear accelerator should be prepared to pay N100,000. A cervical cancer patient would pay N50,00 more. Chemotherapy costs an average of N100,000 per course of treatment.
The high cost of treatment is compounded by dearth of manpower. Treatment of cancer requires a multidisciplinary approach. Experts needed for treatment include surgeons, pathologists, physiotherapists, oncologists.
In the country, total number of oncologists is less than 100. A consultant oncologists, Ajekgbe, who conformed this, said, ”There are 20 consultant oncologists and 40 others that are at different levels of training.”
Also, the coordinator of government cancer control programme, stated, ”For a country of 140 million population, there is a shortage of trained personnel like radiation oncologists, therapy radiographers, medical physicists and oncology and palliative care nurses. As at the last count, three years ago, there were about 27 qualified radiation oncologists, eight medical physicists and 14 oncology nurses.”
With the high cost of treatment, does cancer afflicts the rich alone? Experts, including Ajekigbe and Ntekim, said that it was common in both the rich and the poor.
According to Ajekigbe, ”There are some cancers associated with being poor. An example is cancer of the cervix. If a girl is pretty, but comes from a poor home, she may use her beauty to get what she wants. This may lead to her being loose or promiscuous, thus exposing herself to cancer of the cervix.
”Also, a rich person, who can afford certain things like food that is rich in high cholesterol may expose himself to cancer. He may shun local foods which can protect him against cancer of the colon..”
Besides these, some habits such as smoking and drinking alcohol may also predispose people to cancer.
Explaining further, Ajekigbe said, ”You cannot place your finger on a cause when you are talking about cancer, but there are factors that predispose one to it. For example, if your parent has certain cancer, you have a higher chance of having it than a person, whose parent does not have it.”
Experts said that Nigeria had facilities for the treatment of cancer. The major hindrance, however, is that they are few. Also, there are late presentation of cases, uneven spread and the high cost of treatment.
Ajekigbe explained why some Nigerians travelled abroad to treat cancer. He said, ”We normally do not refer patients abroad. But if a patient says we should refer him abroad, we do that. But we do not on our own refer patients abroad.”
On referrals, Osinubi said, ”The advantage of going abroad is the availability of several choices of cancer treatment centers. But Nigerian patients still have to pay a lot of funds except they have dual citizenship making them eligible for national health schemes.
”Only the rich, as has been observed in Nigeria, can go abroad for treatment. The outcome of their treatment will be the same unless the cancer is detected early.”
Explaining reasons for misdiagnosis of cancer, she said that it was not peculiar to the ailment. She said, ”Several diseases have similar presenting symptoms. A patient‘s diagnosis also depends on the level of competence of the medical facility he visits.”
With more Nigerians coming down with cancer, the Federal Government has intensified efforts to combat it. The government is partnering with organisations such International Atomic Energy Agency, Vienna to fight cancer.
Osinubi said, ”The partnership with the IAEA is called Programme of Action on Cancer Therapy. Within the next eight years, nuclear medicine equipment, which can diagnose cancer efficiently ,and linear accelerators, will be available in federal tertiary hospitals in all the six geopolitical zones.” The government has already paid the first $2m to the IAEA as part of the counterpart fund for the programme.
Government‘s efforts as laudable as they may be, experts and non-governmental groups said preventive measures should be intensified. The Executive Director of the African Tobacco Control Regional Initiative, Mr. Olufemi Akinbode, disclosed that only Osun State and the Federal Capital Territory had passed bill on smoking.
According to him, the bill is still in the second reading in the National Assembly. Akinbode said that tobacco-related cancer accounted for 30 per cent of cancer deaths globally.
Chronic Human Papilloma Virus can cause cervical cancer. It can be prevented through the administration of HPV vaccines. The National Cervical Cancer Control Policy states that girls from the age nine-years should be eligible for the vaccine. Adults can also get it.
The implementation of the programme is yet to start fully. But, Osinubi said, ”The Federal Ministry of Health is trying to get Global Alliance for Vaccines and Immunisation‘s assistance to procure the vaccines at an affordable cost to sustain its inclusion in the National Programme on Immunisation.”
While Nigerians await the full implementation and success of government‘s anti-cancer measures, who will tame the rampaging monster?

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Smoking: 6.5 million Nigerians risk death in 2010

BEN UKEJI, Abuja

No fewer than 6.5 million Nigerian smokers may die this year from tobacco-related sickness.An international expert, Akinbode Oluwafemi, who said this also said about 65 million Nigerians smoke cigarette.
Oluwafemi said that inability of government to tax tobacco producing companies heavily was responsible for the cheap prices of cigarette making it easily available to low income earners. According to him, increased taxation will lead to increase price of the product thereby, discouraging the youths who were the most vulnerable group from smoking cigarette.

He said a pack of cigarette that sells for N200 in Nigeria goes for about $5 in the United States of America (USA) due to the heavy taxation placed on the manufacturing companies saying “smoking is a sure gateway to drug addiction.”

While describing smoking as a major risk factor for different cancer cases, Akinbode said it is also linked to about fifteen various cases of cancer in human body saying “apart from the high cost of treatment, infrastructural challenges, smoking related cancers accounts for 30 per cent of cancer related deaths.”

The expert who is the Programme Manager, Environmental Rights Action/Friends of the Earth Nigeria said that cigarette contains about 4000 toxic and cancer causing chemicals and is responsible for more than 85 per cent cases of lung cancer.

He said that smoking causes cancer of the mouth, pharynx, larynx, oesophagus, stomach, pancreas, uterine, cervix, kidney, ureter, bladder and the colon.

While urging the National Assembly to hasten the process of passage of bill on the ban on tobacco smoking in the country, Oluwafemi urged Nigerians to support the passage of the National Tobacco Control Bill.

The Secretary for Social Development of the FCDA, Habiba Kalgo while declaring the workshop open said the decision to ban smoking in public places in FCT was necessitated by the increase in the number of deaths arising from cancer cases in the FCT.

She, however, urged FCT residents to support the ban since they were the secondhand smokers were also affected by the fumes of the product.

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Story - CHAMPION

Picture - Vector picture after Vincent van Gogh’s “Skull of a Skeleton with Burning Cigarette”, 1885 (Van Gogh Museum in Amsterdam)