In Kenya, musculoskeletal sarcomas (bone cancers) present a significant healthcare challenge, with the country’s leading teaching and referral hospital, Kenyatta National Hospital, reporting approximately 600 new cases annually. Unfortunately, less than 30% of these patients receive timely and specialized treatment. Consequently, nearly half of the diagnosed cases result in death within five years due to late detection and limited access to comprehensive care.  

Notably, survival rates in the Global South, including Kenya, are as low as 15% for advanced stages compared to rates as high as 85%  in high-income countries.

Global Health Unfiltered speaks with Global Surgery Advocacy Fellow Dr. Nicholas Okumu, who heads the orthopedic oncology unit at the Kenyatta National Hospital, about proposed structural reforms in cancer treatment toward ending preventable deaths.

Q: What is the state of musculoskeletal sarcoma treatment in Kenya?

A: Late diagnosis and limited access to specialized care challenge treatment for musculoskeletal sarcoma. Kenyatta National Hospital reports approximately 600 new cases annually, but actual numbers could be higher due to underreporting across other facilities. This results in a national data gap that obscures effective interventions. 

Moreover, the high costs of treatment, averaging at a minimum of Ksh 500,000 (approx. 4,000 USD), are a significant barrier. This financial burden is often insurmountable for many in a country with a 35.1% poverty rate. As a result, delayed presentations are on the rise, further exacerbating the problem. 

Kenya, a country with a population of over 50 million, only has five fully equipped facilities. The national budget for health in Kenya for the financial year 2023/2024 is Ksh 141.2 billion (1.06 billion USD), but the National Cancer Control Strategy 2023-2027 estimates that Ksh 53 billion (397 million USD) will be required to fund cancer care over the next five years.

Q: How are you addressing these challenges?

A: The Kenyatta National Hospital’s orthopedic oncology unit, the Ministry of Health, the National Cancer Institute, and the Kenya Orthopaedic Association are working together to enhance existing healthcare frameworks. We are establishing national screening guidelines, increasing public awareness, and improving the training of healthcare professionals. This collaborative approach bridges the gap in early detection and specialist training and builds on existing efforts to create a more robust healthcare system. The project acknowledges and complements ongoing initiatives such as the National Cancer Control Strategy 2023-2027, ensuring a synergistic enhancement rather than duplication of efforts.

Q: What impact do you anticipate on healthcare practices and outcomes?

A: Our aim is not just to improve but to save lives. We are determined to increase the survival rate for musculoskeletal sarcomas from 15% to 85% within the first five years. By implementing early detection and standardized treatment protocols and a more responsive referral system, we will significantly improve survival rates and patient outcomes. Our training programs are designed to enhance the skill set of healthcare professionals, filling critical gaps in sarcoma care without undermining the existing standards of medical training. This initiative will elevate the level of specialized care available and strengthen the overall healthcare system’s response to cancer.

Q: Looking ahead, how do you envisage the evolution and sustainability of your proposed project towards cancer treatment in Kenya?

A: The future of this project lies in its sustainability through establishing a robust trust fund that provides long-term financial support for sarcoma care initiatives. This endowment, inspired by models like the Aga Khan University and Harvard Endowment funds, will ensure ongoing funding independent of fluctuating donor support. Public-Private Partnerships (PPPs) will play a crucial role, leveraging private sector efficiency and resources for public health gains. This strategic approach will enable the project to adapt and expand, potentially setting a precedent for healthcare funding in low-resource settings.

Q: How can others get involved?

A: Join us in revolutionizing sarcoma care in Kenya. Your support will provide a foundation for sustainable healthcare improvements, significantly impacting the lives of many. Invest in our trust fund and be part of a transformative change that promises a healthier future for all Kenyans. Contact me by email at nicholas.okumu@live.com or via WhatsApp at +254720797450.