The cancer crisis in South Africa is becoming insurmountable, where access to cancer treatment and care is disproportionately associated with socio-economic status, access to health insurance, and geographic location. With high costs, many standard-of-care treatments are unaffordable for partially insured or uninsured patients. The situation is made worse by long waiting lists, inadequate human resources and infrastructure weaknesses.
Radiation oncologist Dr Sudeshen Naidoo, who practises at the Sandton Oncology Centre, aims to address these disparities. As founder of the Johnson Rose Cancer Foundation – named after his father and aunt – he is tackling this human rights crisis via an ambitious multi-pronged approach.
“One of the objectives of the foundation is increase the number of oncologists in South Africa by funding doctors to specialise in the field and to try and retain them in the state sector,” he says. “Secondly, we aim to provide equitable access to cancer care for partially insured and uninsured people of this country. By directly funding treatment with curative intent, we can prevent many avoidable deaths. The third objective of the Johnson Rose Cancer Foundation is to support families and communities that have been affected by cancer through access to counselling and other support services.”
Dr Naidoo is no stranger to the tragedy of cancer. “My first experience was in childhood, when my beloved aunt Rosie was diagnosed with stage 4 cancer and passed away within a few weeks of her diagnosis,” he says. “This shattered our family – and her death solidified my later career decision to specialise as an oncologist.”
In 2019, his father, Dr Johnson Naidoo, was diagnosed with an aggressive stomach cancer. “Although he had a successful surgical resection, he could not complete his chemotherapy and radiation treatment due to the side effects and his age,” Dr Naidoo explains. “He’d always been a superhero to me – a juggernaut in his field who helped shape Occupational Medicine in Kwa-Zulu Natal. As an oncologist I felt helpless and an inner rage to see him deteriorate so quickly. Just a year after his initial diagnosis, he succumbed to the illness in August 2020.”
After graduating, Dr Naidoo joined the largest private radiation oncology group practice in South Africa. “But more importantly, I was also given the opportunity to serve my country as the radiation oncology advisor to the Ministry of Health in South Africa from 2017 to 2020,” he explains.
“During my time as the minister’s advisor I co-authored guidelines and contributed to the National Strategic Cancer Plan in SA 2017-2022. I also authored Radiation Oncology crisis in South Africa which led to some public private partnerships. This tenure equipped me to understand the complexities involved in South Africa in enabling access to treatment and has shaped the purpose of the Foundation.”
Dr Naidoo says that the cancer crisis in South Africa will be ongoing for one simple reason. “Eighty five percent (85%) of the population are serviced by only 15% of the oncologists in the state sector, while 85% of the oncologists are currently in the private sector, servicing only 15% of the population
who are insured,” he says. This inevitably causes bottlenecks in the state sector because there simply aren’t enough oncologists.
“We know the current public healthcare system is under immense pressure and in crisis. However, cancer is a time sensitive disease, the sooner a patient receives evidence-based treatment the better the outcome for them. Unfortunately, in some geographical areas a fair number of cancer patients need to wait months for treatment to start. Even if they receive surgery and chemotherapy, the waiting lists at radiation oncology units are months-long.”
“As an oncologist, I must ask what was the point of that chemotherapy and surgery? Radiation must occur within a certain window period, which is either two to four weeks after chemotherapy, or four to seven weeks after surgery depending on the stage of disease. So, all those patients are waiting to be treated, to be saved, but unfortunately, they’re waiting too long and are at risk of the disease returning,” says Dr Naidoo.
This impacts families negatively. Cancer, and its treatment, result in the loss of economic resources and opportunities for patients, their families, communities, and society overall. Children are at particular risk of dropping out of school especially when the sole bread winner is sick.
The foundation understands these complexities and will take a multi-disciplinary approach that integrates services to focus on the patient, and their families. The aim is to partner with government, other NGOs and organisations and refer patients and their families for additional services when required. This includes support services for transport and accommodation to access treatment and care and referral to services in community including palliative care and counselling.
The Johnson- Rose Cancer Foundation is led by a team of dedicated cancer care professionals, which includes co-founders Dr Keo Tabane and Dr Omondi Ogude. Its Board of Directors is a collaboration of experts from the South African oncology community and includes, oncologists,
business and managed healthcare professionals, patient advocates and social workers. Importantly the Foundation is also convening an Academic Advisory Committee which is open to all government oncology heads of department, to advise on policy and process.
The registered NPC is the first of its kind in Southern Africa providing much-needed funding and assistance to state patients and families afflicted by cancer. But as Dr Naidoo says, “we can only close the gap in cancer care, if we have your support and your investment in the people with no voice who need our help.”
To learn more about the foundation and how you can help uninsured South Africans to receive cancer treatment and care visit www.johnsonrosecancer.org.