South African activists have called on the government to provide legislative and policy certainty to ensure cancer patients have access to the health care they need.

Currently, the country’s only policy framework on cancer comprises cervical and breast cancer policies and the palliative care strategic framework. The government has so far failed to develop a national cancer control plan.

According to activists, the public healthcare system is failing to fulfil the right to access health for cancer patients. They say this is mainly due to:

• Issues with policy creation and implementation
• The structure of public healthcare; and
• The current funding model of healthcare in the country.

No specific legal framework 

Section 27 of the Constitution states that ‘everyone has the right to have access to healthcare services. This includes reproductive healthcare and that no one may be refused emergency medical treatment, as well as the right to cancer treatment. 

But according to Khanyisa Mapipa, an activist who works as an attorney for health rights programmes at SECTION27, there is no specific legal framework that relates to cancer as a disease under the right to health.

“Cancer has been identified as one of the diseases that causes the deaths of people in South Africa. Yet, it hasn’t been allocated a specific budget to deal with the disease,” said Mapipa.

She further stated: “Although the state understands that cancer is an important disease, there is still no legal framework that regulates how the treatment of cancer should go.”

Mapipa was speaking during the CANSA/Cancer Alliance seminar titled Unpacking the implications of constitutional guarantees on the right to health for cancer patients yesterday.

“The state is only bound to take reasonable steps within its available resources to progressively realise the rights under section 27,” added Mapipa.

According to a study done by the Cancer Alliance in 2021, titled Cost of Cancer: Challenges for the next 10 years, the country has an incomplete policy framework with policy implementation lagging even further behind as several policies remain at the development stage. The policies for prostate, childhood and lung cancer are included. Meanwhile, the breast cancer policy was developed and approved at national level in 2017 but not at provincial level. The palliative care strategic framework was developed and approved in 2017 but is yet to be implemented.

Importance of collaborations

National Chairperson of the Treatment Action Campaign (TAC), Sibongile Tshabalala, has since urged all non-profit organisations (NPOs) that advocate for proper access to healthcare services, to unite and fight for the rights of patients.

“It does not only require oncologists in hospitals or the government’s response to these issues. It also needs us as activists, as patients and survivors to work together to fight cancer and ensure access to treatment,” said Tshabalala.

“We are seeing it on the ground. Patients are unable to work and they are left stranded, not receiving any kind of support. At the end of the day, they don’t where to turn to,” said Tshabalala. 

The World Health Organisation (WHO) states that cancer is the second leading cause of death globally. It accounts for an estimated 9.6 million deaths or one in six deaths. While lung, prostate, colorectal, stomach and liver cancer are the most common types of cancer in men, breast, colorectal, lung, cervical and thyroid cancer are the most common among women.

Long waiting periods 

Another challenge faced by patients is the long waiting period for treatment. Some must wait years to access essential treatment within public health facilities. This is due to some of them not being fully equipped to offer comprehensive treatment and care.  

Dr Duvern Ramiah, Head of Radiation Oncology at Charlotte Maxeke Johannesburg Academic Hospital, said that the hospital has been waiting for the procurement of radiation equipment machinery for the past four years. However, the tender process has dragged on for years which has affected the provision of services.  

“The hospital does not have rapid therapy available which is necessary to treat patients with cervical cancer,” said Ramiah.

He continued: “The reality is that several patients are unnecessarily dying unnecessarily once referred to our radiation oncology unit. We cannot buy a piece of equipment although the budget is there for it.”  

"The state does understand that cancer is an important disease but there is no legal framework that regulates how specifically the treatment of cancer should go." – Khanyisa Mapipa, attorney at SECTION27. pic.twitter.com/lfJ4TcWZiU

— SECTION27 (@SECTION27news) October 6, 2022

Unfair labour practices 

The National Director of the Legal Resources Centre (LRC), Nersan Govender, said the country should learn from HIV. Similarly, cancer patients also have to fight to be treated fairly at their workplaces. 

“Our constitution does not guarantee automatic protection against dismissal, unfair labour practice of cancer patients at their place of work. For example, people diagnosed with HIV/Aids have automatic protection. However,  people diagnosed with cancer do not have this health benefit,” said Govender.

“The constitution states that everybody has got a right to fair labour practice. But many people who are diagnosed, are battling fronts like securing their jobs,” he said.

The 2019 National Cancer Registry (NCR) report indicated that cancer of the breast, cervix, colorectal, and prostate are some of the leading types of cancer in SA. – Health-e News