The paediatric ward at Kamuzu Central Hospital and the Baylor Clinical Centre of Excellence are not even 50 metres apart. A small gate and garden separate them within an overcrowded and decrepit hospital in Lilongwe, the capital of Malawi.
But walking the short distance between the facilities feels like travelling thousands of kilometres – from a third world hospital where four children share the same bed to a first world clinic equipped with the latest diagnostic kit.
“Walking from Baylor into the Kamuzu Central Hospital for the first time was like stepping into a different world,” says Allyson McKenney, a doctor from Texas who splits her time between the facilities. Baylor is state of the art, she says, while the hospital suffers from chronic shortages.
The difference between the facilities – replicated in dozens of other places in Africa and Asia – is simultaneously a sign of an impressive global success and a perverse policy failure.
The Baylor centre, funded by the Baylor College of Medicine in Texas and the philanthropic foundations of pharmaceuticals group Abbott, serves as the outpatient paediatric HIV clinic for the main hospital in Lilongwe.
The international focus on HIV, malaria and tuberculosis – with billions of dollars spent annually under the umbrella of the UN Millennium Development Goals – has dramatically reduced their impact in Africa. But the well-intentioned focus on these three diseases has meant less attention and funding for nontransmissible illnesses such as cancer.
“I think cancer is getting less attention from the international donor community because it is a chronic childhood problem and not an acute problem,” says Ms McKenney. “Most of the funding has been focused on . . . malaria, HIV-Aids, diarrhoea, pneumonia . . . cancer is not attracting the money.”
World Child Cancer, the partner in this year’s Financial Times Seasonal Appeal, is trying to narrow the gap between the funding that HIV, malaria, TB and other infectious diseases such as polio and cholera receive every year, and that of cancer.
The charity works with children with cancer in developing countries. This year, about 200,000 children globally will be diagnosed with the disease. In rich nations such as the US and the UK, this does not have to be a death sentence: decades of medical research and advances in treatment mean eight in 10 children battling cancer there survive.
But the vast majority of children diagnosed with the illness live in the developing world, and for them the odds are inverted. In some poor countries as few as one in 10 survive.
Allison Ogden-Newton, the chief executive of World Child Cancer, says fighting cancer in developing countries such as Malawi is relatively cheap. She cites one hospital in the country that last year treated 260 children for just £40,000. “Unfortunately, 100,000 children are dying every year unnecessarily from treatable cancer simply because they do not have access to proper care,” she says.
Rachel Miotha, the head of paediatrics at the Kamuzu Central Hospital, is well aware of the difficulties of providing care to children suffering from cancer. “We have been experiencing drug shortages,” she says. Chemotherapy treatments are often in short supply, as are antibiotics and basic painkillers.
The difference in funding for infectious diseases and conditions such as cancer has prompted many doctors to question whether a fair balance is being achieved.
Peter Kazembe, who heads the Baylor centre in Lilongwe and is an expert on malaria and HIV, believes the focus on infectious diseases is right. But he says the centre is starting to move beyond its initial mandate to focus on those conditions, a process he calls “collateral benefit”. For example, he says, “HIV money” from the Baylor centre is funding chemotherapy treatments and doctors’ salaries and has contributed thousands of dollars for the renovation of the paediatric ward at Kamuzu Central Hospital.
The growing collaboration between the Baylor centre and the hospital is a sign that a “win-win” scenario is possible, in which the focus on infectious diseases contributes to the fight against cancer and other nontransmissible illnesses. But without the support of charities such as WCC, many children in developing countries suffering from cancer will continue to go untreated.
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