IT is that time again when policymakers at the Finance Ministry are putting together the national budget for the coming year. This process typically involves gathering input from different stakeholders, representatives from various industries and even the public.
Those living with cancer, their caregivers and healthcare professionals are hoping that Budget 2022 will be more transparent and clearer when it comes to allocations for cancer treatment and care, especially as the country’s attention would still be focused on rebuilding the economy after the ravages of the Covid-19 pandemic. This would be a bad time to under-invest or cut spending on cancer, however.
This past year-and-a-half has been anything but typical. The Covid-19 pandemic has overloaded health systems, consumed valuable resources, caused massive disruptions to livelihoods and businesses, and cost the lives of so many, including healthcare workers.
The crisis is severely impacting all aspects of cancer care, including prevention, diagnosis and access to treatment.
People are worried about going to the hospital to be screened. Community cancer programmes have been halted since last year. Screening measures such as mammograms and colonoscopies have been postponed. Surgeries have been deferred or delayed. Beds and personnel have been reassigned to Covid-19 wards.
The number of cancer diagnoses has seemingly decreased during this past year, but it is likely to increase in the near future.
An estimated 65,000 people in Malaysia are now expected to be diagnosed with cancer in 2030. If the current conditions remain, most of them will continue to be late-stage cancers. Upstaging, where cancer is diagnosed at a later stage, will be more common as opportunities for early detection are missed. It is not yet known how many more lives will be lost to cancer due to the disruptions caused by this pandemic.
Researchers have studied the effects caused by Covid-19-related delays in cancer treatment. They found that depending on the type of cancer, a treatment delay of four weeks increases the risk of death to between 6% and 13%. For breast cancer, still the top cancer among women in Malaysia, an eight-week delay in surgery increases the risk of death by 17% while a 12-week delay increases it by 26%.
These extraordinarily challenging times have forced healthcare practitioners to innovate the delivery of quality care so that equal or better outcomes can be achieved despite the limited resources.
Another key lesson learnt from this crisis is that investments in strong and resilient health systems are critical in mitigating the country’s response to a pandemic such as this one. Malaysia’s decades of investment in its public health infrastructure have paid off. Our health system, despite the multiple surges and being under tremendous pressure, continues to weather the Covid-19 storm and we are still considered in better shape compared to several of our neighbours.
That lesson on the value of investment should be applied to cancer care. Effective interventions in cancer prevention, timely diagnosis, advances in therapies and care delivery models, which have reduced the number of cancer deaths and improved the quality of life for those living with the disease, need serious consideration.
Cuts or reductions in treatment and care would undoubtedly set back years of progress for cancer patients, especially those accessing and depending on services and treatment in public healthcare services. Safeguarding the cancer budget will ensure continuity, efficiency, and sustainability of cancer care for those who depend on it.
AZRUL MOHD KHALIB
Galen Centre for Health & Social Policy