Support for blood cancer patients is thin. This needs to change

While South Africans recently observed Human Rights Day, the notion of basic human rights continues to be a global topic of contention, particularly as the World Health Organisation (WHO) asserts that health is a fundamental human right.

The organisation’s director-general, Dr Tedros Adhanom Ghebreyesus, expands on this notion well, explaining that enjoying the highest attainable standard of health is a fundamental right of every person.

In SA, the public’s right to health is protected by Section 27a of the constitution, which declares that everyone has the right to access to healthcare services. While this is embedded in our rights as citizens, it is often our misinterpretations and the failures of providers that lead to the collapse of such rights.

The right to adequate healthcare is particularly relevant when addressing dread diseases such as cancer, where specialised medical interventions can prolong or save a life. Most notable is the need for interventions to address more pressing cancers, such as hematologic malignancies, or blood cancers. These are orphan diseases and are not nearly as common as the more predominant types, such as breast and prostate cancer.

All cancers require immediate intervention, but once blood cancer is detected in a patient, the clock starts ticking to seek appropriate treatment. While conventional intensive treatments such as chemotherapy have proven useful, they can only drive the disease into remission and patients have a high likelihood of relapse.

Treatments such as blood stem cell therapy have a high probability of eradicating the disease. However, there have been challenges to the procedure in SA.

The department of health promulgated the Medical Schemes Act 131 in 1998, which featured an annexure that defines what stem cell transplantation is and how patients would qualify. It also noted that the act would be reviewed and updated every two years. However, this has not happened.

While treating blood cancer is expensive, with a single blood stem cell transplantation for a patient with leukaemia costing the same as treating hundreds of patients with chronic illnesses such as HIV and tuberculosis, not attending to them infringes on their right to healthcare. The outcomes of blood stem cell therapy are excellent and the procedure is no more expensive than providing dialysis to a patient with chronic kidney failure for one year.

There is a dearth of hematologists in SA and a scarcity of haematology centres. For this reason we constantly engage with universities to train and create more positions for the profession.

Doing so will allow us to increase our geographical availability and enable us to attend to patients in rural areas who do not have the luxury of going to nearby healthcare facilities or the finances to travel to facilities in urban areas to seek specialised medical intervention.

There are two steps to consider that will ensure South Africans dealing with blood cancer are afforded their constitutional right to access healthcare and protect their right to human dignity. It begins with the updating of Prescribed Minimum Benefits (PMBs), a set of defined benefits to ensure all medical scheme members have access to certain minimum health services.

The next step is to continue creating awareness around blood cancers and informing South Africans how they can become involved in saving the life of another. We envision members of the public becoming advocates for life-saving blood stem cell transplants to fend off blood cancers and this is where DKMS Africa plays a pivotal role.

It provides a second chance at life for more than 22 patients every day. While these numbers are admirable, doctors have to scour the registries for matching donors. Often a patient’s siblings have a 25% probability of being a match. However, in a country such as SA, siblings often don’t have the same mothers or fathers. This makes seeking treatment that much more difficult. While the next step would be to seek an unrelated donor, for many this cannot become reality with the state not paying for procedures linked to unrelated donors.

The donor registration process takes less than seven minutes to offer someone new hope. After registering online, DKMS Africa couriers a swab kit to potential donors free, and once a swab has been collected, the sample is sent to the organisation’s laboratory for HLA typing.

For more information, visit www.dkms-africa.org

Dr Theo Gerdener is medical director at DKMS Africa.