<div><span style="font-family: helvetica; font-size: 14.6667px;">The hopes and fears of cancer patients in 2016 are best captured in the gentle conversations between cancers patients who spend up to 8 hours hooked to intravenous cocktail of drugs in chemotherapy centers.  Their constant prayer is that a mechanism to make cancer treatment more accessible will be found.  Another item that keeps cropping up in the chitchat that fills the long chemotherapy hours is the need to establish guidelines on how and when patients should seek treatment abroad so as to curb the runway exploitation of cancer patients by medical tourism agencies. </span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">Whether it is chemotherapy patients or counties trying to outdo each other in acquiring ‘cancer machines’, the cancer problem will increasingly continue to pre-occupy our healthcare system for a long time.</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">The clamor for ‘cancer ‘machines’ by  counties which is supported by both the public and the media as the only solution to the cancer crisis is obviously a simplistic approach to  a complex problem.   Unfortunately this myopic view is what appears to inform some counties in their quest to procure high end technology as the ultimate solution to the cancer problem. Though specialized equipment is critical to effective cancer diagnosis and treatment effective cancer control requires more than specialized machines. It requires political good will and moral courage to put tough legislation on cancer causing agents like tobacco and alcohol and say no to industry overtones in form of gifts and campaign funds.</span></div><div> </div><div><span style="font-family: helvetica; font-size: 14.6667px;">Several counties have already made plans to build cancer centers; others have committed money to establish the same.  These well-meaning efforts must be cast within the framework of the national cancer control strategy, engaging all sectors of the society from the hawkers to the politicians.</span></div><div> </div><div><span style="font-family: helvetica; font-size: 14.6667px;">Counties need help in identifying priority areas of cancer control that require low financial, material and human resources investment but with the greatest impact.  Smoking cessation services, lifestyle modifications programs, HPV vaccinations, cervical cancer screening using table vinegar are low cost interventions that would not need ‘machines’.  According to the International Association of Cancer Research, almost a quarter of all cancers in Africa are caused by infectious agents. Aggressive vaccination programs  against viruses such as Hepatitis B (associated with liver cancers),  Human Pappiloma Virus (associated with cervical cancer) and treatment and prevention of other infectious agents such as those causing bilhazia (associated with bladder cancer) would not need as much money as buying machines.  Perhaps this is where counties should put their money and free the national government to establish the much talked about regional cancer centers of excellence.</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">Cancer is a multifaceted and complicated disease.  It cannot be ‘fought’ with machines alone nor can it be approached as a series of ad hoc screening events and occasional television or radio talk shows. Cancer experts are now coming to the realization that early detection alone does not save lives.  Lives are saved by prompt and appropriate treatment.</span></div><div> </div><div><span style="font-family: helvetica; font-size: 14.6667px;">Clearly the newly appointed cabinet secretary for health Dr Cleopa Mailu has his job cut out for him. But he can count on the support of cancer stakeholders and the vibrant cancer civil society under the network of cancer organizations to design low cost models of increasing access to cancer information, screening, diagnostics and treatment. </span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;"><em>By Mr David Makumi, Regional Manager, Cancer Programme at Aga Khan University Hospital and Chair of the Kenya Network of Cancer Organizations.</em><em></em></span></div>