In the World of Politics and Stigma Around Cancer, Can Cancer Survivors With Political Career Become Cancer Advocates?

Abstract

Background and context: According to WHO estimates in 2012, around 20,000 Afghans suffered from various types of cancers while around 15,000 die of this disease. Until late 2015, there was not a single dedicated bed for cancer patients nor there was a doctor, nurse or other cancer care professionals within the structure of Afghan government, especially within the Ministry of Public Health. In November 2014 when Dr. Shinkai Karokhail, member of parliament, returned Afghanistan after spending almost a year overseas for breast cancer treatment misdiagnosed in Afghanistan, she and H.E. the First Lady, Rolla Ghani, began advocating for cancer prevention and control in Afghanistan. They managed to bring the few cancer care professionals and advocates under one umbrella called Afghanistan Cancer Foundation (ACF). Aim: To provide cancer care services to cancer patients. Strategy/Tactics: The main strategy was the involvement of known social and political figures in cancer advocacy. Considering the disparity in cancer incidence among men and women and breast cancer being the leading cancer, one of the most influential people was H.E. the First Lady who is a strong advocate of women rights. The other tactic was the involvement of members of parliament who were cancer survivors. Program/Policy process: Once the political commitment regarding cancer prevention and control was gained, H.E. the First Lady and members of parliament asked the Ministry of Finance to allocate fund for cancer prevention and control. Thus, first fund of only $50,000 was provided by the Ministry of Finance provided to Ministry of Health in the fiscal year 2015. Outcomes: As a result of the advocacy efforts by cancer control advocates, especially by Ms. Shinkai Karokhail, the breast cancer survivor, and H.E. the First Lady of Afghanistan, the first 10-bed day-care and 29-bed IPD cancer center was established in Afghanistan in March 2016. Subsequently, the National Cancer Control Program (NCCP) was created in January 2017 within the Ministry of Public Health. In addition, the first hospital-based cancer registry was formed which will be followed by establishment of Kabul Cancer Registry. The only cancer center provided health care services to around 12,000 patients in 2017 who were either not receiving cancer care services or were traveling to neighboring countries for diagnosis and treatment. What was learned: Cancer patients/survivors who have political career can be the best cancer prevention and control advocates.