08 January 2014
Authorities are working to open two dedicated cancer centres in Batna and Sétif by early 2014, a small but important step towards addressing a growing number of cancer cases. Like many emerging markets, Algeria is experiencing an epidemiological transition: as the treatment improves for infectious ailments, non-communicable illnesses such as cancer, diabetes, chronic respiratory and cardiovascular disease are drawing more attention.

Disease burden

Cancer accounted for 21% of mortalities in Algeria and one-third of deaths from non-communicable diseases among the 30-70 age group in 2008, according to the most recent data from the World Health Organisation. The prevalence rate, which increased from 80 cases per 100,000 people in the 1990s to 120 cases in 2008, is expected to reach 300 cases per 100,000 within 10 years, comparable to rates found in the US, Canada and France.

In 2003, Algeria became one of the first countries in North Africa to establish a publicly funded nationwide cancer prevention programme, which promotes healthy living, early testing and improving the quality of care. Yet the country still faces a shortfall in terms of hospitals, oncologists and equipment. Wait times for radiotherapy or surgery can be as long as 18 months, according to public comments by Abdelmalek Boudiaf, the minister of health, population and hospital reform.

Expanding infrastructure

Most cancer patients seek care at one the country's six public cancer centres, all of which operate well beyond their capacity. In an effort to address this shortage, the government is investing in new facilities, in line with its 2010-14 five-year plan. The goal is to construct 45 specialised health centres, 15 of them dedicated to oncology.

The recent opening of two in Batna and Sétif should improve access, at least in the eastern provinces. The anti-cancer centre (centre anti-cancer, CAC) at Batna, about 70 km inland of the coastal midpoint between Algiers and Tunis, will eventually serve that city and its five neighbouring provinces. Its 90-bed day hospital, opened in mid-2012, offers diagnostic services and outpatient chemotherapy. The centre's radiotherapy service, originally slated to open in 2012, is now planned for the first quarter of 2014 due to delays in acquiring equipment and recruiting qualified specialists. The full 240-bed facility is expected to open in 2014, offering a range of in- and out-patient diagnostics, treatment and surgical services. About 130 km north-west of Batna, the Sétif CAC officially launched its oncology ward in October. The 160-bed centre will also be developed in stages: services in radiotherapy, nuclear medicine and surgery will become available over the course of 2013-14.

These two radiotherapy clinics should relieve some of the pressure on the cancer treatment facility in Constantine. According to data published by provincial health officials, around 1200-1500 new cancer cases are registered each year in Sétif and 5000-6000 per year in the Hauts Plateaux region, a figure well beyond the capacity of the facility in Constantine.

CACs in Annaba and Tlemcen are also slated for completion in 2014, and studies have been commissioned for several others elsewhere. Most recently, the ministry gave a green light to preliminary studies for a CAC in Oran, Algeria's third-most populous province.

Equipment shortages

The new facilities will go a long way to improve access to specialised care, yet many existing centres face equipment shortages, especially in radiotherapy, and maintenance can be challenging. To remedy this, in September 2013 Algeria formed partnerships with two major manufacturers of linear accelerators, the primary machinery used in radiotherapy - US-based Varian Medical Systems and Sweden's Elekta. The agreements ensure the supply of machines, along with the maintenance and personnel training to improve equipment performance in the long term.

The CACs in Batna, Sétif and Annaba are scheduled to receive linear accelerators in February 2014, in time for the launch of their radiotherapy services. One machine has already been delivered to the hospital in Constantine, with two more expected to follow in the first half of 2014.

In the long term, rising cancer prevalence and the need to triple the number of specialised clinics will require significant expenditures on technology and pharmaceuticals by the government. The new cancer centres are coming along, but delays related to equipment purchases and insufficient medical personnel continue to be obstacles, even for centres already completed. The health ministry says it is interested in teaming up with private sector partners, especially for the purchase of equipment and chemotherapy medications, which may help to accelerate efforts to meet the growing need for cancer treatment.

© Oxford Business Group 2014