World Cancer Congress Paris 2016 Crossing borders, crossing diseases: sharing what works for civil society in responding to

Cancer and other NCDs

Dr. Msafiri Marijani Chairperson Zanzibar NCDA United Republic of Tanzania

Introduction

• Zanzibar is a semiautonomous country made up of 2 sister islands (Unguja and Pemba) and forms part of United Republic of Tanzania.

• Population: 1.3 million • Economy: mostly depend on tourism and

Agriculture (cloves) GDP – USD 600 mil Per capita income 617 USD

Health sector in Zanzibar

• priorities infant mortality, martenal mortality & communicable diseases (HIV, TB & Malaria).

• Top 3 causes of death in hospitals: pneumonia, severe Anaemia and Hypertension.

• NCD burden: 33% ↑B.P, 35.5% Overweight, 3.7% ↑FBG, 7.3% Smokers (WHO STEPs 2011).

Cancer – 124 cases per annum (Path. Lab data 2014).

• NCD unit, Ministry of Health established in 2012.

Health sector in Zanzibar

• One main referral hospital (Mnazi mmoja). • 1-2 specialists in every department. • 3 general surgeons, 2 radiologists, 1

Pathologist, 1 Diabetelogist, 1 Cardiologist, 1 Oncologist.

• Histopathology services reestablished in 2014. • Oncology services (most chemotherapy not

available) 2016. most patients still referred to Ocean road cancer institute in Dar es salaam.

Health sector in Zanzibar & NCDs

Lack of awareness on NCDs both in Government & community

Most patients with common NCDs report to the hospital at late stages of the disease requiring costly interventions outside the country

(Government & Families) and yet with poor outcomes!

Zanzibar NCD Alliance

• Established in 2013 with support from Danish NCD Alliance.

• Initially comprised of Diabetes Association of Zanzibar and Zanzibar Cancer Association, Zanzibar Heart Foundation joined later in 2014.

• Aim is to improve welfare of people living with common NCDs (Diabetes, Heart, Cancer and chronic Respiratory diseases) and promote its prevention to the general public in Zanzibar.

Zanzibar NCD Alliance

Number of members in each member association:

• DAZ : 1730 • ZCA: 108 • ZHF: 265 A total of 50 Volunteers were trained, but only

24 are active.

Zanzibar NCD Alliance

Project funding for ZNCDA activities mainly from CISU (Civil Society Fund) where application was done in partnership with Danish NCDA.

• 2013 – 2014: total funds DKK 500,000/- • 2015 – June 2017: total funds DKK 1,612,798/-

ZNCDA OFFICIAL LAUNCHING

Zanzibar NCD Alliance

Main activities: • Raising awareness on risk factors for common

NCDs. • Raising awareness on early detection of

common NCDs through screening activities. • Advocacy for affordable quality care for

people with common NCDs.

Zanzibar NCD Alliance

Raising awareness on NCD risk factors • ~250 NCD radio and TV slogans/spots were aired

~40,000 people have heard about NCD prevention and risk factors.

• 50 volunteers trained on risk factors, patient support, counseling and Nutrition.

• 2500 brochures for public awareness on common NCDs were produced and distributed

• Commemoration of the World’s Diabetes, Cancer and Heart Days through walks, exercises and media briefings.

ZNCDA ORGANIZED WALK

Zanzibar NCD Alliance

Early detection of common NCDs Outreach services: • 2014: cervical cancer screening ~400 women

(3.3% detected with early stage cancer) • 2015: ~1300 people screened for D.M (13% )

and Hypertension (36% detected) • 2016: ˜1500 people screened for D.M (0.7%

detected) and Hypertension (40% detected)

Zanzibar NCD Alliance

Advocacy for quality care to people with NCDs Four position papers developed and presented to the

Government, stakeholders and Members of Parliament:

• Establishment of Zanzibar Cancer Registry – efforts ongoing btwn. Govt & AFCRN to train 2 staff.

• Availability of Essential Medicines for NCDs – some cancer drugs included in the Essential Drug List

• Nutrition • Access to qualified NCD health care workers

Zanzibar NCD Alliance

Ongoing Alliance strengthening activities: establishment of Lung Disease Association & fund raising applications to donors and partners. Conclusion…..Way Forward • ZNCDA currently a member of EA NCD Alliance

established in 2015 in partnership with DNCDA aims to be a powerful CSO in the region assisting the Government in a fight against NCDs.

Thank you!