After years of conflict, Liberia's health system faces a vast array of challenges. The impact of communicable diseases continues to rise and the recent Ebola outbreak has had a devastating effect on the population’s health.1 As a consequence, investments to address other public health concerns, including the growing cancer burden, have significantly lagged behind.
In June 2016, the IAEA Programme of Action for Cancer Therapy (PACT) conducted an assessment of Liberia’s cancer services with international cancer experts nominated by the IAEA, the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC). The team visited public and private healthcare facilities, primary clinics and medical schools, and liaised with national stakeholders involved in the fight against cancer, including NGOs such as the Liberian Cancer Society. Such an assessment, known as an "imPACT review", is usually the first step IAEA Member States take in developing a national cancer control strategy. It is one of a number of activities the IAEA offers to assist a country tackling its cancer burden.
Collecting reliable cancer data is extremely important to build an understanding and response to the disease. Re-establishing the national cancer registry, closed since the late 1970s, was a key priority identified by the imPACT team. Its re-engagement would allow Liberia to direct services to areas where they are most needed, for instance to address breast and cervical cancers, two of the country’s most common cancers.
It is estimated that there are over 2,000 new cases of cancer and approximately 1,600 related deaths each year in Liberia, and the rate is anticipated to nearly double by 2030.2 Women are particularly affected because of the high burden of cervical cancer which accounts for almost a third of all female cancer deaths, followed by breast cancer which claims one in five.
The Review's experts also drew attention to the urgent need to re-build and train the much depleted health workforce following the Ebola crisis, and to provide adequate palliative care, by way of psychosocial support and pain relief, for the high percentage of cancer cases diagnosed at an advanced and incurable stage.
Dr Alex Gasasira, WHO Representative in Liberia, said that the recommendations of the imPACT review mission will greatly enhance the ability of Liberia's health system to take a comprehensive approach in delivering cancer services. The Review's findings and recommendations are expected to be reflected in the National Cancer Control Strategy, which is currently under review.