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P1 billion cancer project to halt patients’ referrals to SA

Publishing Date : 10 April, 2018


Botswana could soon be manufacturing isotopes which would pave the way for cancer treatment in hospitals in Botswana and internationally. The project is the brain child of the Botswana International University of Science and Technology (BIUST) in conjunction with MAGO Enterprise of South Africa.

An isotope is a form of a chemical element whose atomic nucleus contains a specific number of neutrons, in addition to the number of protons that uniquely defines the element. Basically they are atoms of the same element which have different relative masses.
Confirming the development, BIUST Vice Chancellor, Professor Otlogetswe Totolo said “It will be a good example of University-Industry partnership to produce solutions for societies we live in.”  The project will be capital intensive because it will need an injection of close to P1 billion which shall be a cost shared by BIUST and MAGO Enterprise.

But Professor Totolo cautioned that the project is still at its initial stages. He said before the project takes off, they need to have an agreement with the Ministry of Health and Wellness and the Ministry of Tertiary Education, Research Science and Technology (MOTE) because the isotopes will be used in hospitals. Professor Totolo also indicated that the Radiation Protection Agency will also have to regulate the isotopes production facility.

Botswana’s public health facilities predominantly refer cancer patients for treatment and in some cases diagnosis to private facilities. South African hospitals receive a lot of cancer patients from Botswana because of lack of appropriate equipment in Government hospitals. Professor Totolo is confident that having an isotopes production facility will help reduce the number of patients referred to private hospitals especially South Africa for medical attention.

Government currently pays in the region of P92 000 and P200 000 for a single cancer patient referred to a private hospital locally and to South Africa respectively. The main problem at public hospitals is the lack or shortage of equipment used for radiotherapy. The Vice Chancellor said as an institution that is aggressive in research and innovation, their programmes are accredited by Botswana Qualifications Authority (BQA) and various other bodies such as the Engineering Council of South Africa, the Engineers Board and automatically BIUST students are recognized by the Washington Accord because of their affiliation to these bodies. He said technologically advanced projects such as the production of isotopes will position BIUST as an academic centre of excellence while also helping the country to diversify its economy.

Professor Totolo encouraged students to take up sciences and mathematics and enroll in similar subjects with BIUST because they will have the opportunity to provide solutions to the country’s economy by partaking in the in these kinds of projects as they continue to take shape.“I would envisage a BIUST that has more products and services responding to the challenges of Batswana. Botswana is experiencing an increase in the number of cancer cases and a project of this nature will be most welcome in the health sector. A BIUST that has a closer cooperation with other parastatals that have a similar mandate such as BITRI and Botswana Innovation Hub.”  He said the two parastatals could tap into the resources at BIUST to streamline costs and to share knowledge.

Research conducted elsewhere indicates that the rest of the radioisotopes encountered in the world are man-made. When a combination of neutrons and protons, is produced artificially, the atom will usually be unstable and is called a manmade radioactive isotope or radioisotope. Meanwhile studies in developed countries in which surgeons, pathologists, oncologists, radiologists, social workers or psychologists, and nurses are involved in discussing each case suggest that multidisciplinary teams (MDTs) can decrease time to diagnosis, time to treatment, and duplication of investigations, as well as improve accuracy of diagnosis. Thus, the establishment of an MDT is warranted.

According to a journal article that appeared on the Journal of Global Oncology authored by Surbhi Grover, Sebathu Philip Chiyapo, Priya Puri, Mohan Narasimhamurthy, Babe Eunice Gaolebale, and  Neo Tapela: “More than 75% of patients with cervical cancer in Botswana have locally advanced disease. In Botswana, current treatment includes radiotherapy and cisplatin-based chemotherapy. Radiotherapy, however, is not available in the public sector; hence, patients are referred to the private sector for radiation. On the basis of our pilot data, the median time from diagnosis to treatment is 108 days. To decrease cervical cancer morbidity and mortality, it is imperative to identify and address factors contributing to delays,” they wrote.

It is evident from their paper that delays are caused by lack of appropriate equipment and the long waiting list that has to be referred to private hospitals for medical attention. The six health professionals, whose journal is titled Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings indicate that cervical cancer is a major cause of mortality in low- and middle-income countries (LMICs) and the most common cancer diagnosed in women in Botswana. “Most women present with locally advanced disease, requiring chemotherapy and radiation. Care co-ordination requires input from a multidisciplinary team (MDT) to deliver appropriate, timely treatment. However, there are limited published examples of MDT implementation in LMICs.”



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