Mozambique: Combating Cancer Initiative

Over 30 million people reside in Mozambique, however almost half of the population live in absolute poverty with limited access to the public health system. The Government of Mozambique provides healthcare services to most of the population through the Ministry of Health, which manages public hospitals and health care centers. The remaining population rely on traditional approaches for medical assistance involving community health agents, elementary agents, and birth attendants. Finally, there is a small niche that can afford healthcare services from private clinics and are often medical tourists to South Africa, Brazil, India, and Portugal. 

According to the WHO 2020 Cancer Country Profile report, Mozambique witnessed over 25,000 cancer cases, of which almost 70% caused deaths. Cervical cancer leads the number of diagnoses marking 5325 cases in 2021. Additionally, cervical cancer is the most frequently detected tumor amongst women aged between 15 and 44 years of age. With a positive rate of 11.5 percent in adults aged 15-49, Mozambique has the 8th highest HIV (Human Immunodeficiency Virus) rate in the world, and UNAID studies found that women who are HIV-positive are up to five times more likely to develop invasive cervical cancer. The second most detected cancer as a common malignancy is Kaposi’s sarcoma. It is also associated with HIV/AIDS (acquired immunodeficiency syndrome) patients and stands as one of the lead causes of morbidity and mortality. Furthermore, the country has seen alarmingly growing numbers of prostate, breast, and lung cancers. 

In 2008, Mozambique launched the National Strategic Plan for the Prevention and Control of Non-Communicable Diseases (NCDs). The plan aims to create a positive environment to minimize or eliminate the exposure to risk factors and guarantee access to care for all. The plan also flags cervical, prostate, and breast cancer as national priority NCDs to receive support for health care improvement. In partnership with the First Lady of Mozambique Isaura Nyusi, the Ministry of Health launched the National Cancer Control Plan for the years 2019-2029. The plan will guide the health care system in the following areas: prevention, diagnosis, treatment, palliative care, cancer registration, and systems of information. Go Further, a public-private partnership between PEPFAR, the George W. Bush Institute, and the United Nations Program on HIV/AIDS, funds the advancement of treatment services, including cervical screening within the existing platforms for HIV treatment. 

The Government of Mozambique has opted to prioritize cancer prevention and screening initiatives as a cost-effective strategy rather than handling the treatment of advanced disease. It is channeling investment towards women’s health hospitals. In 2020 the Government financed a $2.1 million hospital in Beira, the second most populous city in the country, which offers maternity and gynecological services and will screen women for cervical and breast cancer. Despite these efforts, the healthcare system still lacks early detection equipment and consumer-led cancer screening technologies. As a result, cervical cancer is often detected at a later stage when treatment might not be as effective. While the country has seen an increase in cancer cases, there is growing demand for traditional cancer treatment technologies like chemotherapy, radiation, and newer, innovative solutions.

Although public medical care is provided at cost for immediate payment by the patient, Mozambique’s health system is highly dependent on donor aid. It is estimated that donor assistance amounts to 70% of Mozambique’s health budget by offering direct financial support to the Ministry of Health and specific country disease areas, including cancer. Most patients pay for their hospital visits and medical assistance. However out-of-pocket expenditure corresponds to 6.4% of the of government’s costs. On the other hand, there is a growing number of insurance companies that provide coverage to a small portion of the population.

According to the African Development Bank, Mozambique’s health sector is crippled by limited government resources and worsening income distribution among various social groups. There are large discrepancies between people with coverage in rural and urban areas. Healthcare facilities in the rural areas of the country lack even the most basic resources, including electricity and running water. Most advanced equipment is placed in central hospitals. Although, private hospitals offer state of art healthcare, the general population cannot afford the services.

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