Cancer is not an equal illness. If you get lucky, you’ll whiz through the tests, get an early diagnosis, receive treatment, and live a long and healthy life in remission. But for those living in developing countries, the outcome could be much worse. And if you’re a woman, your chances are even more bleak.
A recent World Health Organization (WHO) study shows 20 million people globally were diagnosed with cancer in 2022. Yet, 61% of countries are failing to meet the needs of patients — and that’s mostly in the Global South.
Women across the globe are subject to overlapping forms of discrimination and inequity which influence their rights and opportunities to avoid cancer risk factors and impede their ability to seek and obtain timely diagnosis and quality cancer care, according to a 2023 Lancet Commission.
After returning from training and working as a pediatrician in the UK’s National Health Service (NHS), Dr. Zainab Shinkafi-Bagudu witnessed the reality of this first-hand in Nigeria, where mothers in rural and disadvantaged communities were having to make impossible decisions, forgoing necessities to support their children and often being forced to delay urgent healthcare until a late stage in their illness.
“There were inequities in terms of gender, education, economic capacity, and more,” she says. “As a pediatrician, I was interacting with mothers more than fathers in the clinics. Not only was I amazed at the misinformation I was hearing but also the lack of access. In the UK, there were one-stop clinics where you could have all your tests done. The diagnosis is that much quicker. [In Nigeria,] we had nothing like that.”
Each year, about 70,000 women in Nigeria are diagnosed with cancer, more than half of whom will die.
Dr. Bagudu was moved to action. “I tried to do something about it informally by bringing women together. We had open evenings where we talked and educated women. This grew into a more formal structure that had outreach programs and screenings.”
That more formal structure became a comprehensive diagnostic medical center and then she founded the Medicaid Cancer Foundation (MCF), an organization that has worked for the past 15 years across the full spectrum of cancer care — from prevention to diagnosis and treatment. Through awareness and outreach programs, screenings, and more, they’ve disbursed over $3 million, helped over 1,000 patients, and impacted over 10,000 people.
Dr. Zainab Shinkafi-Bagudu founded the Medicaid Cancer Foundation (MCF), an organization that has worked for the past 15 years across the full spectrum of cancer care — from prevention to diagnosis and treatment.
“It might not sound like much,” says Dr. Bagudu, who has been advocating for women’s health with a focus on cancer for over 20 years. “But it takes a lot to be able to run it and sustain it for the length of time that we have been able to. It’s not about just giving services. We are teaching communities about the importance of prevention. We raise funds for patients’ treatment. We give lectures. We run workshops. We interact with doctors. Amplifying the message is really important.”
As Dr. Bagudu explains, there are policies, frameworks, and funding set aside for cancer in Nigeria. The issue, a lot of the time, is that people just don’t know about them.
“We have to work harder at communicating all the efforts that are being made,” she says. “Most importantly, we need to amplify early detection and prevention so that it’s not late stages that people come to us.”
Cervical cancer is particularly deadly in Nigeria — it’s the third most common cancer and the second most frequent cause of cancer deaths among women aged between 15 and 44.
Last year, Nigeria achieved a significant milestone by incorporating the human papillomavirus (HPV) vaccine into its routine immunization programme. Since HPV is known to cause at least 70% of cervical cancers, this could make a tangible difference to women and girls.
Yet, Dr. Bagudu doesn’t think it’ll be enough to deliver on the World Health Organization’s (WHO) target to eliminate cervical cancer as a public health problem by 2030.
“I am not sure that more than two or three countries will reach that target,” she says. “Unfortunately, with the vaccination pillar, we didn’t get on board as early as we should have. But with a lot of hard work and advocacy, it’s started. And It’s going well.”
Some of the challenges have countered initial expectations. “Strangely enough, in the first phase of the roll-out in October 2023, the states that [saw greater uptake of the vaccine] seemed to be the less educated states apart. It seemed that the more information people had, the less the uptake was.”
Cervical cancer is particularly deadly in Nigeria — it’s the third most common cancer and the second most frequent cause of cancer deaths among women aged between 15 and 44.
The reality was that it wasn’t about the quantity of messaging around the vaccine, but the quality. “There was a lot of misinformation and negative anti-vaccine messaging going around WhatsApp and the radio. This news traveled at a much faster rate, wiping away years of work done.”
“We’d assumed that health care workers automatically understood the benefits of the vaccine,” she explains. “But what we found was that a lot of the misinformation was coming from these health care workers. We had been training them on how to administer the vaccine, not how to accept the vaccine.”
One of the biggest myths to circulate: the vaccine makes girls infertile. Instead of shying away from it, she advises, “let’s get our scholars, doctors, and researchers to counter this and tell it in a way that is relatable.”
But changing people’s minds about vaccines requires more than just the naked science. It requires the most low-tech of tools: a conversation.
Dr. Bagudu suggests one particularly innovative way of fostering positive messaging about the vaccine, using sport as the forum for dialogue. “[We realized] each area we worked in had a sports coach. They’re respected figures in the community. The younger generation and the parents defer to these people. We can use those types of mechanisms.”
It’s a tool that’s often forgotten about in high-level board-room discussions about vaccine delivery, but conversations shouldn’t be underestimated for their impact.