SOUTH AFRICAN CANCER CONTROL TIMELINE.
YEAR / ACTION / OUTCOME1986 / Pathology Based National Cancer Registry established / Based at the National Health Laboratory Services collating data from private and public sector.
1991 / South African Bone Marrow Registry (SABMR) established / 65 000 South African donors in data base and access to 20 million donors worldwide. The Sunflower Fund raise for bone marrow testing to link with the SABMR
1993 / Tobacco Control Act 83 of 1993 /
- South Africa the first country to
- SA became a Party to the
- Subsequent changes makes SA one of the strictest
1995 / Hepatitis B Vaccination included in the Expanded Programme of Immunisation / Significant impact on liver cancer in longer term
1998 / First National Cancer Control Plan (NCCP) developed under leadership of Prof Sharon Fonn, Wits Public Health and approved by Minister of Health / Cervical Cancer Policy with National Guidelines for the diagnosis and treatment of cervical cancer developed and implemented that focus on national screening
2000 / Promotion of Access to Information Act 2 of 2000 / Private sector contributions to the National Cancer Registry became a challenge resulting in very little to no contributions from the private sector, thus making data non-comparable.
2003 / National Health Act 61 0f 2003 established
2004 / CANSA makes the First Call to the DOH to revisit the National Cancer Control Plan in accordance to WHO guidelines and to make provision for main cancers affecting the population / No outcome
2004 / Western Cape Government announces combination of Tygerberg and Groote Schuur oncology units after both units equipment of 30 years defunct. CANSA objects to this and calls for a dedicated Task team to investigate / Ministerial Task team appointed. Both oncology units remain with new equipment and maintenance contracts in place. First dedicated Cancer PPP concluded for George hospital to ensure equitable access for rural patients.
2006 / CANSA makes Second Call to the DOH to update the National Cancer Control Plan / No outcome
2008 / Cancer Research Initiative of South Africa (CARISA) makes the Third Call to the DOH to update the National Cancer Control Plan / Tender advertised and awarded to CANSA. The document however was never distributed or approved.
2009 / SA Pharmacy Council does not approve sale of electronic cigarettes. MCC classify electronic cigarette as Schedule 3. / No policing. Electronic cigarettes sold and used publicly.
2009 / CARISA calls for Cervical Cancer Strategic Research Meeting with DOH to discuss the future /
- Cervical Cancer Policy to be
policy is STILL OUTSTANDING
2011 / Promulgation of Regulations to Cancer Registration effective of 26 April 2011 /
- Cancer to be regulated to ensure effective cancer data collection that can be used for planning. Task Team developed DRAFT Regulations. Final regulation promulgated however significantly differs from original DRAFT
- No provision is made for back
- Reporting is not linked to health professional that makes the diagnosis as the responsible person to complete registration form. Power left in Head of Health Establishment. No communication strategy linked to the regulation.
2011 / CANCER ALLIANCE established consisting of 22 Cancer Prevention and Control NPO’s and 2 independent advocates. Team of EXCO manages the collective alliance.
Call from Cancer Alliance to update the National Cancer Control Plan at inaugural meeting / NDoH call for a unified cancer community to consult.
31 May2012 / CANCER ALLIANCE writes to Minister of Health to inform of establishment and request a meeting. / Meeting with Deputy Minister of Health Dr Gwen Ramakgopa and member of the Cancer Alliance
4 February 2013 / CANSA calls for sunbed regulation. / No response
21 March 2013 / Technical meeting between members of Cancer Alliance working in Breast Cancer linked to 17th International Reach to Recovery Breast Cancer Support Conference, Cape Town and Deputy Minister of Health, Dr Gwen Ramokgopa, Ms Precious Matsoso, Ms Sandhya Singh and Ms Bilqees Sayed to Call for development of equitable and sustainable Breast Health Policy for South Africa / Commitment from both DM and DG. No outcome
6 April 2013 / Appointment of the Ministerial Advisory Committee on Cancer Prevention and Control. / Cancer Alliance objects to Minister appointing representative from CANSA as civil society rep. as CANSA is not member of CA and does not represent Minister responds in prescriptive directive for specific rep criteria outside of criteria advertised in original advert.
Emma Bellot of HOSPICE Free State nominated to ensure palliative care skills set and link with CA.
23 August 2013 / Cancer Alliance submit letter to Deputy Minister of Health on Proposed Amendment of the Medicines and Related Substances Act 101 of 1965 / Response from Office of Deputy Minister that matter has been referred to MACC.
No response
18 November 2013 / Cancer Alliance Call to Action 18 November 2013 – Equitable access to Qualitative Care to coincide with UICC leaders meeting held in Cape Town / No response
March 2014 / HPV Vaccination for girls only at public schools initiated by NDoH / Only for public schools, no private schools included. Boys not part of programme. Thus no equitable access
March 2014 / Advocates for Breast Cancer a collective coalition between all breast cancer related NPO’s established to advocate and lobby for the development of an “Equitable and sustainable breast health policy for all South Africans“ / Initiate strategy of education, communication and advocacy of breast cancer survivors.
March 2014 / Letter to Minister of Health re MACC / No response
June 2014 / Follow-up letter to Minister of Health re MACC / Response from Prof Melvyn Freeman
27 June 2014 / CANSA writes to the KZN Minister of Health re the Lack of Radiotherapy services in the province / No response
29 July 2014 / Meeting between Dr Holele, Ms Singh, Ms Sayed and Salomé Meyer of ABC to lobby for equitable and sustainable breast health policy for all South Africans / Commitment from Dr Holele to develop such a policy
September 2014 / DRAFT National Cancer Control Plan circulated for comment by NDOH / Comments submitted from individual members – Linda Greeff, CANSA, Salomé Meyer.
February 2015 / Consultative meeting on Draft National Cancer Control Plan / Draft NCCP of NDoH rejected. Call for new plan to take into account comments submitted and commitment of consultative process to take place. Consultant to be appointed by NDoH with funding from WHO.
New draft available to MACC Sept 2015 – not approved.
STILL NO OUTCOME
February 2015 / CANSA writes to Ministers of Health, Science and Technology and Mineral Resources re Hydraulic Fracking and the potential of contamination of water with Group 1 carcinogens / No response
10 July 2015 / Consultative meeting with stakeholders with regard to proposed Breast Health Policy / Commitment that Policy will be finalised by end March 2016. Task team approach to be adopted.
No further development in this respect
August 2015 / Cancer Alliance and Advocates for Breast Cancer joins the “Fix the Patent Law Campaign” / Call to “Fix South African Patent Law” to ensure access to essential medicines.
Letters to Minister of Trade and Industry supported by Cancer Alliance
28 September 2015 / CANSA calls on Minister of Health and KZN Minister of Health to address the lack of Radiotherapy services in KZN / Acknowledgement from NDOH – Prof Melvyn Freeman.
No positive outcome. Patients turned away for treatment and told to come back in March 2016.
Only after newspaper report equipment in KZN fixed within 2 days
October 2015 / NDoH calls for tender for HERCEPTIN / Only Herceptin in private sector and Herclon in public sector available in SA. 1 supplier. No approved biosimilars available in SA.
4 February 2016 / Cancer Alliance writes to Minister of Health re the functioning of the MACC / No response
4 February 2016 / Cancer Alliance writes to the Minister of Finance and copy Minister of Health re ring fenced budget for Cancer / Acknowledgement from Minister of Finance
No response
4 February 2016 / Advocates for Breast Cancer writes to the Minister of Health re Breast Health Policy and affordable access to treatment / Acknowledgement from Minister of Health and electronic communiqué from Dr Yogan Pillay that all is being attended too.
4 February 2016 / Advocates for Breast Cancer writes to the Minister of Health re the Availability of Herceptin in the public sector / No response
February 2016 / National Tender committee under Prof Marc Blocman turns Herceptin tender down for a 2nd time / No real time data about the incidence of HER2+ available for SA. Cochrane data used for decision making that is extrapolated data.
29 February 2016 / Proposed Breast Health Stakeholder meeting to continue policy development process / Meeting post phoned – no date provided
16, 17 March 2016 / UN High Level Meeting in Johannesburg on Access to Medicines / Cancer Alliance and Advocates for Breast Cancer joined the TAC/Section 27/ MSF coalition and “Fix the Patent Law” campaign. Two HER2+ patients from East London both trained as advocates by ABC gave testimony on the non-availability of Herceptin due to high costs. DG Matsoso member of UN High Level Panel: Access to Medicine
18 March 2019 / Cervical Cancer Policy meeting postponed / No future date provided
29 March 2016 / Breast Health Policy meeting postponed / No future date provided
31 March 2016 / End of Term of current MACC
31 March 2016 / Cancer Alliance, Advocates for Breast Cancer participate with Fix the Patent Law coalition partners TAC/Section27/MSF in picket at ROCHE for the availability of trastuzumab / Letter handed to ROCHE –
1 April 2016 / Cancer Alliance EXCO meets with Minister of Health /
- Open door policy. MACC membership may change. At least 2 consultative Forum meetings to be held per annum to promote communication between stakeholders. New Council to be established similar to SANAC.
- NCCP Draft to be distributed for consultation to stakeholders. Where after it goes to Nat Health Council for approval. NCCP will deal with broad principles and detail accommodated in appendices
- NCR to be incorporated in NAPHISA. Regulation amendment to be considered.
- Herceptin availability discussion to be take further with Roche
- 10 Tertiary Hospitals to be centralised for management and budget purposes within 2 years.
- Palliative care Policy to be available asap
- CA to invite DOH (Prof Freeman) to EXCO physical meetings 2 x per year
11 April 2016 / NDOH circulate Draft National Policy Framework and Strategy on Cancer for comment by 18 April / Cancer Alliance object to short notice period and extension granted till 28 April
18 April 2016 / Follow-up meeting between FTPL and members of Cancer Alliance and ROCHE about availability and price / ROCHE and DOH to discuss the matter further
18 April 2016 / Breast Health Policy meeting held at DOH / Draft Breast Cancer Prevention and Control Policy made available for comment by 28 April.
28 April 2016 / Cancer Alliance submit comment to NDOH on Draft National Policy Framework and Strategy on Cancer / Comments received and incorporated
NDOH present DRAFT National Policy Framework to Technical Committee of National Health Committee / Draft not approved as no budget provision made for any of the objectives
Advocates for Breast Cancer submit comment on Draft Breast Cancer Prevention and Control / No feedback
31 May 2016 / Cancer Alliance an SA NCD Alliance submit comments to the NHI / Ongoing process
28 June 2016 / Advocates for Breast Cancer writes letter to Minister of Health re number of potential HER2+ patients that can benefit from trastuzumab / Letter received and acknowledged
June 2016 / National Tender committee under Prof Marc Blocman turns Afinitor tender down. / Essential treatment Drug for Metastatic Breast Cancer Patients. 85% of patients are in public sector. Most public sector patient present with late stage disease due to issues related to access.
3 July 2016 / Nominations for new Ministerial Advisory Committee on Cancer Prevention and Control Advertised
5 July 2016 / High Level meeting with NDOH and cancer service and Cancer Alliance providers to discuss possible future of service privision / Possibility of PPP’s to be investigated
8 July 2016 / Patient at George Muhkari hospital requested not to attend follow-up chemo treatment due to unavailability of drug / Cancer Alliance members advocate and lobby for human right violation to Minister and NDOH
11 July 2016 / High Level meeting at DOH to identify issues of procurement to solve problems / Patient informed to attend chemo treatment follow-up
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