Presentation (CTI)

OBJECTIVES: Breast and cervical cancers pose a major public health burden in Nigeria, which ranks among the top ten countries globally for breast cancer deaths and cervical cancer incidence and mortality. Yet, evidence on access to medicines for treating these conditions remains limited. We assessed the availability, prices, and affordability of essential medicines for breast and cervical cancers in Nigeria.
METHODS: A cross-sectional survey using an adapted WHO/Health Action International methodology assessed fourteen essential medicines for breast and cervical cancers (31 products). Data were collected from purposively selected public (n=7) and private (n=7) health facilities, including major cancer care centers, across three regions. A standardized survey form hosted on REDCap was used to collect data on medicine availability and prices. Availability was measured as the percentage of outlets stocking each medicine. Prices were analyzed using median price ratios (MPRs) relative to international reference prices. Affordability was defined as the number of daily wages required to purchase one defined daily dose (DDD), based on the poverty line threshold and the lowest-paid government worker's wage.
RESULTS: Overall availability was low, with a mean availability of 46.9% in public and 51.1% in private facilities, well below the WHO target of 80%. Prices were moderately elevated, with mean MPRs of 1.56 in the public and 1.32 in the private sectors. The average cost of one DDD was USD 3.07, more than three times the poverty-line affordability threshold (USD 0.84). Affordability was poor in both sectors, with medicines requiring an average of 1.95 days’ wages per DDD in the public sector and 2.25 days’ wages per DDD in the private sector for the lowest-paid government workers.
CONCLUSIONS: Low availability and poor affordability of essential medicines for breast and cervical cancers in Nigeria highlight the urgent need for income-sensitive pricing, procurement, and access policies.