Adoption and use of immunotherapy in breast cancer management in Africa: barriers and prospect - a narrative review.

Breast cancer (BC) is the world's most frequently diagnosed cancer in women, with 7.8 million women diagnosed with BC in the past 5 years. BC has the highest incidence rate of all cancers in women worldwide (1.67 million), accounting for over 500 000 deaths annually. In Africa, BC accounts for 28% of all cancers and 20% of all cancer deaths in women. The African continent has recorded an alarming increase in incidence, with the highest mortality rate globally. Despite BC being a major health concern in Africa, there is limited access to adequate healthcare services to combat the growing need. Immunotherapy, a promising treatment approach that harnesses the immune system's power to fight cancer, has shown great potential in BC management. However, in the face of the growing body of evidence supporting its effectiveness, the adoption and use of immunotherapy in BC management in Africa remain limited. Hence, this review aimed to explore the barriers and prospects of immunotherapy adoption and use in BC management in Africa. A comprehensive search across various databases and sources using specific keywords related to immunotherapy and BC to achieve the study aim was conducted. The criteria for including data in the study were based on relevance and availability in English, with no publication year restrictions. The collected data underwent narrative analysis, supplemented by information from sources like country reports, newsletters, commentaries, policy briefs, and direct Google searches. By identifying the challenges and opportunities, this review provided insights into how healthcare providers, policymakers, and other stakeholders can work together to improve the availability and accessibility of immunotherapy to BC patients in Africa.

Strengthening monkeypox diagnostics and healthcare amidst Covid-19 realities: A call to action.

Monkeypox virus is a zoonotic DNA virus related to the virus that causes smallpox. It was first isolated and identified in 1958 but its first confirmed human case was in 1970 when the virus was isolated from a child in the Democratic Republic of Congo. Since then, several cases have been reported within the African continent and globally. Despite its spread, Monkey pox disease has continued to suffer neglect in terms of research and funding due to its reported inefficiency in transmitting from Man to man as its transmission was reportedly limited to its endemic regions in Africa. Poor health data management, inadequate capacities in terms of testing infrastructure and health care workers and weak surveillance systems are some of the challenges faced by African countries. Multisectoral collaboration in breaking the transmission cycle of monkeypox infection and other preventive measures must be improved upon. Community advocacies and education play integral roles in infection spread preparedness, as well as in strengthening the healthcare system.

Diabetes and depression in Africa: Causality, relationship and clinical implications.

The public health threats posed by diabetes and depression individually have been well emphasised globally. However, it is increasingly important to understand these diseases' causes, relationships, and implications in comorbid states. Depression, anxiety, and diabetes are the top 10 causes of disability-adjusted life years (DALYs) in countries worldwide. Several reports have also suggested depression to occur two to three times more frequently in people with diabetes mellitus; with the majority of the cases remaining under-diagnosed, the causes and relationship remain rather complex and understudied. Although the exact link between depression and diabetes is yet to be detailed, quite a number of studies have supported that there is a bidirectional relationship between diabetes and depression. As Pieces of evidence, theories and reports continue to shed more light on the cause and relationship between these two conditions, its implications remain understudied, especially in low-middle-income settings. This commentary draws out the need for intentional screening for depressive symptoms in diabetic patients as early as possible from the implications of its neglect. It is, however, recommended that in the management of diabetes mellitus, emphasis should also be placed on depression as a co-morbidity, just as certain other disease conditions like hypertension and dyslipidaemia are considered.

Increased Risk of Death Triggered by Domestic Violence, Hunger, Suicide, Exhausted Health System during COVID-19 Pandemic: Why, How and Solutions.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, just like many other public health emergencies, is a well-established global health burden that has resulted in several changes in routines and lifestyles of people globally. The coronavirus disease (COVID-19) pandemic, caused by SARS-CoV-2, has directly or indirectly involved in the loss of lives of more than 3.24 million as of 6th May, 2021. The increasing threats posed by this pandemic were subsided by the swift and drastic measures put in place by different countries. As other causes of death before the emergence of COVID-19 still exist, the pandemic has further worsened their impact. The increased risks of COVID-19 deaths are not only due to the health burden it possesses, but also due to some other factors. These factors include domestic violence that becomes rampant, especially during lockdowns; hunger due to low economic development, unemployment, and loss of jobs; suicide due to depression; exhausted health system due to high level of COVID-19 cases and inability to contain it. As we move from the response phase into recovery, the pandemic's direct and broader impacts on individuals, households, and communities will influence the capacity to recover. An understanding of these impacts is therefore required to develop priorities to support recovery. This paper identifies other causes of death amidst the pandemic, such as domestic violence, hunger, suicide, and exhausted health system, and how to minimize their effects.

Pharmacoeconomics in Africa: needs, prospect and challenges.

Africa as a continent has experienced a continuous increase in the cost of healthcare as its demands increase. With many of these African countries living below the poverty threshold, Africans continue to die from preventable and curable diseases. Population increases have led to an increase in demands for healthcare, which unfortunately have been met with inequitable distribution of drugs. Hence, the outcomes from healthcare interventions are frequently not maximized. These problems notably call for some economic principles and policies to guide medication selection, procurement, or donation for population prioritization or health insurance. Pharmacoeconomics drives efficient use of scarce or limited resources to maximize healthcare benefits and reduce costs. It also brings to play tools that rate therapy choice based on the quality of life added to the patient after a choice of intervention was made over an alternative. In this paper, we commented on the needs, prospect, and challenges of pharmacoeconomics in Africa.

Uneven power dynamics must be levelled in COVID-19 vaccines access and distribution.

COVID-19 is one of the major global health threats of the 21st century, causing unprecedented humanitarian crises worldwide. Despite concerted efforts to curb the spread of the disease, the pandemic continues to strain healthcare systems globally and a safe, highly effective, and globally acceptable and equitable vaccination program, together with pre-existing precautionary measures, is essential to effectively contain the outbreak. We commented on the need to level any uneven power dynamics in COVID-19 vaccines access and distribution. The COVID-19 vaccines distribution must not allow for sovereignty which is tightly linked to historical imbalances in power and resources to result into discrimination between rich and poor countries. Poor countries must be supported in ensuring access to COVID-19 vaccines by levelling the power dynamics that perpetuate inequality and fuel inequity. We must ensure equity, fairness and transparency in COVID-19 vaccines distribution and gain public trust in COVID-19 vaccines through participatory community engagement. COVID-19 vaccines distribution and access must be equitable and not politicized.