Harnessing the law to advance equitable cancer care in South Africa: exploring the feasibility, desirability and added value of a dedicated national cancer act

Abstract

Background: The 2017 World Health Assembly resolution on integrated cancer prevention and control provided clear guidance on creating an enabling environment for cancer care. Through a variety of mechanisms, including civil society advocacy, some countries have secured overarching legislation in the form of national cancer acts to promote equitable access and outcomes for cancer patients. In South Africa, cancer incidence is set to double by 2030; and, while existing legislative and policy frameworks do address cancer prevention and control, these are fragmented, poorly implemented and have had limited success.

Methods: This study assessed the feasibility and potential impact of promulgating a dedicated national cancer act in South Africa through exploratory in-depth interviews with 25 purposively selected key informants from various stakeholder groups, including cancer survivors; legal scholars; human rights advocates; health care providers; public health specialists and academicians.

Findings: Following thematic analysis, three key themes were identified: the content of a dedicated national cancer act, the socio-political leveragability of an act and accountability mechanisms that would support such an act.

Conclusion: While most respondents had not considered the possibility of a dedicated national cancer act, they were open to the concept for South Africa. Concerns about widening inequities, duplication, funding and accountability would need to be addressed against the current backdrop of health inequities and limited human rights leveraging for health.

Keywords: South Africa; cancer act; cancer care; cancer survivors; human rights; legislation; public health; social responsibility.