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Myth, Belief Slowing Down Cancer Success Rate – Expert

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By Ebere Agozie

A Clinical and Radiation Oncologist at the Ahmadu Bello University, Zaria, Prof. Sunday Adewuyi, has said that myth and belief have been slowing down the rate of success in cancer treatment in Nigeria.

Adewuyi who was speaking against the backdrop of the 2019 World Cancer Day disclosed this in an interview with the News Agency of Nigeria (NAN) in Abuja.

He said that cancer is real and does not discriminate against tribe, religion, sex, educational level or political class.

“Cancer is a very complex disease that is not yet properly understood by some of our people which makes it more of a problem in our society.

“Some rural people, and even some of the elites, attribute cancer disease to spiritual attack or punishment from the gods.

“Some, due to their religion wouldn’t go to see doctors in their area or discuss with neighbours for fear of being branded a sinner or being punished by the ‘gods’.

He said that some cancer patients do not initially believe in orthodox medicine and treatment until it is too late.

“Some of the challenges faced by cancer health care-givers are apathy and loss of confidence in orthodox treatment and the non-inclusion of comprehensive cancer care in National Health Insurance Scheme (NHIS).

“Cancer success story depends on early detection and treatment but in some cases, majority of the patients come to the hospital when it is already too late to handle”.

Adewuyi pointed out that a nation’s healthcare delivery system had significant inputs from all stakeholders and that a good synergy was required to achieve optimal care.

He enumerated some of the challenges faced by cancer patients in Nigeria.

 “Low insurance coverage to reduce financial burden on patients, deficient supply chain for drugs and consumables, lack of dedicated centres with optimal infrastructures and manpower”.

He said that the other challenges were lack of legislation and policies to fund cancer centres and cancer care.

“Poor funding at all levels of government resultsfrom the fact that the National budget for oncology is too small,’’ he said.

He, therefore called for the declaration of a state-of-emergency in cancer care in Nigeria and 100 per cent implementation of the 2018-2022 plan.

“There is the need for NHIS to carter sufficiently for cancer patients and also a need for strategic funding for cancer patients as is done for HIV patients.’’

He said that the Federal Government is working hard to improve the quality of life of cancer patients in the country.

“There are ongoing programmes, like reduction in cervical cancer through strategic plans, and national vaccination sponsored by the World Health Organisation, both programmes of which are at advanced stages. 

“There is also ongoing training and retraining of oncologists and other specialists in centers with linear accelerators, done in partnership with the International Atomic Energy Agency (IAEA).

“There is also rehabilitation of old centers and the building of new Bunkers for linear accelerators (eg ABUTH Zaria) and increase in access to radiotherapy in the country.

   

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Time Nigeria is a modern and general interest Magazine with its Headquarters in Abuja. The Magazine has a remarkable difference in editorial philosophy and goals, it adheres strictly to the ethics of Journalism by using the finest ethos of the profession to promote peace among citizens; identifying and harnessing the nation’s vast resources; celebrating achievements of government agencies, individuals, groups and corporate organizations and above all, repositioning Nigeria for the needed growth and development. Time Nigeria gives emphasis to places and issues that have not been given adequate attention by others. The Magazine is national in outlook and is currently being read and patronized both in print and on our vibrant and active online platform (www.timenigeria.com).
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The Missing Middle of Infrastructure Finance: Why Capital Still Fails to Become Infrastructure

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  By Chidi Nwafor  In October 2023, a Gulf sovereign wealth fund quietly closed a $2 billion allocation to global infrastructure, earmarked in part for emerging-market energy and transport assets. The announcement drew the usual applause: another sign, commentators said, that institutional capital was finally waking up to the infrastructure opportunity in the Global South. Eighteen months later, less than a tenth of that allocation had actually left the fund’s balance sheet. Not because the mandate had changed. Not because the fund had lost appetite. According to two people familiar with the portfolio, the constraint was simpler and more uncomfortable: there were not enough investable projects to put the money into. This is not a story about a reluctant investor. It is a story about capital that wants to move, cannot find enough places willing and able to receive it in a form it can underwrite, and quietly waits instead. Multiply that fund by the hundreds of pension schemes, sovereign wealth vehicles, commercial banks and infrastructure funds now carrying dedicated allocations for emerging-market infrastructure, and a pattern emerges that rarely makes it into a headline: the world is not short of capital for infrastructure. It has capital in historic abundance, sitting adjacent to a historic infrastructure gap, unable to cross the distance between the two. The Comfortable Explanation  The explanation on offer at every major infrastructure summit is a familiar one. Global infrastructure investment needs run into the tens of trillions of dollars over the coming decade; committed capital falls well short; therefore, the problem is one of insufficient funding, and the solution is more of it: more pledges, more blended-finance facilities, more climate funds, more multilateral capital increases. It is a comfortable explanation because it assigns responsibility clearly to governments who under-fund, institutions who under-commit, and it offers a clean remedy: raise more. It is also, on close inspection, not what the evidence shows. Pension funds globally hold trillions in assets under management with explicit infrastructure allocations that remain structurally underweight, not because trustees have rejected the asset class but because deal flow meeting their risk and governance thresholds has not materialised at the pace their mandates assume. Sovereign wealth funds report the same pattern. Commercial banks with dedicated project finance desks describe pipelines that look full at the term-sheet stage and thin dramatically by financial close. Development finance institutions, whose entire purpose is to absorb risk that commercial capital will not, routinely report that their binding constraint is not capital adequacy but the volume of bankable transactions their teams can originate and structure in a given year. None of this fits the scarcity narrative. All of it fits a different one. Availability Is Not Deployability  Capital availability and capital deployability are not the same condition, and the conflation of the two is doing real damage to how the world thinks about the infrastructure gap. Availability asks whether money exists somewhere with a mandate that could, in principle, be pointed at infrastructure. Deployability asks something much narrower and much harder: whether a specific project, at a specific moment, has been engineered, structured, documented and de-risked to the point where an investment committee can approve it without exception. The first condition is met, overwhelmingly, across nearly every category of capital that matters to infrastructure. The second is met by only a small fraction of the projects competing for it. The result is a market that looks, from the outside, like a financing gap, and functions, from the inside, like a conversion problem: an abundance of capital on one side, an abundance of infrastructure need on the other, and an underbuilt set of mechanisms in between capable of turning one into the other at any meaningful scale. Where the Conversion Breaks  The break does not happen at the ends of the process. It happens in the middle, in the unglamorous sequence of work that turns a plausible concept into an instrument a fiduciary can sign. A promising transmission project needs a feasibility study rigorous enough to survive institutional scrutiny rather than optimistic enough to attract early interest. It needs offtake arrangements that hold up under real counterparty and currency risk, not the counterparty risk assumed in a base case. It needs environmental and social documentation calibrated to the standards of the institutions being asked to fund it, not the standards of the jurisdiction hosting it. It needs a legal and commercial structure that allocates risk in ways a commercial lender, not only a development financier, will accept. It needs a sponsor capable of executing what has been proposed, not merely capable of proposing it. Each of these is ordinary project finance discipline. None of it is exotic, and in mature infrastructure markets it happens as a matter of course, absorbed into systems built over decades: specialist advisers, standard-form contracts, established procurement norms, deep pools of transaction expertise. What is missing in the markets where the infrastructure gap is largest is not the standard itself but the machinery that meets it. Projects arrive at investment committees with ambition intact and preparation incomplete, and that gap is treated, again and again, as an individual project’s failure rather than what it actually is: a structural absence in the systems responsible for producing investable transactions at scale. The Missing Middle  This is the Missing Middle of Infrastructure Finance: the institutional architecture that sits between capital that wants to move and infrastructure that needs building, and whose incompleteness explains far more of the global infrastructure gap than any shortfall in committed funds. It consists of project preparation facilities able to fund feasibility and structuring work before commercial viability has been proven. Transaction advisers capable of building deals that satisfy development mandates and commercial return thresholds at once, rather than treating the two as separate constituencies to be managed sequentially. Risk-sharing and guarantee instruments that convert political, regulatory and currency risk into something a commercial balance sheet can underwrite. Aggregation platforms that bundle smaller, individually sub-scale projects into portfolios large enough to justify institutional transaction costs. Standardised documentation that reduces the bespoke legal cost of every new deal. And coordination across ministries, regulators and financiers robust enough that a technically sound project does not die in bureaucratic sequencing after the money has already been found. None of these are new ideas in isolation. What is missing is their assembly into a coherent system, deliberately funded and institutionally accountable, rather than scattered across donor-funded pilots that end when the grant does. The African Dimension  Africa makes this dynamic unusually visible, and consequently offers an unusually clear opportunity to correct it. The continent’s infrastructure financing need, by any measure, is vast. Less understood is that the shortfall is disproportionately one of preparation rather than capital. Nigerian gas-to-power, off-grid solar and mini-grid developers have each demonstrated that individual projects can clear the bankability bar; what has not emerged is systemic pipeline scale, a steady stream of comparably prepared projects large enough to absorb the capital already circling the sector. The pattern repeats, with local variation, from grid infrastructure in East Africa to transport corridors in West Africa. Interested capital is rarely the scarce input. Investment-ready projects are. The Global Comparison  Mature markets solved this problem gradually and mostly invisibly, through decades of institution-building that predates the current infrastructure conversation: specialist project finance units inside banks, standardised PPP frameworks, established regulatory playbooks, deep benches of transaction lawyers and engineers who move between deals rather than between one-off assignments. Emerging and frontier markets are not being asked to meet a lower standard. They are being asked to meet the same standard without having built the same machinery, and then being told, when deals fail to close, that the problem is insufficient funding….
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