Medical professionals have raised serious concerns about the ability of the Social Health Authority (SHA) to adequately support the complex and costly treatment of cancer patients under the new universal health coverage system.

They say while the new framework is a step forward, it still falls short in meeting the real financial and medical demands of cancer care, especially for advanced and aggressive forms of the disease.

According to Dr Timothy Olweny, chairperson of the National Cancer Institute, although access to cancer services under SHA has improved, the coverage is still far from sufficient.

“Cancer is not a single disease. It is made up of many types, each with different treatment needs and costs,” he explained during an interview at Radio Generation on Thursday.

“Right now, we are treating all types of cancer as if they were the same, which is a major limitation. While the current cover may be enough for some cases, especially if detected early, there are many others where it simply doesn’t cover what is required.”

Olweny noted that SHA patients can now access some level of support, but the amount is limited and does not reflect the realities of modern cancer care.

“Targeted therapies are now the standard for some cancers, and these are very expensive. Some of them are not even covered, yet patients need continuous treatment over a long period. You cannot just treat them for two or three months and stop,” he added.

Dr Zahra Mohamed Ahmed, a radiation oncologist at HCG Cancer Center, highlighted further challenges related to how SHA benefits are structured.

She said that SHA currently provides a cancer care limit of Sh540,000 per household per year , a model that may leave families in difficult situations when more than one person is diagnosed.

“In just one week, I had two couples, both newly diagnosed with cancer,” Zahra said.

“In one couple, the husband had prostate cancer, the wife had breast cancer. In another, one had prostate and the other had oesophageal cancer. Now with the cover being per household, who is supposed to use it? Before, NHIF used to give Sh600,000 per spouse. SHA has changed that, and it is affecting real families.”

The radiation oncologist added that the structure also fails to recognise the wide range of radiotherapy needs.

“Radiotherapy isn’t just one type. There are advanced other options , which are more accurate and less harmful to healthy tissue, but also more expensive. With SHA lumping all radiotherapy into one category, it’s hard to give patients the best.”

Dr Zahra also pointed out that even patients with the same diagnosis may need completely different treatments.

“Take breast cancer, for example. Some patients respond well to standard treatment. Others need dual blockade therapy, which is far more costly. This one-size-fits-all model doesn’t work,” she added.

BothMedical professionals called for the SHA system to be revised to reflect the diversity of cancer types and treatment stages, including separate benefits for different forms of cancer and individualised treatment plans.

“It would be ideal if we could allocate funds based on cancer type and stage. That would offer more fairness and better care, even though it may make the system more complex,” Olweny said.

They emphasised that while SHA is a good start, the country must now focus on refining the model to make it work better for patients facing one of the most difficult and expensive health challenges