By Andile Masuku

A few months ago, my wife, Sithabiso Daphne Masuku née Ncube, and I celebrated our 10th wedding anniversary. Naturally, she’s been on my mind a lot lately. But it’s her eclectic STEM career that I feel compelled to share with you this week.

With Women’s Month in full swing, now seems like the perfect time to cast a spotlight on the important and timely breast cancer-related research that she is currently devoted to.

Wake-up call

Did you know that breast cancer is the most common cancer affecting women in South Africa, with a lifetime risk of one in 27, according to the 2019 National Cancer Registry? Turns out, in South Africa, patients are more likely to present with late-stage (stage III or IV) breast cancer, with studies indicating that the incidence of advanced stage breast cancer in South Africa is between 50% and 57%. This stark reality underscores the urgency of effective interventions.

Side-note: While rare, breast cancer can also occur in men, representing about 1% of all breast cancer cases. Shout out to the Cancer Association of South Africa (Cansa) for the incredible work they do in raising awareness around the disease.

Treatment delays

In South African public hospitals, the initiation of breast cancer treatment often faces delays, impacting the timely start of adjuvant chemotherapy, radiotherapy or endocrine therapy. These delays contribute to lower survival rates among women who undergo upfront surgery. Pervasive inefficiencies in healthcare delivery represent a major obstacle to enhancing patient outcomes.

Pivot table

After spending seven years in the reinsurance and life insurance industries with firms like Munich Re and Liberty, Masuku, an actuarial analyst, decided to take a hefty pay cut (yay, us!) to make a passion-driven career pivot into health economics research. In 2016, she joined the Health Economics and Epidemiology Research Office (HE²RO), part of the Wits Health Consortium, a wholly-owned company of the University of the Witwatersrand.

There, she conducted a budget-impact analysis to inform the South African Department of Health’s first breast cancer prevention and control policy, which was signed off in 2017.

Since then, Masuku has conducted Wellcome Trust-funded research into using economic modelling to determine the optimal package of services against non-communicable diseases (NCDs) in South Africa.

She is currently a year into a five-year Wellcome Trust-backed study that explores the economics of stepwise implementation of breast care improvements, a collaboration between HE²RO and the University of Sheffield in the UK.

What is health economics?

Health economics is a field that applies economic theories and principles to understand how healthcare resources are allocated and utilised. It aims to improve health outcomes by optimising the use of limited resources. In the context of breast cancer or any other disease area for that matter, this involves analysing the cost-effectiveness of different treatment options and identifying the most efficient ways to deliver healthcare.

Masuku’s current research focuses on several critical questions, one of which is identifying the bottlenecks in implementing South Africa’s breast cancer policy. The intersection of her actuarial science and health economics expertise is proving to be incredibly handy in this endeavour.

Broader systemic change

Addressing suboptimal research culture and gaps in expertise, data, and network access are essential for systemic change. Masuku’s participation in international early-career researcher-focused initiatives like the Union for International Cancer Control (UICC) Young Leaders programme and Springer Nature and the Breast Cancer Research Foundation (BCRF) Rising Scholars: Breast Cancer fellowship is instrumental in bridging these gaps. By fostering a more collaborative and data-driven global research environment, we have a better chance of making significant strides in improving health outcomes.

It’s personal

Over the past year, things got personal for us. A close family friend, Refiloe (not her real name), experienced a miraculous six-months public healthcare treatment journey in the UK, moving from stage III breast cancer diagnosis to remission. Despite the positive outcome, the battle has only just begun for Refiloe and her family. They now face a complex, long-tail treatment and recovery regime, managing recurrence risks, emotional and psychological impacts, and numerous quality of life concerns.

This experience highlighted the stark contrast between the public healthcare systems in the UK and South Africa. It reinforced the urgent need for improved healthcare intervention outcomes for breast cancer patients in Africa.

In South Africa’s relatively under-resourced public healthcare environment, it is essential to optimise outcomes that minimise death while both extending life and enhancing quality of life. This is where health economics plays a pivotal role. By leveraging data and economic principles, we can influence more effective policy-making and develop more efficient healthcare interventions.

Masuku’s work is a testament to the impact that dedicated, data-driven research can have on public health policy. Her unlikely professional journey from the insurance industry to health economics research is a powerful example of how passion and expertise can drive meaningful change.

As we continue to navigate the complexities of healthcare in South Africa, it is crucial to support and invest in research that aims to improve patient outcomes and make stories like Refiloe’s commonplace across the continent.

Andile Masuku is co-founder and executive producer of African Tech Roundup. Connect and engage with Andile on X (@MasukuAndile) and via LinkedIn.

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