20 UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE The radiation cancer crisis at Charlotte Maxeke Hospital has been a pressing issue since 2018, when it was rst brought to the attention of the Human Rights Commission. Over the past ve years, the Cancer Alliance has consistently highlighted the inadequacy of radiation oncology services at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Key concerns include the hospital's failure to meet international standards for radiation equipment and stafng, leading to frequent equipment breakdowns and extended waiting times for cancer patients in need of treatment. In November 2021, the Cancer Alliance, in collaboration with the Treatment Action Campaign and SECTION27, marched to the Premier's ofce to demand the establishment of a Task Team to address this ongoing crisis. The neglect of equipment and stafng issues resulted in a signicant backlog of patients waiting for radiation treatment. A medical doctor was appointed by the Cancer Alliance to work alongside the CMJAH Radiation Oncology team, uncovering a backlog of nearly 3,000 patients - most of whom were prostate cancer patients. Some of these individuals have been waiting for treatment since 2016. Patients were categorized based on risk levels, from expedited services for high-risk cases to low-risk patients. Due to the crisis, most patients have been placed on androgen deprivation therapy without receiving further interventions, as CMJAH is unable to provide necessary treatments. In March 2022, the Gauteng Department of Health established a Task Team to develop a comprehensive plan to address the backlog, including the possibility of outsourcing radiation services. However, this initiative has yet to yield meaningful results, with promises of tenders for outsourcing remaining unfullled. In March 2023, the Gauteng Finance Department allocated R784 million from the province's equitable share, with R250 million earmarked for outsourcing radiation services to address the backlog. Despite this, no patients have beneted from this allocation, even though a planning tender for R17 million was awarded in May 2024. The remaining R534 million is designated for addressing equipment shortages related to radiation and surgical backlogs. Additionally, many prostate cancer patients are waiting for radical prostatectomies at either Chris Hani Baragwanath Academic Hospital or Charlotte Maxeke Academic Hospital, neither of which currently offers either open or robotic radical prostatectomy procedures. Training for healthcare professionals in this critical area requires motivation for the necessary equipment and expertise, utilizing both the National Treasury Services Grant (NTSG) and the Statutory Health Professionals Training Grant. Unfortunately, Gauteng's academic institutions and hospitals have not leveraged these funding opportunities or addressed the backlog issues in surgery and radiation. One recent positive development is that some brachytherapy is now available, which provides an opportunity for patients diagnosed with early-stage prostate cancer to have treatment. In response to the stagnation in government action, the Cancer Alliance led a court case against the Gauteng Department of Health (GDoH) in July 2024. CASE NO. 2024-071038. The aims of this case include: Why the Cancer Alliance has launched a court case against the Gauteng Department of Health,for their failure to provide timeous radiation oncology services to cancer patients at Charlotte Maxeke Hospital Salomé Meyer BA(SW) Pret. BA (Medical Social Work) Hons (US). M.Soc Sci (UCT). Salome is the chairperson of the Cancer Alliance EXCO Committee, has been actively involved in the organisation since its inception in 2011. As an independent cancer advocate, she was instrumental in the development of the breast cancer policy in 2017. She took on an activist role when she joined the Fix the Patent Law campaign in 2017 as the Access to Medicine Project Manager and successfully leveraged and advocated for trastuzumab and lenalidomide to be added to the Essential Medicines List of the National Department of Health. Salomé serves on the Unitaid NGO Delegation for Cervical Cancer, the Medicines Patent Pool Community Advisory Panel for Cancer, We CAN Africa (Women's Empowerment Cancer Advocacy Network) and the newly established African Cervical Health Alliance (ACHA) as a Steering Committee member.
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