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Navigating the cancer crisis: a mother's fight for affordable treatment amidst rising costs

Navigating the cancer crisis: a mother's fight for affordable treatment amidst rising costs
Long patent life of oncology drugs is a big part of the high cost of the treatments it ensures product exclusivity preventing the production of affordable similar alternatives. (Phoyo by OJ Koloti/Gallo Images)
Naledi Sikhakhane
By Naledi Sikhakhane
5 Feb 2025
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Twenty-four-year-old Caitlyn Micholson is fighting cancer and for a chance to access lifesaving alternative treatment that is inaccessible for the average South African.

Tamarin Nieuwoudt is the mother of Caitlyn Micholson, 24, who has metastatic melanoma stage four cancer. Caitie was originally diagnosed three years ago. She received treatment and had a mole removed, but it came back a year later in her lymph nodes. 

“Caitie then had more surgery to remove further cancer, and it has just gone downhill from there. The cancer has spread into her bones, her lungs and now probably into her brain. She is developing new lumps daily and needs urgent treatment,” Nieuwoudt said.

Daily Maverick originally came across Nieuwoudt as she shared her fundraising efforts trying to highlight her challenge to access treatment that is not offered in state facilities. A treatment cycle of Keytruda (an immunotherapy treatment for advanced melanoma) costs approximately R1.65-million per treatment cycle, more than 250 times the cost of conventional chemotherapy for this condition.

Naturally the family hopes to have access to this treatment for Micholson.

“At the moment we are managing and Caitlyn is responding to the radiation. It’s still not a fix just to give more time. There have been so many people who have reached out and given advice and tried to steer us on the right course of action. The support we have received has been overwhelming so far,” said Nieuwoudt.

She added that apart from the mammoth task of fundraising, some of the challenges included “adjusting to this disease. It takes so much away, not only from the person who is inflicted, but also from all those that love them. Watching your child in pain and losing their hair and their ability to have children is absolutely heartbreaking. But you need to carry on and get up and keep fighting. Also balancing work and home life is a challenge. You have to work to survive, but feel such guilt that you are not at home to take care of them and be there for them,” said Nieuwoudt.

She and her daughter live on The Bluff, Durban, in KwaZulu-Natal. 

World Cancer Day


On 4 February 2025, the world commemorated World Cancer Day, and in South Africa it is estimated that R1,6-million is the amount of money some cancer patients need to access effective treatment. The biggest challenge according to experts is that “South Africa has an outdated patent legislative framework that enables anti-competitive practices by pharmaceutical companies”.

South Africa had 111,321 new cancer cases and 64,547 cancer deaths in 2022, with the most frequently reported cancers (in both sexes) being breast, prostate, cervical, lung, and colorectal cancer.

Cancer patients and activists march to the Gauteng Department of Health on 30 April 2024 in Johannesburg, South Africa. (Photo: OJ Koloti / Gallo Images)



The marchers demanded that the Gauteng Department of Health spend the R784-million set aside by the Gauteng Treasury in March 2023 to outsource radiation oncology services for more than 3,000 patients who were on the backlog list. (Photo: OJ Koloti / Gallo Images)



With the increasing incidence of cancer and the rapidly rising costs of its treatment, health insurance company Discovery says that this poses a serious challenge for health funders worldwide, “including government and private health insurers such as South African medical schemes. These funders are seeking ways to ensure that patients can access these medicines, while at the same time ensuring that the resulting costs do not undermine the long-term sustainability of the system.

“So how can health funders solve this dilemma? In theory, if health insurers could apply strict underwriting, excluding those with cancer from cover, either permanently or for a period of time, they could sustainably provide cover for these medicines. However, the obvious downside of this approach is that anyone with a history of cancer would be excluded from cover in totality,” the article reads.

Health advocacy groups have continuously stated that the cost of treatment could be reduced by amending patent laws, allowing for the decreased exclusivity of these treatments and making room for similar and more affordable treatments to be produced.

Cancer association of South Africa (Cansa) together with the Cancer Alliance, Doctors Without Borders, Treatment Action Campaign, SECTION27 and other organisations called for the government to amend the patent laws, which would result in more affordable medicines for cancer and other chronic ailments. 

In May 2018,  a landmark move by the South African government, after years of advocacy efforts by civil society through the Fix the Patent Laws campaign, was celebrated.

“This was to release a new intellectual property policy that will stop the country’s process of blindly handing out patents, providing hope to people who cannot afford the medicines they need. The policy is a first big step to amend the country’s patent law in favour of public health. Fix the Patent Laws Coalition and Cancer Alliance continue to push for the government to urgently address the patent issue and provide affordable generic medicines for cancer,” the groups said.

The fight continues


The Cancer Alliance, represented by SECTION27, has been admitted by the Competition Tribunal as an intervening party in the excessive pricing case initiated by the Competition Commission. The case is against Switzerland-based multinational healthcare company Roche Holdings AG and its subsidiaries (collectively referred to as Roche).

In November 2024 the Competition Commission lodged a complaint with the Competition Tribunal alleging that Roche had violated the Competition Act by overpricing Trastuzumab, a life-saving treatment for an aggressive type of breast cancer called Human Epidermal Growth Factor Receptor 2 Positive breast cancer (HER2+). 

SECTION27 said in a statement that the “commission also alleged that the limitations to accessing trastuzumab imposed on South African breast cancer patients, as a result of the excessively high prices charged by Roche for its products during the relevant period, constituted a violation of basic human rights, including access to healthcare”.

These accusations stem from between 2011 and 2020. Asiphe Funda, who has played a crucial role in cancer advocacy and who is a health rights attorney at SECTION27 said this was part of strategic legal advocacy by SECTION27 and the coalition. 

“The biggest challenge right now is that South Africa has an outdated patent legislative framework that enables anti-competitive practices by pharmaceutical companies. These practices include abuse of dominance and excessive pricing. SECTION27 is also using strategic litigation in the fight for affordable cancer medication,” said Funda.

Way forward


What can both the private and public health sector do to build capacity to offer the more expensive treatment? 

Salomé Meyer, the Cancer Alliance Access to Medicine Campaign manager, said the alliance and civil society organisations had called for the establishment of a National Cancer Institute that could coordinate and take responsibility for “standardised clinical treatment guidelines with the associated healthcare professionals and training that is required. We say that the body will be responsible for determining the medicines associated with clinical treatments.”

She said these medicines needed to undergo proper and extensive Health Technology Assessment (HTA) “so that there could be an evidence-based argument for the provision of new therapies such as checkpoint inhibitors that are very expensive but can add life years to a person diagnosed with a specific cancer. Usually one would also look at the age of the person — meaning if a person is 45 and still has many life years to add to the economy it would make sense to provide treatment,” Meyer said.

She added that genetic tests that were already available could predict the efficacy of these medicines “which means that you can clearly determine who will benefit from more expensive therapies. We cannot wait for National Health Insurance to be implemented one day — we need to start addressing the increase in cancer incidence now” DM

Caitie has a BackaBuddy account. Any donations towards saving Caitie would be greatly appreciated.

https://www.backabuddy.co.za/campaign/caities-cancer-fund

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