Introduction
South Africa faces one of the highest burdens of cancer in Africa. In 2022 alone, the country’s National Cancer Registry recorded 111,321 new cases and 64,547 deaths (International Agency for Research on Cancer , 20221). On average, 21 out of every 100 South Africans are at risk of getting cancer by the time they are 75 years old. This risk is notably higher for males and affects people across all socioeconomic groups. The rising incidence and the high treatment costs present a significant challenge, especially for those relying on the public healthcare services.
The 2017-2022 National Cancer Strategic Framework (Department of Health, u.d2) recognised these challenges and emphasised the need to strengthen surveillance and research on cancer (Goal 5) while improving early screening, treatment, and overall outcomes. Cancer biobanking is one such innovation to drive cancer research and personalised medicine in the country.
Implementation
The South African National Cancer Biobank plays a pivotal role in the fight against cancer by collecting and storing biospecimens from cancer patients across the country. These samples are essential for researchers studying cancer biology, identifying biomarkers, and developing personalised treatments. By providing high-quality tumour samples and associated clinical data, the biobank supports both local and international research efforts aimed at improving cancer treatment outcomes.
The biobank is critical to personalised medicine initiatives. Personalised medicine involves tailoring medical treatments to individual patients based on their genetic makeup, allowing for more effective and targeted therapies. The biobank’s stored samples provide researchers with the resources needed to explore new ways of treating cancer, thereby offering hope for better patient survival rates and treatment outcomes.
Policy and Legal Framework
South Africa’s legal and policy environment has been key to the success of biobanking. The National Health Act, 2003 outlines legal parameters relating to collection, storage and use of tissue, cells, organs, and blood products. Although there are no specific policies governing biobanking, the act provides framework for developing them ensuring that human specimens are used for research ethically. The National Cancer Strategic Framework and the National Digital Health Strategy for South Africa also supports cancer research and establishment healthcare innovations and promote their utilisation.
In addition, the Health Professionals Council of South Africa and the South African Medical Research Council provide regulatory oversight and ethics governance surrounding all public health research. The research council also collaborates with the Department of Science and Technology through the Strategic Health Innovation Partnerships to provide funding for innovations in health including digital technologies.
The government’s commitment to promote integration of digital innovations in healthcare services, is solidified in the 2nd Presidential Health Compact 2024-2029. These initiatives include:
- Enhancing the National Digital Health Strategy to meet current and future healthcare needs
- Establishing a Digital Health Governance Framework to ensure accountability and data protection
- Promoting data use and capacity building, equipping healthcare workers with skills to use digital tools and data analytics
This strong support for digital health creates more opportunities for the biobank to be an integral part of cancer treatment innovations, helping to bridge the gap between research and patient care.
Impact of cancer biobanking
Cancer biobanking in South Africa offers opportunity for researchers to monitor disease trends through biospecimen research, results which can be applied in public health services. A study in 2023 found that biobanks can significantly contribute to building local research capacity and strengthening the scientific research processes through development of standards and guidelines (Croxton, Jonathan et al, 20233). For instance, the biobanks in the H3Africa Consortium contributed to increasing staff skills in DNA extraction and quality control processes.
Lessons Learnt
Policymakers and other stakeholders in other countries, who aim to establish human biobanking facilities should consider the following lessons from South Africa:
- Supportive policies and a regulatory framework are critical to successful implementation of innovative health technologies such as biobanking. Having a law, as South Africa’s National Health Act (2003), sets parameters within which such innovations can operate. The law should also be accompanied by policies and guidelines to guide implementation.
- Government leadership is important. In South Africa, the Department of Health through its various agencies lead the way in cancer research and innovation. While partnerships with other stakeholders and the private sector can spur the development of innovations, the full integration into public health care heavily depends on government ownership and leadership.
Conclusion
Research in cancer continues to find new ways of prevention and management of the illness and helping to save many lives each year. While the country continues to record a heavy cancer disease burden, advances in technology are expected to contribute to better treatment outcomes. Cancer biobanking in South Africa provides a critical service in this journey; by making personalised medicine possible, the centre plays a significant role in improving treatment outcomes for patients.