Lack of basic death data leads to false claims in Kenya

At the launch of a new political party at a sports stadium in Nairobi, Kenya, the country’s deputy president William Ruto talked about a disease that Vice President Joe Biden has made his life’s mission. At the start of the year, following the death of Biden’s son to brain cancer, the vice president took the lead in the administration’s Cancer Moonshot project, an effort to rapidly accelerate cancer research.

Ruto cast cancer as a top public health priority for his country.

"Cancer and matters to do with kidney failure kill more people in Kenya today than malaria, tuberculosis and AIDS combined," Ruto said Sept. 9, 2016.

Given that AIDS is the No. 1 killer in sub-Saharan Africa, and malaria ranks fourth, our Africa Check partners decided to check Ruto’s numbers. He is wrong.

For the record, Ruto’s office did not provide any supporting data.

A dearth of numbers

Solid data is sorely lacking in Kenya as it is in most sub-Saharan African nations. But the numbers that are available disprove Ruto’s claim.

Kenya just launched a national cancer registry, but it won’t be fully in place until 2019. For the time being, the highest estimate puts the number of cancer deaths at 28,000 in 2015.

On kidney disease, Kenya has no national data at all. The World Health Organization estimates 3,100 deaths for 2014.

Combined that’s a rough count of 31,100 deaths.

WHO is the most reliable source for tuberculosis death estimates in Kenya as well, with about 9,400 deaths in 2014.

The United Nations AIDS program relies on statistical models to derive the number of AIDS deaths in Kenya. UNAIDS says it is "logistically impossible and ethically problematic" to investigate all deaths. According to its statistical model, there were between 28,000 and 50,000 deaths due to AIDS in Kenya in 2014, with 38,000 being the most likely figure.

For malaria, the WHO said in its World Malaria Report for 2015 that it was unable to collect data for six East African countries, including Kenya, between 2000 and 2014 because of "inconsistent reporting, or changes in health service accessibility or diagnostic testing".

The best we could find for malaria deaths was Kenya’s civil registration data, which provisionally shows 23,789 deaths in 2013 and 20,691in 2015.

As you can see, while the numbers are far from perfect, they do not support Ruto’s point.

This table pulls the numbers together. Even using the lowest estimates for AIDS and malaria deaths, the combined toll is greater than for cancer and kidney disease.

Cancer/Kidney deaths

AIDS/Malaria/TB deaths

Cancer

28,000

Kidney disease

3,100

AIDS

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28,000

Malaria

20,691

TB

9,400

Totals

31,100

58,091

There are efforts such as the Health Data Collaborative and the African Health Initiative that aim to beef up the health data collected in sub-Saharan Africa. But it will be a tough slog.

Robert Black at the Johns Hopkins School of Public Health helps oversee the data coordination program at the African Health Initiative and he told us it will take many years before these countries have robust systems.

"The funding that is available for this from both national and donor funds is grossly inadequate to reach that objective in the near term," Black said.

In May 2016, Kenya became the first African country to launch a national effort to ramp up its systems for collecting health data. One of the top priorities? Making sure that every death and cause of death is recorded.

Our ruling

Ruto said that cancer and kidney disease "kill more people in Kenya today than malaria, tuberculosis and AIDS combined." The precision of the numbers leaves a lot to be desired, but based on the best estimates, Ruto isn’t even close. Using conservative estimates, deaths from AIDS, malaria and tuberculosis are double those from cancer and kidney disease.

We rate this claim False.