Abstract
Despite accounting for more than 70% of global cancer deaths, sub-Saharan Africa has fewer than 30 radiotherapy machines per 100 million people — compared with over 400 in high-income countries. This paper presents a policy framework for closing that gap, drawing on health systems analysis across 12 countries.
Background
The cancer care crisis in sub-Saharan Africa is characterised by late-stage diagnosis, limited treatment infrastructure, and a severe shortage of trained oncology professionals. Radiotherapy — essential for treating more than 50% of cancer patients — remains inaccessible to the majority.
Methods
We conducted a multi-country health systems assessment across Kenya, Nigeria, Uganda, Rwanda, Ghana, and seven other sub-Saharan African nations. Data were collected through facility surveys, policy document analysis, and key informant interviews with 148 clinicians, policymakers, and patient advocates.
Key findings
Our analysis identifies five structural barriers to radiotherapy access: insufficient capital investment, workforce gaps, supply chain failures, regulatory complexity, and weak regional coordination. We propose a five-pillar policy framework addressing each barrier, with implementation guidance for national governments, regional bodies, and international partners.
Conclusions
Achieving equitable access to cancer radiotherapy in sub-Saharan Africa is technically and financially feasible within a decade, given coordinated political will. This paper provides the evidence base and policy roadmap to make it possible.