Equitable Access Is Not Automatic: What It Takes to Deliver Cancer Care in Africa

Cancer in Africa is not a future crisis. It is happening now, and it is accelerating. By 2040, Africa will face over 2.1 million new cancer cases annually, with breast, cervical, prostate, and colorectal cancers driving much of the increase.1 The medicines exist. The evidence is clear. But the question that matters is not whether we see the problem. It is whether health systems can deliver solutions at the speed and scale that patients need.2

That is the urgent call in the recent The Oncologist article, “Cancer: A looming public health crisis in Africa—a call to accelerate access to care.” The authors Rose Anorlu, et al. document aging populations, rising risk factors, and health systems already stretched beyond capacity. They call for policy changes, infrastructure investment, and international collaboration. All essential. But equitable access is not automatic. Approving medicines or writing guidelines is only the beginning. Real delivery requires people and systems that can make those tools work where patients live.3

The Delivery Gap Is the Real Barrier

Global oncology often celebrates what is new: targeted therapies, immunotherapies, breakthroughs. Those advances matter. But in resource-limited settings, patients often face more fundamental challenges. Can a woman in Lagos get timely breast cancer screening? Can a clinic in Addis Ababa deliver safe chemotherapy? Can a rural center in Kenya follow up effectively after diagnosis? These are not questions of science. They are questions of capacity: training, workflows, leadership, and sustained execution.

Sub-Saharan Africa already sees about 820,000 new cancer cases and 550,000 deaths yearly, with breast and cervical cancers dominating.4 Without intervention, these numbers could double by 2040. The barriers are clear: too few cancer centers (only 102 across the continent), workforce shortages (extreme patient-to-oncologist ratios), late diagnosis, and costs that force patients to choose between treatment and food.5 Equipment sits unused. Guidelines go unimplemented. Even donated medicines expire on shelves.

Capacity Through People, Not Just Projects

Sustainable progress requires health workers who can adapt global standards to local realities. Physicians who design screening programs that last. Teams who train others and build workflows that endure beyond funding cycles. Leaders who connect hospitals, governments, and communities to close the gap between knowledge and action.

Building that kind of leadership does not happen by chance. It requires intentional investment.

This is why STO’s Fellowship (STOF) program exists. STOF trains early- and mid-career physicians from high-burden regions, including those within the China-Africa Hospitals Alliance. Fellows gain expertise in bothoncology and implementation: project design, measurement, scaling. They return home equipped with powerful networks and institutional backing to drive lasting change.

Real impact looks like this: A STOF fellow at National Hospital Abuja strengthens HPV screening, training local teams to sustain 650 additional women screened yearly. Another at Xiangya Hospital adapts protocols, managing 33 more cervical cancer cases annually. Each fellow trains 10 local clinicians per year. These are multipliers, turning individual training into hospital-wide capacity.

The Path Forward Is Clear

The Oncologist article demands bold action, and it is right. But action without local capacity risks fading when funding ends. Sustainable progress means investing in people alongside infrastructure. It means fellowships that build leaders, not just trainees. Partnerships that prioritize implementation science, not just donations. Metrics that track sustained programs, not just new cases.

Africa’s cancer crisis calls everyone in oncology to step up.

Researchers prioritize delivery alongside discovery.
Policymakers back local leaders over imported fixes.
Global partners fund capacity that compounds over decades.

The medicines wait. The need grows. Health systems need the teams to turn proven tools into consistent care: screening, diagnosis, and treatment that actually reach patients.

That work starts now.

Related Reading

Political Will and Government Commitment for Cancer Care in Africa
– Dr. Rose Anorlu expands on a critical enabling factor in sustainable cancer care.

References

  1. Sharma R, Aashima, Nanda M, Fronterre C, Sewagudde P, Ssentongo AE, Yenney K, Arhin ND, Oh J, Amponsah-Manu F and Ssentongo P (2022). Mapping Cancer in Africa: A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates From GLOBOCAN 2020. Front. Public Health 10:839835. doi: 10.3389/fpubh.2022.839835.
  2. Rose I Anorlu, Lemchukwu C Amaeshi, Kehinde S Okunade, Adeyemi A Okunowo, Ephriam O Ohazurike, Adaiah P Soibi Harry, Okechukwu N Duru, Ann Murphy.Cancer: A looming public health crisis in Africa–a call to accelerate equitable access to medicines. The Oncologist. 2026, oyag089.https://doi.org/10.1093/oncolo/oyag089.
  3. Omotoso O, Teibo JO, Atiba FA, Oladimeji T, Paimo OK, Ataya FS, Batiha GE, Alexiou A.Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions. Int J Equity Health. 2023 Sep 11;22(1):189. doi: 10.1186/s12939-023-01962-y. PMID: 37697315; PMCID: PMC10496173.
  4. Jemal A, Sung H, Kelly K, Soerjomataram I, Bray F (Eds). The Cancer Atlas. Fourth Ed. Atlanta, GA: American Cancer Society, 2025.
  5. Stefan DC. Cancer Care in Africa: An Overview of Resources. J Glob Oncol. 2015 Sep 23;1(1):30-36. doi: 10.1200/JGO.2015.000406. PMID: 28804769; PMCID: PMC5551648.

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