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The Pardee Papers, No. 17, Dec 2015 | Cancer in sub-Saharan Africa

“The many actors in global health will once again be tested on our ability to extend beyond cost-effective “low-hanging fruit” solutions and our willingness to commit to long-term prevention and care delivery efforts that will more sustainably and equitably address the national cancer burden in sub-Saharan Africa […] Institutional behavior change will be required, and the stakes are high for many cancer patients without access to treatment and care in resource-limited settings. It is increasingly important that their voices are not lost in current and future policy planning.”

Published in December 2015 by the Frederick S. Pardee Center for the Study of the Longer-Range Future at Boston University, “Cancer in Sub-Saharan Africa: The Need for New Paradigms in Global Health” is the 17th volume of The Pardee Paper series, an interdisciplinary set of scholarship by Pardee Center Fellows and other invited authors.

Check out the BU Pardee Center’s website for more information about Pardee initiatives and publications across public health and other disciplines.

Abstract

Cancer now ranks as the leading cause of death globally, outpacing mortality rates for HIV/AIDS, malaria, and tuberculosis combined. Cancers and other non-communicable diseases (NCDs), in particular, are quietly taking center stage in many low- and middle-income countries in sub-Saharan Africa and worldwide, and these countries are projected to carry as much as 80 percent or more of the global cancer burden by 2030. Yet, there are severe inequities in the response to this burden, and many patients are unable to access comprehensive cancer care simply because of where they live. In policy and advocacy circles, cancer is often seen as too challenging and expensive to treat in low resource settings, and funding and priority-setting for cancer has fallen substantially behind the current disease burden in sub-Saharan Africa. This is an often repeated narrative in global health, with the HIV/AIDS epidemic serving as an especially telling example of how inaction can fuel the costly spread of disease. However, the global HIV/AIDS response has broken the cycle of inaction and achieved impressive successes in expanding access to treatment, even in the poorest regions of the world most in need of support. The trajectory of the HIV/AIDS epidemic in sub-Saharan Africa and its international response can provide critical lessons for the future of political advocacy, funding, and treatment delivery for cancer in low- and middle-income countries worldwide. This paper examines these lessons for cancer in the context of new international agenda-setting priorities such as the post-2015 Sustainable Development Goals, and discusses the feasibility of providing cancer treatment in sub-Saharan Africa.