article · JCO Global Oncology
Access to radiotherapy remains a significant challenge across Africa, where fewer than 15 percent of patients requiring treatment currently receive it. In Nigeria, a population of over 206 million requires an estimated minimum of 280 radiotherapy machines, yet only eight government-funded units exist. An evaluation across ten critical operational areas revealed severe deficits in public cancer care infrastructure. In 2021, six of the eight public centres could not deliver treatment due to non-functioning teletherapy equipment. Only two facilities possessed the technical capacity to deliver advanced radiotherapy, and none housed positron emission tomography-computed tomography imaging. Furthermore, the public system suffers from inadequate infrastructure and a lack of dedicated residency training programmes for essential staff, including medical physicists and radiation therapy technologists, leading to an acute shortage of trained personnel to maintain and deliver treatments.
Radiotherapy is essential for curative and palliative cancer management, yet severe public shortages leave vast populations without care. Demonstrating the breakdown of machinery, lack of imaging, and scarcity of trained technical staff highlights immediate bottlenecks that health authorities and international partners must resolve to establish equitable, functional cancer services.
The findings define operational baselines rather than a commercial product, but they directly inform equipment manufacturers, service providers, and training consortia targeting public healthcare upgrades. The data serves implementation planners by identifying precise gaps in teletherapy machinery, advanced diagnostic imaging, and technical workforce education, representing an immediate need for capital equipment procurement and specialised clinical training programmes.
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PURPOSE: Access to radiotherapy (RT) is now one of the stark examples of global cancer inequities. More than 800,000 new cancer cases require potentially curative or palliative RT services in Africa, arguably <15% of these patients currently have access to this important service. For a population of more than 206 million, Nigeria requires a minimum of 280 RT machines for the increasing number of cancer cases. Painfully, the country has only eight Government-funded RT machines. This study aimed to evaluate the status of the eight Government-funded RT services in Nigeria and their ability to deliver effective RT to their patients. METHODS: A survey addressing 10 critical areas was used to assess the eight Government-funded RT services in Nigeria. RESULTS: Unfortunately, six of the eight centers (75%) surveyed have not treated patients with RT because they do not have functioning teletherapy machines in 2021. Only two RT centers have the capability of treating patients using advanced RT techniques. There is no positron emission tomography-computed tomography scan in any of the Government-funded RT centers. The workforce capacity and infrastructure across the eight centers are limited. All of the centers lack residency training programs for medical physicists and radiation therapy technologists resulting in very few well-trained staff. CONCLUSION: As the Nigerian Government plans for the new National Cancer Control Plan, there is an urgent need to scale up access to RT by upgrading the RT equipment, workforce, and infrastructure to meet the current needs of Nigerian patients with cancer. Although the shortfall is apparent from a variety of RT-capacity databases, this detailed analysis provides essential information for an implementation plan involving solutions from within Nigeria and with global partners.
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DOI: 10.1200/go.22.00406
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