[Access to anticancer drugs in Africa]

Childhood cancer is rapidly increasing across the African continent, but survival rates remain significantly lower than in high-income countries due to structural and economic barriers. This review analyses the major challenges hindering access to pediatric cancer medicines in Africa and examines the initiatives implemented to address them. Three main obstacles are identified: the low availability of medicines, exacerbated by stockouts and the lack of local production; the high cost of treatments, limiting accessibility, especially in the absence of universal health coverage; and weaknesses in pharmaceutical governance, including inefficient supply chains and insufficient regulation. In response to these challenges, several initiatives are emerging. While emergency actions, such as the shipment of cancer medicines by organizations like the GFAOP, have helped meet urgent needs, they do not replace structural solutions. Sustainable improvement relies on the training of healthcare professionals, particularly pharmacists specialized in pediatric oncology - an area supported by the GFAOP through the MAEva program and the University Diploma in Clinical Oncology Pharmacy -, the integration of anticancer medicines into universal health coverage policies, and the strengthening of local production and pharmaceutical governance, notably through the African Medicines Agency. An integrated approach, combining local production, effective regulation, and specialized training, is essential to sustainably improve access to treatments and reduce inequalities in pediatric oncology care across Africa.