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Global Disparities in Cancer Care for Conflict-Affected Populations: Africa's Neglected Crisis
Nazik Hammad1, Omar Abdihamid2, Moawia Mohammed Ali Elhassan3
1Division of Hematology-Oncology, St Michael's Hospital, University of Toronto, Toronto, Canada.
Abstract:
Cancer care in conflict-affected settings represents a growing yet underrecognized global health crisis, disproportionately affecting populations in low- and middle-income countries, particularly in Africa. With over 130 million people forcibly displaced worldwide, conflict-driven disruptions to health systems have created profound gaps across the cancer care continuum, from prevention and diagnosis to treatment and palliative care. In these settings, cancer is often deprioritized in favor of acute and communicable diseases, resulting in delayed diagnosis, treatment interruptions, and poor outcomes. This review examines the impact of conflict on cancer care delivery, highlighting structural disruptions, including infrastructure destruction, workforce displacement, and supply chain collapse. Drawing on case studies from Sudan, Somalia, Burkina Faso, and Kenya, it presents exploratory, field-informed strategies to sustain care. In Sudan, telehealth, primarily through WhatsApp and mobile communication, has enabled continuity of care, real-time triage, and cross-border clinical collaboration despite severe connectivity challenges, supported by emerging hybrid digital platforms. In Burkina Faso, the collapse of surgical oncology capacity has led to predominantly late-stage, palliative interventions; however, adaptive responses such as mobile clinics, tele-oncology, and decentralized service delivery have partially mitigated these gaps. The manuscript further emphasizes the potential role of mobile oncology units in delivering cancer medicines, basic surgical care, and palliative services, alongside context-adapted training for health care workers in crisis settings. It highlights the need for coordinated safe cross-border referral systems, interoperable digital health platforms, and the establishment of safe humanitarian corridors for patient transfer. Addressing cancer care in conflict settings requires integrating oncology into humanitarian responses, strengthening decentralized and resilient systems, and fostering regional collaboration to ensure equitable access for vulnerable populations.
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