Targeting Inequities: Addressing Lung Cancer Care Challenges in Africa Through Drug Access, Radiotherapy, and...

Lung cancer remains one of the leading causes of cancer-related mortality in Africa, with survival rates starkly lagging behind global benchmarks because of systemic inequities in prevention, diagnosis, and treatment access. Despite representing only 6% of global smokers, the continent faces a disproportionate burden driven by environmental and occupational carcinogens, aggressive tobacco marketing, and fragmented health care infrastructure. Key challenges include prohibitive delays in accessing targeted therapies like epidermal growth factor receptor inhibitors and immunotherapies, a dire shortage of radiotherapy infrastructure-0.12 megavoltage units per million people versus the International Atomic Energy Agency's recommended five megavoltage units per million, and a dearth of thoracic surgeons (0.03 thoracic surgeons per 100,000 people). These barriers contribute to over 90% of patients presenting with advanced-stage disease and 5-year survival rates below 10%. Multifaceted strategies are essential to bridge these gaps: regional pooled procurement and compulsory licensing to lower drug costs, telemedicine platforms like the African Radiation Oncology Network to expand radiotherapy access, and task-shifting surgical training programs through institutions such as The College of Surgeons of East, Central, and Southern Africa, which graduates 15 cardiothoracic specialists annually and partnerships such as that between the West African College of Surgeons and Global Oncology Group at Queens University, Canada. Investments in critical care infrastructure, exemplified by dedicated thoracic intensive care units in Ghana and Kenya, alongside harmonized guidelines from the African Cancer Coalition, are pivotal. The Lancet Oncology Commission underscores the urgency of political commitment and sustainable investment in diagnostics, workforce training, and technology transfer to align Africa's cancer care with global standards. Addressing these inequities is a clinical imperative and a moral obligation to ensure life-saving innovations benefit all populations equitably.