The Africa We Want: A Perspective on the African Code Against Cancer To Be Developed for Sub-Saharan Africa

Sub-Saharan Africa (SSA) faces a unique cancer burden, characterized by a disproportionately high mortality-to-incidence ratio, a large share of infection-related cancers, and distinct environmental exposures. Implementation of national policies on primary prevention is limited, and public literacy regarding cancer risk and curability remains low. Furthermore, the implementation of existing prevention and treatment interventions is hindered by resource constraints and deeply rooted cultural beliefs. Thus, cancer prevention guidelines developed for other regions are often inadequate for this specific context. Following the International Agency for Research on Cancer's strategic and methodological World Code Against Cancer Framework-which develops region-specific, evidence-based recommendations-we call to join forces for the development of an African Code Against Cancer (AfCAC). The AfCAC would be targeted to the public and policymakers, tailored to the epidemiological, socio-cultural, and health system realities of SSA, and incorporated into existing National Cancer Control Plans (NCCPs). This Code would be aligned with the most relevant risk factors, local knowledge, and culturally appropriate effective cancer preventive interventions. Successful development of the AfCAC will require sustained commitment from diverse African stakeholders, including national governments, key scientists, non-governmental actors and funders. Successful implementation will necessitate multistakeholder input such as from policy implementers, advocacy groups, social anthropologists, religious leaders, and traditional healers and other local multisectoral stakeholders who possess a nuanced understanding of local norms integral to cancer prevention efforts. Importantly, strong national governmental commitment, demonstrated through developing and funding effective NCCPs and robust cancer registries, alongside capacity building for local health and non-health actors, will be paramount.