Strengthening Cancer Care in the Democratic Republic of the Congo: Experts Recommend Decentralizing Services

Assessing the DRC’s cancer control needs and capacities, the experts noted the importance of training staff in all areas of cancer control, and of strengthening the capacity of the National Centre for the Fight against Cancer, the country’s main coordination body set up in 2020. Cancer surgery, for example, is currently performed by general surgeons and other specialists without dedicated training on oncology.

The Review team recommended a more frequent, cost-effective use of the private radiotherapy facility established in 2020 and which treated 130 patients in its first year. The facility has the capacity to treat 500 patients annually, and the creation of an agreement between the Ministry of Health and the facility could optimize the use of the radiotherapy unit, they advised.

The experts also suggested making radiotherapy progressively available in the provinces through infrastructure, education and training, and related necessary financing, to ensure that the more than 25 000 patients requiring treatment each year could be treated. Across the country, maintenance of machines and medical equipment would be crucial to ensure delivery of care to patients, they noted.

“Cancer is a major public health problem in our country,” said Pacifique Misingi Aye, Director of the National Centre for Blood Transfusion in Kinshasa. “We need to prioritize prevention and early detection to minimize the need for care at advanced stages in poorer populations that are the most affected.”

An integrated approach to cancer control, including the development of a National Cancer Control Plan (NCCP) would be critical, advised the experts. A NCCP includes areas such as prevention in terms of, for example, vaccination campaigns against the Human Papilloma Virus (HPV), and treatment in terms of setting out pathways to improve the quality and quantity of training available to surgeons. In the DRC, the experts noted, cancer is often treated through surgery because radiotherapy and chemotherapy services are not sufficiently developed, and diagnostic services are limited.

“Saving lives requires the engagement of all relevant parties, from local to international levels,” said Sambou Bacary, the WHO’s Head of Disease Control Cluster. “The government is encouraged to elaborate the development of its NCCP. The UN organizations will continue to provide support along the way,” he added.

The imPACT review provides the DRC with short, medium and long term recommendations covering topics such as the development of a population-based cancer registry, early detection of cervical, breast, colorectal and prostate cancers, palliative care and radiation protection.

The review is part of the broader ongoing technical cooperation support provided by the IAEA in the areas of radiation medicine and radiation safety. A new project will focus on establishing a multi-diagnostic and radiotherapy centre to provide the country with an integrated medical facility dedicated to health care (diagnosis and therapy), education and training, and research to contribute to the reduction of cancer mortality.

On World Cancer Day on 4 February 2022, Félix-Antoine Tshisekedi Tshilombo, President of the DRC and Chairperson of the African Union, co-hosted the launch of Rays of Hope, the IAEA’s initiative to bridge the global cancer care gap in low- and middle-income countries, jointly with Senegal’s President Macky Sall, incoming Chairperson of the African Union. imPACT Review recommendations offer important input to the Rays of Hope initiative, as they help define the support packages for recipient countries such as the DRC.