Global Key Message

  • All countries should ensure access to cancer drugs on the WHO Model List of Essential Medicines that are low-cost and effective. Access and affordability of essential cancer medicines can be facilitated through the adoption of policies that support the use of generic medicines.
  • Access to new, patented, and expensive NCD medicines should be considered on an individual basis based on priorities identified within national cancer control planning with the number and variety of cancer medicines increasing with the level of available resources.
  • Radiotherapy is a critical component of high-quality cancer care. It can cure cancers alone, or in combination with surgery or chemotherapy.

The Facts

  • Household surveys show that 41–56% of households in LMICs spend all of their health-related expenditure on medicines. The cost of cancer medicines does not have to be prohibitively expensive - most of the off-patent generic cancer medicines required for LMICs are available for less than $US100 per course of treatment, and nearly all for under $US10005.
  • Radiotherapy is recommended in 52% of new cancer patients. In LMICs, the need for RT may in fact be higher due to a more advanced stage of disease at presentation. There is currently a deficiency of at least 5,000 radiotherapy machines in LMICs. This shortage means that up to 70% of cancer patients in LMICs who may benefit from radiation medicine do not receive this essential curative or pain relieving treatment.

Coverage of radiotherapy services according to country as determined by global equipment databases, an activity-based operations model, cancer incidence, and evidence-based estimates of radiotherapy need. Estimates depend on the nature of equipment use. The colour bar shows the operational model: 12 h operation was used as the feasible case, but 8h and 16h were also modelled to capture typical and potential capacity, respectively.

Figure taken from  “The Lancet Oncology: Expanding global access to radiotherapy, Vol 16, September 2015, p. 1168”

Meeting the Challenge

The safe and effective delivery of cancer medicines and radiotherapy, as part of a team-based approach to cancer care, is achievable in both high- and low-income settings if implemented as part of a national cancer control plan and according to evidence-based clinical guidelines that are appropriate for the level of resources.

Country examples

Cancer is increasingly recognized as a major public health problem across Africa. The burden of the disease is worsening as rising living standards lead to lifestyle and environmental changes, such as unhealthy diets, physical inactivity and pollution, that increase the incidence of cancer.

For many years, Mauritania, one of Africa’s 34 least developed countries, has struggled to address the human and financial costs of cancer. Haematological malignancies and solid tumours, for example, require specialized treatments that were not available at Mauritanian hospitals, which meant that patients had to seek treatment abroad. Cancers of the cervix, breast, prostate, liver and ovary are among the most common cancers in the country. After establishing a National Oncology Centre (CNO) in Nouakchott in 2010, the Government of Mauritania sought IAEA support to build capacities in the delivery of radiotherapy, nuclear medicine, and cancer care, generally. The specialized medical staff—radiation oncologists, medical physicists, radiation therapy technologists—trained abroad by the IAEA, are now fully in-charge of the facility.


On November 28, 2014, the completed nuclear medicine facility was inaugurated. Like the radiotherapy centre, it is located within the National Oncology Centre in Nouakchott.

For more information regarding this IAEA project download the pdf.