Nigeria has advanced its national cancer control programme in the last decade and is making steady progress towards expanding care for millions of people, an international assessment has found. Nigeria is strengthening institutional response, increasing resource allocation and building its oncology workforce and services to tackle its cancer burden, according to the review.
The imPACT review, carried out by the IAEA, the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) upon request from the Nigerian Government, evaluated current health system readiness for cancer care and progress since a previous assessment in 2011.
With 220 million people, Nigeria has the largest population in Africa, densely spread across a country with a land mass of 900 000 square kilometres. However, the distribution of health services is uneven, concentrated around larger cities and not easily accessible for many Nigerians outside main urban centres. Noncommunicable diseases, including cancer, are a significant health problem; according to 2022 IARC figures, the number of new cancer cases in Nigeria is estimated at nearly 128 000 per year.
The most frequent types of cancer among Nigerian men are prostate, colorectal and liver cancers. Breast cancer, with over 32 200 new cases and more than 16 300 deaths per year, is the most common cause of death from cancer among Nigerian women. Cervical cancer also poses a major challenge, accounting for the second largest number of female cancer deaths in Nigeria.
The imPACT review team explored the complementary role of the private sector in enhancing access to radiotherapy during a visit to a private hospital in Lagos City, Nigeria. (Photo: A. Karagu/IAEA)
The most frequent types of cancer among Nigerian men are prostate, colorectal and liver cancers. Breast cancer, with over 32 200 new cases and more than 16 300 deaths per year, is the most common cause of death from cancer among Nigerian women. Cervical cancer also poses a major challenge, accounting for the second largest number of female cancer deaths in Nigeria.
In October 2024, an imPACT review team comprising IAEA, WHO and 12 independent experts from Algeria, Cameroon, Cote d'Ivoire, Ghana, Morocco, Kenya, Rwanda, South Africa, the United States of America, Zambia and Zimbabwe visited key sites relevant to cancer control in Nigeria, including university hospitals and primary health care centres. The review team not only brought together a wide pool of expertise, but also fostered regional and south-south collaboration to support capacity building following the review.
An imPACT review mission in October 2024 assessed Nigeria's cancer care capacities and provided recommendations to expand services. Here, the review team visits the University College Hospital in Ibadan. (Photo: L. Haskins/IAEA)
The team, on the ground in Nigeria from 14 to 24 October 2024, interviewed local health authorities and held extensive consultations with cancer stakeholders, including patient advocacy groups. They also met with partners that could potentially support the country in scaling up access to cancer services, including the Islamic Development Bank, the African Development Bank and the Nigerian Sovereign Investment Authority, among others.
The review found that Nigeria has taken positive steps to strengthen cancer care since the last imPACT mission to the country in 2011, including through the establishment in 2023 of the National Institute for Cancer Research and Treatment (NICRAT). The institute has since launched the National Strategic Cancer Control Plan 2023-2027 and is working with several partners to implement its activities in cancer prevention, diagnosis, treatment, hospice and palliative care, as well as data management and advocacy.
"As part of our ongoing efforts to enhance access to cancer diagnosis and treatment across the country, we are working closely with the Federal Ministry Of Health and Social Welfare to establish comprehensive cancer treatment centres and diagnostic facilities across all the six geopolitical zones," said NICRAT Director General Usman Aliyu. "We are also partnering with stakeholders towards strengthening cancer control programs at both the federal and state levels to address the rising burden of cancer in Nigeria."
The imPACT team held meetings with local health authorities, partners and stakeholders, including patient advocacy groups. Preliminary findings were presented to the Federal Ministry of Health and Social Welfare of Nigeria. (Photo: L. Haskins/IAEA).
The imPACT review sought to create a baseline analysis of the current cancer care situation to support Nigeria in building strategic partnerships to expand care, including under broader global cancer efforts such as the IAEA's Rays of Hope, WHO's breast and cervical cancer initiatives, and IARC's cancer registry initiative. The assessment also helped determine national capacity building needs in oncology, pathology and palliative care, among others.
"We are working closely with the Federal Ministry of Health and Social Welfare and other partners under the sector-wide approach framework to promote synergies and enhance coordination for cancer control across at all levels, including the integration of cancer prevention and early diagnosis interventions within the primary health care setting," said Walter Kazadi Mulombo, WHO Country Representative in Nigeria.
In May 2024, IAEA Director General Rafael Mariano Grossi visited Nigeria and pledged increased cancer care support through the IAEA's Rays of Hope initiative. Nigeria expressed interest to expand radiotherapy services - including brachytherapy to treat for example cervical and prostate cancers - in all its 36 states.
"The imPACT Review was well-timed, considering the country's plans to expand cancer care access within the framework of the IAEA's Rays of Hope and technical cooperation programme," said Mickel Edwerd, Section Head in the IAEA Department of Technical Cooperation and member of the review team. "The findings provide a key starting point to increase cancer care access for millions of Nigerians."
