By Karen Nakawala Chilowa, Executive Director, Teal Sisters Foundation.
For the first time since 2020, Zambian women can now access radiotherapy treatment for cancer. The radiotherapy and imaging centre at the Cancer Diseases Hospital in Lusaka has reopened its doors, restoring life-saving services that were suspended due to equipment breakdown.
It’s a crucial step forward in improving cancer care in my country. But it’s also a signal to other African countries: it’s time to plug the gaps that are contributing to our rising death rates, especially from breast cancer.
Breast cancer is the most commonly diagnosed women’s cancer on the continent, but 60-70 per cent of cases are only caught in the later stages, leading to poor outcomes. New World Health Organization data show that only around four in ten women in Africa can expect to be alive five years after a breast cancer diagnosis, compared with almost nine in ten in high-income countries.
Radiotherapy is a key part of the treatment. It uses high-energy radiation (such as X-rays) to damage the DNA of cancer cells, killing them or stopping them from growing. It’s often used after breast cancer surgery to remove any cancer cells that might have been left behind.
The shocking fact is that almost 40 per cent of African countries have no radiotherapy equipment, according to a 2024 report by the World Health Organization.
The past six years have been the most devastating time in Zambia’s healthcare history. Breast cancer death rates almost doubled during the Lusaka centre’s closure. We lost so many women to breast and cervical cancer, including those who could have survived with timely access to treatment. For women who could afford it, travelling abroad became the only option, placing enormous financial pressures on families – and the government’s budgets.
As a cancer survivor myself, this is extremely personal. During my treatment for cervical cancer, I underwent six weeks of chemoradiation (a combined treatment plan of chemotherapy and radiotherapy simultaneously) to cure my cancer. Throughout this time, I noticed clear gaps in the healthcare system and witnessed women falling through the cracks.
It’s this experience that motivated me to become a member of the Africa Breast Cancer Council, a group of women health leaders working with governments to share success stories, to inspire an upgrade in cancer care for all women.
Zambia’s state-of-the art radiotherapy facility, with a capacity to treat 60 patients a day, is one such success story. But it also reminds us, this Breast Cancer Awareness Month, how much work there is still left to do.
For treatment, while important, is just one part of the cancer care puzzle. If countries are to make real progress on survival rates, they must get more women diagnosed sooner, and into an efficient and integrated pathway of care. This means tackling the many barriers to diagnosis, such as stigma and religious and cultural beliefs.
It also means extending quality care beyond fancy hospitals in big cities. One of my fellow Africa Breast Cancer Council members from Kenya, Dorothy N’yongo, has, through her foundation, spearheaded a “clinic on wheels” that takes breast cancer care to women in remote rural areas, providing screening and referrals.
Egypt’s Presidential Initiative on Women’s Health is a beacon of hope for the continent. It has invested in awareness campaigns, screening services, infrastructure, and training nationwide. Since 2019, 60 million women have accessed screenings and consultations; more than 33,500 breast cancer cases have been detected, with thousands of women receiving life-saving treatment at no cost.
One solution is the integration of women’s cancer services, so, for example, women can be screened for both breast and cervical cancer on the same visit. This approach is bearing fruit in Kenya and Côte d’Ivoire which launched Women’s Integrated Cancer Services. The pilot programme resulted in 17,587 women screened for cervical and breast cancers and over 3 million girls protected from cervical cancer through HPV vaccination campaigns.
Lusaka’s reopened facility is something to celebrate, but, with Africa’s breast cancer rates predicted to double by 2040, we cannot stop here. In Zambia, we now have the opportunity to build on this investment, tackle the backlog and expand beyond the capital. But the goal – for Zambia and Africa as a whole – cannot be simply to have equipment; it must be to make sure that all women who need it can access it in time.