Childhood cancer in Africa: the survival gap and what research can change

Health and data · Published 2026-10-24

Most childhood cancers can be cured. In high-income countries, more than 80% of children with cancer survive. In most low- and middle-income countries, fewer than 30% do, according to the World Health Organization. Much of that difference lies in health systems rather than in the biology of the disease, which is why it is a research and policy problem as much as a medical one.

The basic facts

• WHO estimates that about 400,000 children and adolescents aged 0 to 19 develop cancer each year worldwide. Because many cases are never diagnosed or recorded, especially in low-income settings, the true number is uncertain.
• The most common types in children are leukaemias, brain tumours, lymphomas and solid tumours such as neuroblastoma and Wilms tumour (a kidney cancer).
• Childhood cancers generally cannot be prevented or screened for in the way some adult cancers can. Survival depends on early, accurate diagnosis followed by effective treatment and supportive care.
• Several effective childhood cancer medicines are inexpensive generics included on the WHO Model List of Essential Medicines for Children.

Patterns in sub-Saharan Africa

Some cancers are relatively more common in parts of Africa than elsewhere. Burkitt lymphoma, a fast-growing lymphoma first described in children in Uganda in the late 1950s, is closely associated with Epstein-Barr virus infection and with areas of high malaria transmission. Kaposi sarcoma in children is linked to HIV. Retinoblastoma, an eye cancer of early childhood, is often diagnosed late, when it has already spread.

Reliable incidence data are scarce. Population-based cancer registries, which record every case in a defined population, cover only part of the continent. The African Cancer Registry Network (AFCRN) supports registries across sub-Saharan Africa, and improving paediatric data is one of the stated needs in the field.

Why survival is lower

Researchers and clinicians commonly group the causes of the survival gap into a few categories:

Abandonment of treatment, meaning failure to start or complete curative therapy, is specific enough to have become a research topic in its own right. It is often driven by costs that health insurance or social support could cover.

The WHO Global Initiative for Childhood Cancer

Launched in 2018, the WHO Global Initiative for Childhood Cancer (GICC) aims to reach at least 60% survival for all children with cancer by 2030. WHO describes this as roughly doubling the global cure rate. The initiative's technical package, called CureAll, is organised around:

• centres of excellence and care networks;
• universal health coverage, so that families are protected from catastrophic costs;
• regimens: adapted, evidence-based treatment protocols for six index cancers chosen because they are common and highly curable;
• evaluation and monitoring, including registries;

with cross-cutting work on advocacy, financing and governance.

In 2021, WHO and St. Jude Children's Research Hospital announced a Global Platform for Access to Childhood Cancer Medicines, intended to provide a steady supply of quality-assured medicines to participating countries.

A research agenda for the region

Research priorities discussed by paediatric oncology networks, including the African continental branch of the International Society of Paediatric Oncology (SIOP Africa), tend to fall into five areas:

1. Epidemiology and registries. Knowing how many children develop which cancers, where, and with what outcomes. Without denominators, progress cannot be measured.
2. Adapted treatment protocols. Regimens designed for the available resources, with careful evaluation of toxicity and survival. Treatment intensity that is standard in high-income centres can be dangerous where supportive care is limited.
3. Early diagnosis. Training for primary care workers, referral pathways and awareness campaigns, with studies of what reduces time to diagnosis.
4. Implementation and health systems research. How to organise networks between national referral hospitals and regional centres, how to finance care, and how to prevent abandonment.
5. Biology. The genetics and biology of cancers that are more common in Africa, such as endemic Burkitt lymphoma, and their interaction with infections.

A Lancet Oncology Commission on sustainable care for children with cancer, published in 2020, made an economic case for investment, arguing that scaling up childhood cancer care would produce large health and economic returns.

Partnerships and twinning

Much progress in paediatric oncology in lower-income countries has come from long-term partnerships between hospitals, sometimes called twinning, combined with national commitment. They work best when they build local leadership, training and data systems rather than depending on visiting specialists.

Links to the SDGs

Childhood cancer sits under target 3.4 (reducing premature mortality from noncommunicable diseases) and target 3.8 (universal health coverage, including financial protection and access to essential medicines). Target 3.c on the health workforce and target 3.b on access to medicines are equally relevant. International Childhood Cancer Day, marked each year on 15 February, is an occasion for awareness campaigns by patient and parent organisations.

Related explainers: health data and the SDGs and genomics in public health.

Read next

More in Health and data

Health and data

Genomics in public health

Sequencing for pathogen surveillance, rare disease diagnosis and newborn screening, and the equity questions WHO has raised.

Health and data

Health data and the SDGs

What SDG 3 asks countries to measure, where the numbers come from, and why so many health systems still lack timely data.

Cooperation and skills

How the EU and the UN work together

The EU's status at the UN, Team Europe and Global Gateway, SDG reporting, research cooperation and the tensions worth knowing.