WHO: Urgent Changes Needed in Breast Cancer Screening and Care in Africa

It’s been just over a month since the Trump administration withdrew the U.S. from the World Health Organization (WHO) — the international agency that helps countries monitor and respond to health challenges throughout the world. 

The full impact of the U.S. pulling out of the WHO remains to be seen, but one thing is clear: the withdrawal will significantly lower the amount of money the WHO has to support health programs around the world. In 2022–2023, the U.S. contributed more than $1 billion to the WHO. 

One group that may be hurt by the withdrawal of the U.S. from the WHO are women living with breast cancer in sub-Saharan Africa. Without greater investment in breast cancer screening and treatment, the number of women in sub-Saharan Africa dying from breast cancer could double by 2040, according to a recent WHO report.

According to the WHO, there were 2.3 million new cases of breast cancer and over 666,000 deaths from the disease globally in 2022. Most deaths occurred in low- to middle-income countries that have weaker health systems. 

New breast cancer cases in sub-Saharan Africa — the regions of the continent that lie south of the Sahara desert — account for 6.4% of global cases. This region has lower rates of breast cancer than other parts of the world (including Europe and North America), but people are more likely to die from the disease in sub-Saharan Africa than other parts of the world. It’s estimated that about 11% of global breast cancer-related deaths occurred in sub-Saharan Africa in 2022. 

In 2021, the WHO launched the Global Breast Cancer Initiative, which aims to reduce global deaths from breast cancer by 2.5% each year through 2040. The WHO estimates this goal would prevent 2.5 million deaths by 2040. To achieve this goal, the initiative provides countries with guidelines that focus on

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  educating the public about the signs and symptoms of breast cancer, importance of early screening, and ways to reduce risk

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  training healthcare workers to quickly connect people who have early signs of breast cancer with specialists so they can begin treatment

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  improving breast cancer screening and treatment by offering these services in a central location 

The WHO report evaluated how 42 countries in sub-Saharan Africa diagnose and treat breast cancer. Each country was assessed based on the strength of its health workforce, government funding, and treatment services. 

In general, there were significant gaps in early detection of breast cancer and care across the region. The Eastern and Southern Africa region — which includes Ethiopia, Kenya, and Zambia — had better health systems for breast cancer control than other regions of Africa.

Only five countries — including Algeria, Chad, and Kenya — had organized screening programs that are needed to detect the disease early. Pathology labs are crucial for diagnosing breast cancer, but only two countries (Cabo Verde and Seychelles) met the standard of one lab per 100,000 people. 

Once people are diagnosed with breast cancer, it can be difficult to find treatment. While people living in most countries in the region could access chemotherapy, it was harder to access radiation therapy. That’s because only about 60% of countries had radiation equipment. Only about half had specialized cancer centers. Also, nearly half the countries lacked national treatment guidelines for breast cancer, which can help to standardize treatment so that people diagnosed with breast cancer receive the same level of care. 

To address the significant gaps and disparities in breast cancer detection and care in sub-Saharan Africa, the WHO report says countries need National Cancer Control Plans, typically organized and funded by a country’s federal government. Less than half of the countries surveyed, including Algeria, Ethiopia, and Mozambique, already had a control plan in place. 

Since 2012, the International Cancer Control Partnership — a partnership between 25 organizations, including the WHO and the U.S. National Cancer Institute — has supported countries around the world in the development of National Cancer Control Plans. Since the group’s founding, the number of countries with cancer control plans has tripled.