Is there value to sub-specialty training in sub-Saharan Africa?
Over the past three decades, Africa has focused on combatting infectious diseases, such as tuberculosis, malaria, and HIV/AIDS. As treatment strategies for infectious diseases have improved over time, life expectancy has increased, shifting the burden to chronic diseases, such as cancer. The WHO has now identified non-communicable diseases, including cancer, as the new epidemic in sub-Saharan Africa1. Cancer incidence and mortality are increasing rapidly in low and middle-income countries (LMIC) as compared to high-income countries. By 2020, it is predicted that 70% of all new cancers worldwide will occur in LMIC2. In 2012 850 000 new cancers were diagnosed in Africa, and over one million new cancers are predicted on the continent by 20202–4. Developing effective strategies to prevent, detect and treat this growing number of cancer cases poses a great challenge. There is an ongoing lack of resources, and little awareness of the need among policymakers and the general public. In addition, there is a severe shortage of health care personnel in sub-Sharan Africa5–7. With limited resources and a growing need to treat complex malignancies, is it feasible for LMIC to train subspecialists in oncology?