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07 December 2022

Senior King's oncologists collaborate to deliver report on the state of cancer research across the Africa

Senior oncologists Professor Richard Sullivan and Dr Ajay Aggarwal from King’s have co-ordinated a major report that reviews the state of cancer research across Africa over the last decade.

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The report, published in the BMJ Global Health, has been compiled by academics working in collaboration from universities in Africa, Europe, North America and the African Organisation for Research and Training in Cancer and builds on a Lancet Oncology Commission Cancer in sub-Saharan Africa that Professor Sullivan and Dr Aggarwal were recently involved with. It reviews cancer research from all 54 African countries – with a particular focus on Sub Saharan Africa (SSA) – over the last 12 years and culminates in a five-point plan of recommendations designed to boost the continent’s output.

The report states that research is a critical pillar in national cancer control planning and is crucial for improving affordable, equitable outcomes.

Research is not a luxury for building national cancer control planning. This work, led by senior members of the African cancer community such as Dr Miriam Mutebi from Aga Khan Hospital in Nairobi, supported by King’s College London, provides an evidenced-based framework for national and regional policy-makers to building better cancer research funding and infrastructure across the Continent.”

Professor Richard Sullivan, Director of the Institute of Cancer Policy and Co-Director of the Centre for Conflict & Health Research

From 2009 to 2020, African countries published almost 24,000 cancer research papers with 7,500 papers co-authored from international collaborations. Publication numbers were extremely geographically uneven, however, with just 13 countries being responsible for about 90% of total cancer research, and Egypt and South Africa combined making up two thirds of the entire continent’s research.

The analysis found that most African countries are heavily dependent on international collaboration, and that most academic institutions are not financially independent and have to look for external funders. This heavy dependence on international collaboration is further reflected in the privileged authorship ranking in papers. Traditionally, the first name that appears on a paper is the name of the researcher who contributed the bulk of the work, while the last name is that of the Principle Investigator whose research group funded the study. The report found “significant power imbalances” between African and international researchers when assessing name placement.

Certain high-burden cancers, such as liver, cervix and prostate cancers, were also underrepresented in cancer research. SSA has one of the highest incidences of oesophageal cancer globally, but there was “woefully” little research done in that area. A decline in childhood cancer research was also highlighted, as first diagnosis often presents advanced cases across the continent.

The report states that Africa’s contribution to global cancer research is increasing annually by 15%. Despite this, “much of the funding and research structures reflect a long history of colonialism.” In its five-point plan, the report urges lower-middle and upper-middle African countries to invest more money in cancer research and development across a wider range of disciplines that address national and regional needs.

Furthermore, research needs to be a key component of every national cancer control plan across Africa, and academic institutions need to develop independent funding sources that can allow them to drive their own research agenda and become less dependent on international funders. The researchers call for greater collaboration between countries, and in particular multilingual collaborations that promote research in French-speaking and Portuguese-speaking nations.

In this story

Richard  Sullivan

Director, Institute of Cancer Policy and Co-Director of the Centre for Conflict & Health Research

Ajay Aggarwal

Professor of Cancer Services & Systems Research