Rwanda has taken important steps to tackle preventable cancers nation-wide, a recent international assessment has found. This includes measures to improve cancer services, develop key governance documents and train oncology professionals. However, challenges remain to increase comprehensive cancer care access across the country.
The imPACT review, carried out by the IAEA, the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) and completed in January, evaluated Rwanda’s health system capacity and needs for cancer care and control.
“This review is very timely, since Rwanda is now launching its new National Cancer Control Plan 2025–2029 and Accelerated Cervical Cancer Elimination Strategy,” said Claude Mambo Muvunyi, Director General of the Rwanda Biomedical Centre at the Ministry of Health. “Rwanda is continuously making strides towards enhancing cancer prevention and treatment services for its population.”
With 7000 new diagnoses and over 4800 deaths every year, according to 2022 IARC figures, cancer is a growing health concern in Rwanda, driven in part by infectious diseases such as the human papillomavirus (HPV) virus. Cervical cancer is the most common cancer in women, followed by breast and stomach cancers. In men, prostate cancer is the most frequent, followed by stomach and liver cancers.
The in-country mission
During the in-country mission from 20 to 24 January, a team of IAEA, WHO and IARC technical officers and eight international experts from Africa and the Americas met with national authorities, civil society, survivor groups and other stakeholders to better understand the cancer control landscape in the country.
They also visited main health facilities and training institutions, including the Rwanda Military Referral and Teaching Hospital, which hosts the Rwanda Cancer Centre, and the University Teaching Hospital of Kigali (CHUK), as well as district healthcare centres across the country.
The team commended Rwanda for the commitment to strengthen cancer control and the significant progress made since a previous imPACT review in 2014. Rwanda is currently updating its National Cancer Control Plan (NCCP), set to be implemented in 2025–2029, and recommendations from the recent international assessment will help to inform its activities.
“As a strategic tool, the NCCP is crucial to ensure that priority is given to the disease within the national health context, and for guiding actions that address pressing cancer challenges and the distribution of resources,” said Laura Haskins, project officer at the IAEA’s Programme of Action for Cancer Therapy and imPACT review team lead.
Cancer prevention efforts praised
The imPACT team also praised Rwanda’s efforts in cancer prevention, which include programmes to support physical activity, strengthen tobacco control and promote vaccination against HPV – responsible for over 95 per cent of cervical cancers in women. Rwanda was the first country in Africa to introduce the HPV vaccine, and, according to data from the national vaccination programme, by 2023 had a first-dose coverage rate of 90 per cent among girls by age 15. This year, the country plans to step up efforts to eliminate cervical cancer with a nation-wide drive for vaccination and screening.
Despite this progress, the international team found that challenges in cancer control remain in Rwanda, including an uneven distribution of specialized healthcare across the country and some reliance on external funding to finance national health initiatives.
The team made recommendations to help address these issues, urging Rwanda to increase domestic public/private investment in health and stressing the importance of incorporating cancer control in other health programmes to increase access to services and referrals.
“The WHO Country Office is committed to supporting Rwanda as it strengthens health systems for cancer control, in particular to ensure integration with existing programmes and structures,” WHO Representative Brian Chirombo said.
Radiotherapy expansion planned
With two linear accelerators at a health facility in Kigali, Rwanda provides some radiotherapy services, but machine downtime due to a lack of servicing staff remains a barrier for timely access to treatment. The imPACT team recommended expanding radiation medicine services – including brachytherapy – outside the capital, in line with the Ministry’s plans. They also recommended investment in training to facilitate the servicing of equipment in-country. Nuclear medicine capacity is being developed, and the imPACT team suggested expansion of specialist training to include various imaging modalities, among others.
Through its technical cooperation and human health programmes, the IAEA has been supporting Rwanda in building capacity to increase human resources and quality assurance for cancer control, among others. “Following the 2014 imPACT review, the Agency also provided expert advice to the Government on designing and implementing radiotherapy services,” added Tomoaki Tamaki, Section Head for Applied Radiation Biology and Radiotherapy at the IAEA’s Division for Human Health. The support included a costed plan that paved the way for country’s first radiotherapy centre, opened in 2019.
In 2022, the IAEA launched the Rays of Hope initiative to help bridge gaps in access to cancer care worldwide, with a focus on partnerships to ensure the maximum impact and sustainability of efforts.
Distributed by APO Group on behalf of International Atomic Energy Agency (IAEA).
