title: Capacity building for oncology programmes in sub-Saharan Africa: the Rwanda experience.
abstract: Despite an estimated 456,000 deaths caused by cancer in sub-Saharan Africa in 2012 and a cancer burden that is predicted to double by 2030, the region accounts for only 0·3% of worldwide medical expenditure for cancer. Challenges to cancer care in sub-Saharan Africa include a shortage of clinicians and training programmes, weak healthcare infrastructure, and inadequate supplies. Since 2011, Rwanda has developed a national cancer programme by designing comprehensive, integrated frameworks of care, building local human resource capacity through partnerships, and delivering equitable, rights-based care. In the 2 years since the inauguration of Rwanda's first cancer centre, more than 2500 patients have been enrolled, including patients from every district in Rwanda. Based on Rwanda's national cancer programme development, we suggest principles that could guide other nations in the development of similar cancer programmes.
authors.affiliation: Brigham and Women's Hospital, Boston, MA, USA. Electronic address: sstulac@pih.org.
authors.forename: Sara
authors.initials: S
authors.lastname: Stulac
authors.affiliation: Ministry of Health of Rwanda, Kigali, Rwanda.
authors.forename: Agnes
authors.initials: A
authors.lastname: Binagwaho
authors.affiliation: Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Neo M
authors.initials: NM
authors.lastname: Tapela
authors.affiliation: Global Health Delivery Partnership, Boston, MA, USA.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Wagner
authors.affiliation: Ministry of Health of Rwanda, Kigali, Rwanda.
authors.forename: Marie Aimee
authors.initials: MA
authors.lastname: Muhimpundu
authors.affiliation: Ministry of Health of Rwanda, Kigali, Rwanda.
authors.forename: Fidele
authors.initials: F
authors.lastname: Ngabo
authors.affiliation: Ministry of Health of Rwanda, Kigali, Rwanda.
authors.forename: Sabin
authors.initials: S
authors.lastname: Nsanzimana
authors.affiliation: Ministry of Health of Rwanda, Kigali, Rwanda.
authors.forename: Leonard
authors.initials: L
authors.lastname: Kayonde
authors.affiliation: Inshuti Mu Buzima, Rwinkwavu, Rwanda.
authors.forename: Jean Bosco
authors.initials: JB
authors.lastname: Bigirimana
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Lessard
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Lehmann
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Lawrence N
authors.initials: LN
authors.lastname: Shulman
authors.affiliation: Partners In Health, Boston, MA, USA.
authors.forename: Cameron T
authors.initials: CT
authors.lastname: Nutt
authors.affiliation: Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Drobac
authors.affiliation: University of Rwanda College of Medicine and Health Services, Kigali, Rwanda.
authors.forename: Tharcisse
authors.initials: T
authors.lastname: Mpunga
authors.affiliation: Harvard Medical School, Boston, MA, USA.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Farmer
mesh_terms: D044383:Black People; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D003906:Developing Countries; D006291:Health Policy / Q000331:legislation & jurisprudence; D006301:Health Services Needs and Demand / Q000458:organization & administration; D054625:Healthcare Disparities / Q000458:organization & administration; D006801:Humans; D008495:Medical Oncology / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D017146:Models, Organizational; D009369:Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration; D011050:Policy Making; D016730:Program Development; D015397:Program Evaluation; D012432:Rwanda / Q000453:epidemiology