Analysis of Global Radiotherapy Needs and Costs by Geographic Region and Income Level

Abstract

Recent years have seen various reviews on the lack of access to radiotherapy often based on geographic regions of the world such as Africa, Asia Pacific, Europe, Latin America and North America. Countries are often defined by their national income per capita levels based on World Bank definitions of high income, upper middle income, lower middle income and low income. Within the world regions, there are significant variations in gross national income (GNI) per capita among the different countries, and even within similar income levels, large variations exist. This report presents the actual status of radiotherapy and analyses the current needs and costs to provide full access in the different regions of the world. Actual coverage of the needs ranges from 34% in Africa to over 92% in Europe to about double the needs in North America. In line with this, proportional additional investments and operational costs are as high as more than 200% in Africa to almost none in North America. Two world regions face substantial challenges: Africa, based on the important demands to build new capacity and subsequently to maintain operational capability; and Asia Pacific, due to its high population density, translating into large absolute needs in radiotherapy treatments and resources, and hence in associated costs. With the data highlighting a large variability of GNI/capita even within similar income levels in the various world regions, it is expected that additional investment in resources and costs may be more dependent on income level of the country than on the GNI group or the geographic region of the world.

Comparative Analysis of Radiotherapy Linear Accelerator Downtime and Failure Modes in the UK, Nigeria and Botswana

“…Tackling the radiotherapy burden in LMICs is a complex task that requires multidisciplinary collaboration [8], [9], [10]. An International Cancer Expert Corps sponsored workshop held on the CERN campus in 2016 invited experts from fields including oncology and accelerator physics to consider future options, including innovative technology, for tackling this global problem [11].…”

“From good hearted community members we get volunteers” – an exploratory study of palliative care volunteers across Africa

“…The original version of the IMPHV [24] was directed at volunteers themselves, whereas the questionnaire in this study was directed at national champions, asking about their perspective on volunteers' motivations. The authors therefore modified the IMHPV, using a simple checkbox approach (yes/no = 1/0) instead of the Likert scale [1][2][3][4][5] to rate the statements. To be able to compare this study's results with the original IMHPV findings, and thereby seek greater understanding of possible regional differences in the data, a standardised mean sample score was calculated for each motivation:…”

“…4 MWAPO Health Development Group, Nairobi, Kenya. 5 Makerere University, Kampala, Uganda. 6 Cairdreas International Palliative Care Trust, Aberdeen, Scotland.…”

“…Cancer is frequently diagnosed late, and treatment options are often limited. Radiotherapy, for example, is estimated to cover only 34% of the need in Africa [5]. Another increasingly important NCD that imposes new challenges for palliative care provision is end-stage kidney disease [6].…”

History of the development of radiotherapy in Latin America

“…The number of cancer deaths between 2012 and 2030 will rise by 67%, more than what is expected in North America (41%) [28]. The ≈620 radiotherapy centres in Latin America are largely insufficient for the more than 600 million inhabitants [27]. …”