Plan Stratégique National de Prévention et de Lutte contre le Cancer (PSNPLCa)

Objectives

Cameroon’s National Strategic Plan for Cancer Prevention and Control 2020–2024 seeks to reduce cancer-related morbidity and mortality by 10% by 2024, mitigate cancer’s socio-economic effects on national development, and support a 2035 vision in which holistic, optimal cancer care is a reality.[1][2][3]It responds to a substantial and growing burden, with more than 15,700 new cases and 10,533 deaths annually, frequent late presentation, and major constraints in prevention, diagnosis and treatment.[4][5][6]

• Establish and operationalise a national cancer-control policy, supported by strategic and operational guidance, reorganisation of the National Cancer Control Committee, improved oncology education and research, and construction of a National Cancer Institute by 2024.[7][8][9]
• Increase primary-prevention interventions by 25% through social mobilisation, advocacy, information, education, behaviour-change communication, vaccination, and screening for precancerous conditions.[7][10][11]
• Reduce exposure to behavioural, infectious, environmental and occupational risk factors, including tobacco, alcohol, unhealthy diets, obesity, insufficient physical activity, infections, ionising radiation and chemical exposures.[12][13]
• Expand secondary prevention, screening, early diagnosis and prompt treatment, with a target of increasing cancers detected and treated early by 25% by 2024.[2][3][14]
• Improve treatment effectiveness and efficiency, including a 10% increase in the overall cure rate by 2024, alongside quality treatment, psychosocial support and palliative care.[2][15][16]
• Produce strategic epidemiological information through routine data, surveillance, cancer registries and research, and strengthen institutional planning, governance, programme management and capacity at all levels.[3][17][18][19]

Implementation

Implementation is designed as a coordinated, multisectoral and decentralised response aligned with Cameroon’s 2016–2027 Health Sector Strategy and National Health Development Plan.[1][20]Annual, results-oriented work plans will guide delivery under coordination by the Permanent Secretariat of the National Cancer Control Programme, with regional and operational focal points coordinating activities and monitoring.[20]The National Cancer Control Committee is central to policy development, prevention, early detection, treatment, palliative care, cancer-data collection, research and resource mobilisation.[21]

• Engage public and private institutions, civil society, international partners, universities, health facilities and sectors relevant to prevention, financing, treatment, palliative care or cancer-related risks.[22][7][20][23][24]
• Integrate cancer prevention and control into the minimum package of services at all levels, progressively incorporate activities into sectoral, regional and communal development plans, and target interventions to specific population groups.[9][25]
• Deliver prevention through community education, media collaboration, advocacy, behaviour-change communication, hepatitis B and human papillomavirus vaccination in collaboration with the Expanded Programme on Immunisation, and strengthened screening for precancerous lesions.[10][11][14]
• Decentralise screening and early diagnosis, including cervical services at peripheral level and mobile screening, while strengthening referral, histopathology, imaging, specimen transport and permanent screening and early-diagnosis centres.[26][27][15][28]
• Strengthen treatment through multidisciplinary cancer-management committees, harmonised treatment guidance, continuous chemotherapy access, reinforced oncology and radiotherapy services, chemotherapy day hospitals, nuclear medicine, and the planned National Cancer Institute.[16][17][29]
• Expand accessible palliative care by strengthening training, essential-medicine and strong-opioid availability, service capacity and national coordination.[30][17]
• Reactivate population registries in Yaoundé and Douala, expand adult and paediatric hospital registries, improve death certification, publish surveillance information, and translate epidemiological, clinical, psychosocial, health-systems and policy research into action.[31][18][32]
• Monitor delivery through the national monitoring and evaluation plan, routine information transmitted through the National Health Information System and District Health Information Software 2, and monthly, quarterly, half-yearly and annual reporting.[20][25]Conduct annual internal evaluation with the Ministry of Public Health, mid-term and final plan evaluations, and external evaluation every three years involving organisations such as the World Health Organization, UNICEF and the International Atomic Energy Agency.[33]
• Use outcome and effect indicators, supervision missions, consultation meetings and regular data analysis to assess effectiveness, identify shortcomings and implement corrective action.[25]Key intended results include lower morbidity and mortality, fewer advanced-stage diagnoses, improved cure rates, stronger prevention and early detection, better oncology training and research, and improved quality of life.[2][7][33]

Monitoring & Evaluation

The plan establishes a national monitoring and evaluation system linked to annual work plans, routine health information, cancer registries, epidemiological surveillance, research and periodic programme reviews. It aims to measure whether interventions improve prevention, early diagnosis, treatment outcomes, palliative care, governance and cancer epidemiology.[20][25][33]

• Monitor implementation through a national monitoring and evaluation plan annexed to the strategic plan, with monthly, quarterly, half-yearly and annual reports produced under national reporting guidance.[20]
• Use outcome and effect indicators to assess intervention effectiveness and efficiency, identify implementation shortcomings and apply corrective measures through regular analysis of collected data.[25]
• Track the plan’s principal outcome targets: reduce cancer morbidity and mortality by 10%; increase primary-prevention interventions by 25%; increase cancers detected and treated early by 25%; and increase the overall cure rate by 10% by 2024.[2][7][3]
• Measure selected service outcomes through reductions in advanced-stage presentation and, over the longer term, reductions in cancer incidence and mortality, including for breast, cervical and childhood cancers.[34][26][35]
• Publish annual statistics on hepatitis B and human papillomavirus vaccination and screening.[14][36]
• Use annual work-plan monitoring and review, supervision of screening, treatment and registry services, programme-result communication, specialist field missions and consultation meetings as implementation oversight mechanisms.[37][25]
• Conduct annual internal evaluation by the National Cancer Control Committee in collaboration with the Ministry of Public Health, alongside external evaluation by bodies including the World Health Organization, UNICEF and the International Atomic Energy Agency every three years.[33]
• Undertake a mid-term evaluation and a final evaluation, with reports expected to document achievements, unmet objectives, constraints and future plans.[33]
• Strengthen routine data reporting, reactivate cancer surveillance, make population-based registries in Yaoundé and Douala operational, extend hospital registries for adults and children, and improve death-certificate completion and registration.[31][18][38]
• Use civil-registration data, cancer registries and sample surveys to measure incidence, morbidity, mortality, prevalence and survival, document prevention and care interventions, and assess implemented actions.[31]
• Monitor research through defined priorities, planned and followed-up activities, recurrent-cancer situation analyses and translation of operational findings into action.[18][32]

The framework is intended to define actors, roles, responsibilities, information sources, reporting pathways, indicator baselines, targets, methods and frequencies.[25][33][39]However, several extracts do not provide complete indicator definitions, consolidated reporting responsibilities or detailed accountability arrangements for every intervention.[33][40]

Costing & Financing

The plan contains activity-level budget tables for prevention, service expansion, palliative care, cancer registration, surveillance, research and programme management, but the supplied extracts do not identify the currency, overall plan budget, financing shares, funding gap or economic assumptions for most listed amounts.[41][42][29][32][43][40]

• Mobilise resources through advocacy and an investment case for cancer prevention and improved cancer-control services.[14][41][42]
• Address documented resource constraints, including limited financing, shortages of medicines, staff, equipment, maintenance capacity, radiotherapy infrastructure and diagnostic services.[4][44][16]
• Maintain and expand public support for anticancer medicines, noting that the Ministry of Public Health subsidy has covered less than 10% of national needs since 2005.[45]
• Reduce the average cost of comprehensive care by 50% for 95% of cancers detected nationwide by 2023, although the monetary baseline and costing method are not specified.[28]
• Increase the chemotherapy-subsidy indicator from a 0% baseline in 2018 to a reported final target of 90%; intermediate targets are presented without associated dates.[38]
• Recognise affordability barriers, including a reported price of 35,000 FCFA per dose for bivalent or quadrivalent human papillomavirus vaccine and unaffordable private radiotherapy for many patients.[46][47]
• Allocate resources for National Cancer Institute development, including procedures, equipment, staffing, construction, maintenance and communication, although the available extracts do not provide a consolidated institute cost.[9][41]
• Fund cancer-information infrastructure and research inputs, including registry staffing, equipment, consumables, death registration, surveillance publication and research capacity.[18][32]

Wider economic context includes Cameroon’s 2018 current gross domestic product of 15,846 billion CFA francs, annual growth of 5.9% and inflation of 1.9%.[48]The extracts also cite allocations under the Triennial Emergency Plan, but these are wider health-system investments rather than a quantified financing plan for cancer control.[49]