Plan National De Lutte Contre Le Cancer

Objectives

Senegal’s National Cancer Control Plan for 2025–2029 aims to reduce cancer incidence and mortality, improve patients’ quality of life, and ensure equitable access to prevention, early detection and appropriate, sustainable cancer care.[1]Its overall target is to reduce cancer-related mortality by at least 25% by 2029.[2]The plan is aligned with the National Health and Social Development Plan 2019–2028, universal health coverage commitments, the Sustainable Development Goals and international cancer-control frameworks.[3]

• Strengthen prevention and early detection by informing at least 60% of the population about cancer, detecting at least 70% of cancers early, and screening at least 50% of eligible people for precancerous lesions.[2]
• Reduce preventable cancer risks through human papillomavirus and hepatitis B vaccination, tobacco control, healthy nutrition, physical activity, reduced harmful alcohol consumption, and healthier environments.[4]
• Improve diagnosis and treatment by diagnosing at least 50% of cancers, treating 100% of diagnosed cancers according to standards, and maintaining availability of at least 95% of anticancer medicines, adjuvants and quality blood products.[2]
• Expand palliative and psychosocial care to at least 50% of people with cancer and ensure availability of at least 95% of essential palliative-care medicines and products.[2]
• Strengthen cancer registration and research by collecting and compiling data from 100% of targeted health facilities and increasing by 20% the number of research protocols submitted to the ethics committee.[2]
• Strengthen governance through improved institutional anchoring for cancer control, full completion of planned national and regional coordination meetings, annual growth of at least 25% in the cancer-control budget, and completion of all planned monitoring and evaluation activities.[2]

The five intervention areas are prevention and early detection; quality cancer care; palliative and supportive care; cancer registration and research; and governance.[5]The plan adopts a holistic, multisectoral, gender-responsive and human-rights-based approach, using results-based management and systematic monitoring of impact and performance.[1]It prioritises decentralised services and financial protection to reduce social and geographical inequities in access to cancer care.[1]

• Develop regional cancer-care hubs while maintaining Dakar as the national referral hub, with multidisciplinary hubs planned in Touba, Ziguinchor and Saint-Louis.[6]
• Strengthen paediatric oncology by addressing delayed diagnosis, weak referral arrangements, treatment abandonment, staff shortages and limited access to care.[7]
• Expand palliative care across all health-system levels, including national and paediatric services, essential medicines and dedicated human resources.[8]
• Restore reliable national cancer registration to produce incidence and mortality data and support evidence-informed planning and research.[9]

Implementation

Implementation is organised across central, regional, district and community levels, linking prevention, screening, diagnosis, treatment, palliative care, registration, research and governance.[10]The Ministry of Health and Social Action leads the response through the Division for the Control of Non-Communicable Diseases, including its Cancer Office and monitoring and evaluation functions.[11]Annual work plans translate strategic activities into operational actions and are integrated into the Directorate for Disease Control’s overall plan, with eligible hospital and district actions incorporated into their respective plans.[11]

• Coordinate implementation through a multisectoral committee that meets twice yearly, a steering committee, a scientific committee, regional cancer committees and focal points in each Regional Health Directorate.[12][11]
• Engage public institutions, hospitals, the private sector, civil society, communities, international organisations, technical and financial partners, academic experts and professional bodies in cancer control.[13][1]
• Integrate prevention and screening into routine services, community mobilisation and dedicated campaigns, using health posts as screening units and health centres and hospitals as treatment units for cervical precancerous lesions.[14]
• Train health workers, community actors and specialists in prevention, early detection, multidisciplinary care, palliative care, cancer registration, data management and equipment maintenance.[15][6]
• Develop and apply national diagnostic and therapeutic algorithms, harmonised care procedures, treatment protocols and standards for consultation, diagnosis, disclosure, treatment and follow-up.[6]
• Strengthen infrastructure, equipment and maintenance through oncology centres, regional hubs, diagnostic laboratories, radiotherapy, imaging, nuclear medicine, pathology, medical oncology and biomedical engineering capacity.[16][17]

The delivery model combines decentralisation with referral-centre strengthening. Community actors act as an interface between populations and health practitioners, while referral hubs provide specialised multidisciplinary care.[18]Palliative-care expansion begins with a national situation analysis, mapping of existing services, definition of service packages by level, identification of gaps and pilot sites before national scale-up.[19][20]

• Operate the cancer registry through trained registrars, digital recording systems, the Regsen software, quality control, data analysis and regular reviews.[21][22]
• Hold twice-yearly cancer-data reviews involving the Minister of Health and Social Action and relevant intra- and intersectoral departments, producing semi-annual reports to support decision-making.[22]
• Report programme and financial performance quarterly and produce an annual National Cancer Control Plan performance report.[11]
• Conduct an independent external mid-term evaluation in 2027 and a final evaluation in 2029.[10]
• Use a performance framework, data-management system, routine reporting, supervision, coordination meetings and regional reviews to identify implementation problems and take corrective action.[23][10]

Financing is intended to combine increased State funding, resource mobilisation, technical and financial partner support, municipal contributions, public-private partnerships and private-sector Corporate Social Responsibility contributions.[12][11]The Ministry of Health and Social Action is to assess resource requirements through a budgeted action plan and mobilise resources through multi-year expenditure planning, sector investment mechanisms and advocacy to national and international institutions.[23]

• Increase State financing for cancer prevention, treatment and follow-up by at least 25% annually.[12]
• Prepare annual cost projections to support progressive expansion of free chemotherapy and adjuvant treatment.[12]
• Mobilise 200,000 euros annually from technical and financial partners between 2025 and 2029 and develop a resource-mobilisation strategy and bankable document in 2026.[24]
• Establish sovereign financing arrangements for procurement of essential supportive-care medicines, including morphine and other palliative-care products.[21]

Monitoring & Evaluation

The plan establishes a results-based monitoring and evaluation system linking a performance framework, data-management system and coordination mechanisms to continuous collection, analysis and use of data at central, regional, district and community levels.[10]It aims to track implementation, assess intervention effects, support stakeholder information-sharing and enable timely corrective action.[10]

• Monitor the overarching impact target of reducing cancer-related mortality by at least 25% by 2029, including a reduction in cancer deaths from a 2020 baseline of 7,893 to 5,919 in 2029.[2][25]
• Track prevention, early-detection and care targets, including informing 60% of the population about cancer, detecting at least 70% of cancers early, screening at least 50% of eligible people for precancerous lesions, diagnosing at least 50% of cancers and treating 100% of diagnosed cancers according to standards.[2]
• Collect and compile cancer data from 100% of targeted health facilities, increase ethics-committee research protocol submissions by 20%, and monitor publication outputs annually.[2][22]
• Revitalise the Senegal Cancer Registry, RegSen, which became non-operational from 2015 because of technical and budgetary constraints and resumed operation in the last quarter of 2023.[26]
• Establish a legislative and institutional basis for cancer registration, integrate paediatric registration into the national registry, formalise agreements with data-collection centres and link registry data with the District Health Information Software 2 platform.[9][8]
• Use Regsen software, digital recording systems, data-quality control and trained cancer registrars to strengthen registration, archiving, analysis and evidence-informed decision-making.[21][22]
• Conduct twice-yearly cancer-data reviews involving the Minister of Health and Social Action and relevant sectors, produce semi-annual statistical reports, and prepare annual cancer-control implementation reports.[22][27]
• Report programme and financial performance quarterly, prepare an annual performance report, conduct annual joint and regional reviews, and undertake independent external mid-term and final evaluations.[11][23]
• Undertake the mid-term evaluation in 2027 to inform strategic adjustments and the final evaluation in 2029 to assess results against the plan’s original objectives.[10]
• Use routine quarterly reporting for many service, infrastructure, workforce and screening indicators, while monitoring cancer incidence and mortality annually through registry data, activity reports and DHIS2.[25][16]
• Make national and regional steering, monitoring and scientific committees functional, hold all planned coordination meetings, and use validated monitoring reports to support accountability.[2][28]

Costing & Financing

The plan combines explicit financing targets, subsidies, resource mobilisation mechanisms and a budgeted action-plan approach, but the supplied extracts do not provide a single total cost for implementation, a quantified overall financing gap or detailed economic assumptions.[12][23]

• Increase the budget or State subsidy allocated to cancer control by at least 25% annually, including financing for prevention, treatment, follow-up and governance activities.[2][12]
• Mobilise resources through technical and financial partners, public-private partnerships, private-sector Corporate Social Responsibility contributions, municipal budgets and advocacy to national and international institutions.[12][11][23]
• Mobilise 200,000 euros annually from technical and financial partners between 2025 and 2029 and develop a resource-mobilisation strategy and bankable document in 2026.[24]
• Use the multi-year expenditure planning document, sector investment planning mechanisms, annual cost projections and a financial needs assessment to support progressive expansion of free chemotherapy and adjuvant treatment.[12][23]
• Maintain subsidies for anticancer medicines, chemotherapy and radiotherapy, while recognising persistent patient costs for some examinations, medicine stock-outs and constrained supplies of consumables.[29][30]
• Provide chemotherapy free of charge for breast and cervical cancers since October 2019, extend subsidies to childhood cancers and other cancer types, and pursue full free access to anticancer medicines by 2029.[29][31][19]
• Use a sovereign financing mechanism to support sustainable procurement of essential supportive-care medicines, including morphine and other palliative-care products.[21]
• Increase financing for the cancer registry and research, including registry equipment and operation, while establishing a dedicated research fund and innovative financing mechanisms.[8][22][27]
• Recognise that insufficient financing limited implementation of the 2015–2019 cancer plan, which had a budget but no resource-mobilisation strategy.[26]
• Fund major childhood cancer, diagnostic, radiotherapy, pathology, imaging and interventional-radiology investments identified in costing tables.[32][33]