Plan National De Lutte Contre Le Cancer

Objectives

Senegal’s National Cancer Control Plan for 2025–2029 seeks to reduce cancer incidence and mortality and improve patients’ quality of life through systematic, equitable and evidence-based public-health strategies. Its vision is an equitable Senegal in which all citizens can access prevention, early detection and appropriate, affordable and sustainable cancer care.[1]The overall target is to reduce cancer mortality by at least 25% by 2029 while improving equitable access to prevention, diagnosis, treatment, palliative care and psychosocial support.[2][3]

• Strengthen prevention and early detection by informing at least 60% of the population about cancer, addressing risk factors, promoting healthy environments and nutrition, supporting vaccination, and screening and treating precancerous lesions.[2][4][3]
• Achieve early detection for at least 70% of cancers and screen at least 50% of eligible people for precancerous lesions, with particular attention to cervical, breast, childhood and prostate cancers.[2][5][3]
• Improve diagnosis and treatment by diagnosing at least 50% of cancers, treating 100% of diagnosed cancers according to standards, and ensuring the availability of anticancer medicines, adjuvants, quality blood products, equipment and specialist services.[2][6][7]
• Expand palliative and psychosocial care so that at least 50% of patients can access services, alongside availability of at least 95% of essential palliative-care medicines and products.[2][8][9]
• Strengthen cancer registration, data management, operational research and innovation, including collection and compilation of cancer data in 100% of target health facilities.[2][9][10]
• Reinforce governance through national and regional coordination, decentralisation, institutional strengthening, resource mobilisation, financial protection and multisectoral engagement.[2][11]

Implementation

The plan uses a whole-of-health-system and multisectoral delivery model across five intervention areas: prevention and early detection; diagnosis and treatment; palliative care and psychosocial support; cancer registration and research; and governance.[11]It is grounded in equity, gender equality, human rights, community participation, multisectoral action and results-based management, and is intended to operate throughout the health pyramid from community services to specialised referral care.[1][11]

• Deliver prevention through risk-factor regulation, health communication and advocacy, vaccination, community mobilisation, screening for precancerous lesions and early detection integrated into routine services before wider scale-up.[11][12][5]
• Organise cervical screening at service-delivery points for women aged 25 to 69 years using visual inspection with acetic acid, cytology and human papillomavirus testing, with treatment units at health centres and hospitals and referral for cases requiring further management.[5][13]
• Develop regional cancer hubs to decentralise diagnosis, treatment, palliative care and support, with Dakar as the reference hub and multidisciplinary hubs planned for Touba, Ziguinchor and Saint-Louis.[4][6]
• Strengthen service quality through harmonised diagnostic and treatment algorithms, national protocols, quality-management procedures, quarterly joint supervision by the Ministry and experts, and multidisciplinary consultation meetings at service, hospital, hub and national levels.[7]
• Build workforce capacity through recruitment, continuing training and scholarships in oncology, pathology, radiology, radiotherapy, nuclear medicine, medical physics, nursing, biomedical engineering, nutrition, addiction care and technical support.[6]
• Improve medicine security by revising the essential-medicines list, strengthening stock management, pharmacovigilance, haemovigilance and chemotherapy-preparation capacity, and progressively expanding free anticancer medicines to cover all needs by 2029.[7][8]
• Expand palliative care across public, private, hospital, primary and community settings by mapping services, defining packages by care level, creating pilot sites, developing adult and childhood standards, training personnel, and improving morphine supply and distribution.[8][9]
• Strengthen information systems by recruiting and training archivists and registry personnel, digitalising registration in public and private cancer-care facilities, reactivating and extending the tumour registry, using Regsen, and assessing potential adoption of CanReg5.[10][14]
• Establish governance structures through the cancer office within the Non-Communicable Disease Control Division, national and regional coordination bodies, regional cancer focal points, local cancer-control committees, a multisectoral steering committee and a scientific committee.[11][15][16]
• Coordinate implementation through annual plans incorporated into hospital and district work plans, with participation from the Ministry of Health and Social Action, regional health directorates, health facilities, districts, hospitals, pharmacies, local authorities, communities, civil society, technical and financial partners and the private sector.[15][16][17]
• Monitor performance through continuous data collection and use at central, regional, district and community levels, quarterly programme and financial reports, semi-annual steering-committee reports, annual implementation reports, a mid-term evaluation in 2027 and a final independent evaluation in 2029.[16][17][18]
• Mobilise resources through annual state-budget increases of at least 25%, technical and financial partnerships, public-private partnerships, corporate social responsibility and bankable proposals; the plan also targets mobilisation of 200,000 Euros annually from partners.[19][20]

Monitoring & Evaluation

The plan establishes a results-based monitoring and evaluation system linking cancer registration, routine service data, performance indicators, coordination mechanisms and periodic evaluation. It aims to strengthen health-information collection and analysis for evidence-based decisions, while recognising persistent weaknesses in registry functionality, data completeness and integration with the District Health Information Software 2 (DHIS2).[1][2][21]

• Collect and compile cancer data in 100% of target health facilities, digitise registration and archiving, equip public and private cancer-care facilities with registration systems, and conduct data-quality control through Regsen, with possible assessment of CanReg5.[9][10][14]
• Restore and maintain the national cancer registry, which had been inactive from 2015 because of technical and budgetary constraints; registrars are to collect data with clinicians in health facilities to improve completeness beyond the previous passive system, which did not follow patients or record deaths.[22]
• Monitor headline outcomes, including a reduction in cancer mortality of at least 25% by 2029, early detection for at least 70% of cancers, screening for at least 50% of precancerous lesions, diagnosis for at least 50% of cancers, and standards-based treatment for 100% of diagnosed cancers.[2][5][6]
• Track service and prevention indicators through routine quarterly collection, activity reports and DHIS2, including population awareness, cervical screening coverage, thermoablation treatment, trained community health workers, early breast-cancer detection, prostate-specific antigen testing, childhood-cancer detection training and hepatitis vaccination of providers.[23][24][25][26]
• Monitor medicine availability, free provision, radiotherapy access, immunotherapy, adverse effects, transfusion safety, palliative-care units, beds, mobile teams, opioid availability and policy implementation through Ministry of Health and Social Action reports and designated focal points.[27][28][29]
• Apply quality assurance through national diagnostic and treatment algorithms, harmonised protocols, quarterly joint supervision, external quality audits, medicine-quality controls, accreditation of cancer-care centres and multidisciplinary consultation meetings held at facility, hub and national levels.[7][30][31][32]
• Require accountability for recorded medicine stock-outs or other supply deviations through an improvement plan, and monitor at least 80% of adverse effects and proper disposal of all relevant healthcare waste.[8]
• Conduct semi-annual cancer-data reviews involving the Ministry of Health and Social Action and relevant sectors, produce semi-annual reports on incidence and mortality, and prepare annual implementation monitoring and evaluation reports through the Cancer Bureau.[14][19]
• Produce quarterly programme and financial implementation reports, an annual plan-implementation report and semi-annual reports for the steering committee; conduct a mid-term evaluation in 2027 and a final evaluation in 2029, with mid-term and final reviews undertaken by an independent external entity.[16][18]

Responsibilities are assigned principally to the Directorate for the Fight against Non-Communicable Diseases, its Cancer Bureau, regional health directorates, health districts, hospitals and designated focal points. The Cancer Bureau is intended to consolidate national statistics, coordinate prevention and care, assess quality, coordinate annual planning and report on implementation.[19][15][16]Although the plan specifies multiple indicators, reporting frequencies and review mechanisms, it does not provide a fully consolidated indicator dictionary, detailed data architecture or an independent sanctions framework.[14][19]

Costing & Financing

The plan frames financing as essential to equitable cancer prevention, diagnosis, treatment, palliative care, registration, research and decentralisation. It seeks greater state financing, partner support, innovative funding and improved financial protection, but the supplied material does not provide a consolidated total budget, full activity-level costing, confirmed financing commitments, quantified funding gap or economic evaluation.[2][19][17]

• Increase the state budget allocated to cancer control by at least 25% annually during 2025–2029.[11][19][20]
• Mobilise resources through the Ministry of Health and Social Action in line with the Multi-year Expenditure Planning Document and Sector Investment Plan, supported by advocacy with national and international institutions.[17]
• Develop innovative financing, public-private partnerships and corporate social-responsibility contributions, including bankable proposals and collaboration with the Senegalese Universal Health Coverage Agency to improve financial access to preventive and curative care.[19][15][20]
• Mobilise 200,000 euros annually from technical and financial partners for implementation of the National Cancer Control Plan between 2025 and 2029.[20]
• Maintain government subsidies for anticancer medicines and adjuvant treatments, extend chemotherapy subsidies, and progressively expand free anticancer medicines to cover 100% of needs by 2029.[33][7][8]
• Provide palliative-care medicines and products through a sovereign financing mechanism intended to support autonomy and sustainability, while seeking increased morphine quota, supply and distribution capacity.[9]
• Increase maintenance funding to protect and repair cancer-care equipment, though no financial amount or period is specified.[6][7]

Previous cancer-control implementation was constrained by insufficient financing and lacked a resource-mobilisation strategy despite having an accompanying budget.[34]Current resource constraints include limited laboratory and pathology capacity, equipment and maintenance needs, recurrent medicine and consumable stock-outs, insufficient paediatric-oncology funding, patient costs for certain examinations and geographical inequalities in access to specialised services.[35][36][37]

Specified affordability measures include a radiotherapy subsidy that reduces the patient cost to 150,000 CFA francs per course, a dedicated 1.5 billion CFA-franc budget line for anticancer medicines and adjuvant treatments, and free chemotherapy since October 2019.[38][39]The wider public-health financing context reports state health expenditure at 9% of the national budget, below the cited 15% international reference.[33]