Plan Stratégique National De Lutte Contre Le Cancer 2022-2026

Objectives

The National Strategic Plan for Cancer Control 2022–2026 is the Republic of the Congo’s five-year reference framework for coordinating high-impact cancer-control interventions and operationalising the National Cancer Control Programme. It aligns with national health and development policy, contributes to Sustainable Development Goal 3, and seeks to reduce cancer-related morbidity, mortality and household socioeconomic harm through a more resilient health system with universal access to quality services.[1][2][3][4]

• Strengthen governance, leadership, legal and regulatory arrangements, accountability and partnerships for cancer control.[3][5][6]
• Mobilise domestic, partner, corporate and innovative resources to improve financial access to cancer prevention, diagnosis, treatment and supportive care.[3][7][8]
• Expand access to diagnosis, pathology, surgery, radiotherapy, nuclear medicine, palliative care, anticancer medicines, supportive medicines, equipment and trained multidisciplinary teams.[9][7][10][11]
• Strengthen prevention, health promotion and early detection by addressing infectious, behavioural, environmental and social risk factors, including hepatitis B, human papillomavirus, tobacco and alcohol.[12][13][14]
• Increase awareness of cancer risk factors, primary prevention and early detection among at least 50% of people aged over 12 years, and screen at least 50% of people reached through awareness activities for precancerous lesions.[15][16][17]
• Expand vaccination against human papillomavirus and hepatitis B, with targets including at least 45% coverage of the human papillomavirus target population and more than 95% coverage for hepatitis B vaccination.[17][18]
• Establish a national cancer registry, integrate cancer indicators into District Health Information Software 2, improve timely reporting, map cancer patterns and support applied cancer research.[15][19][20]
• Achieve measurable service and system improvements, including a 50% increase in the cancer workforce, diagnostic access for at least 80% of people with cancer, treatment access for at least 30% of patients according to cancer type, and radiotherapy and nuclear-medicine services in two general hospitals.[9][7]

Implementation

Implementation is led by the Ministry of Health and Population through the National Cancer Control Programme, established by Decree No. 2019-228 of 13 August 2019 and situated within the Programme and Project Coordination Unit. The plan replaces isolated activities with a federated national response across governance, financing, service provision, demand generation, and information management and research.[21][22][5][4]

• Coordinate delivery through the National Cancer Control Programme Directorate, the Ministry of Health Cabinet, central coordination bodies, directorates responsible for health services, health promotion, pharmacy and medicines, health information and hospitals, alongside departmental focal points and health facilities.[23][24][10][19]
• Develop annual budgeted work plans and quarterly departmental plans; convene monthly steering-committee meetings, fortnightly programme staff meetings, annual regulatory-authority meetings and quarterly monitoring meetings with civil-society organisations.[24][25]
• Establish 12 departmental cancer-control focal points, formalise memoranda with non-governmental organisations and associations, and involve local authorities in incorporating cancer financing into local plans.[25][26]
• Engage technical and financial partners, the World Health Organization, the International Atomic Energy Agency, civil-society organisations, hospitals, pharmaceutical partners, international cancer organisations, private providers and relevant enterprises.[27][28][29][30]
• Strengthen service delivery through referral and general hospitals, specialised oncology units, district health teams and community-level services; train personnel nationally and internationally in oncology, pathology, radiology, radiotherapy, medical physics, palliative care and related fields.[31][32][33]
• Procure and distribute generic anticancer medicines, supportive medicines and diagnostic inputs through the Central Medicines Purchasing and Supply Agency, while advocating for their inclusion in the essential medicines list and for free provision through legal or governmental measures.[10][34]
• Equip four health facilities in Brazzaville and Pointe-Noire for cancer imaging and laboratory examinations, and work with the International Atomic Energy Agency to obtain radiotherapy equipment for two general hospitals.[11]
• Deliver prevention through surveys, community and facility guidance, a national communication plan, departmental training workshops, district supervision, mass awareness campaigns and vaccination activities integrated with the Expanded Programme on Immunisation.[16][35][17][18]
• Monitor implementation through registry completeness, reporting timeliness, work-plan completion, regulatory outputs, service availability, workforce training, medicine supply, equipment functionality, screening, vaccination, referral, treatment and community knowledge indicators.[23][19][36][37]
• Finance the strategy through State budget lines, Universal Health Insurance advocacy, technical and financial partners, corporate social responsibility, local-authority contributions, fundraising and proposed taxes on tobacco industries and telecommunications mast installations.[29][6][38][39]

The budgeted strategy is estimated to cost 12.725 billion Central African CFA francs for 2022–2026, including 9.540 billion Central African CFA francs for care provision; monitoring and evaluation activities are costed at 665,364,418, although the supplied extract does not specify a consolidated financing gap or confirmed funding commitments.[40][41][42]

Monitoring & Evaluation

The plan establishes a monitoring and evaluation approach centred on a National Cancer Registry, integration of cancer surveillance into the District Health Information Software 2, facility reporting, tumour files, cancer mapping, research outputs and structured implementation reviews. It also assigns national oversight functions to the Ministry of Health and Population, the National Cancer Control Programme, the Directorate of Health Information and Epidemiological Research, and relevant departmental structures.[22][15][19][20]

• Strengthen cancer surveillance by establishing a National Cancer Registry intended to contain at least 95% of relevant factual cancer data and by integrating cancer trend indicators and surveillance forms into the District Health Information Software 2.[15][5][19]
• Ensure timely reporting, with a target for 100% of reports from intermediate and peripheral levels to reach the National Cancer Control Programme on time.[5]
• Monitor implementation through indicators on legal and regulatory texts, workplan completion, coordination meetings, partner engagement, resource mobilisation, service readiness, workforce training, medicine availability, equipment functionality, prevention, screening, vaccination and treatment access.[23][6][24][25][36][37]
• Track service-delivery targets including diagnostic access for at least 80% of people with cancer, treatment access for at least 30% of patients according to cancer type, trained teams in 31 district referral hospitals and 10 general hospitals, and prevention and early-detection awareness among at least 50% of people aged over 12 years.[9][7]
• Strengthen research and data quality through registrar training, district tumour files, cancer mapping, annual collection of oncology dissertations, scientific oncology meetings, risk-factor studies and research on genetic cancer factors among young people.[20][43][44]

A 2022–2026 monitoring and evaluation plan covers data collection, processing and conversion into strategic information for decision-making, at an estimated cost of 665,364,418 with no currency specified in the extract.[40][41]The plan’s diagnostic assessment nevertheless identifies previous weaknesses in monitoring and evaluation, health-information management and cancer research.[3]Although numerous indicators and verification sources are provided, the supplied extracts do not specify a consolidated reporting cycle, indicator baselines, comprehensive evaluation methodology, data-verification procedures, or formal accountability arrangements.[6][19][36][37]

Costing & Financing

The 2022–2026 National Cancer Control Strategy has an estimated overall budget of 12,725,000,000 Central African CFA francs, covering governance, financing, care provision, demand generation, and information management and research.[42]The largest stated allocation is for care provision, estimated at 9,540,245,851 Central African CFA francs.[14][42]

• Allocate 379,680,171 Central African CFA francs to Axis 1, governance, leadership and partnership, and 87,618,501 Central African CFA francs to Axis 2, cancer-control financing and resource mobilisation.[26][39][42]
• Allocate 1,606,339,183 Central African CFA francs to Axis 4, demand generation, and 1,111,485,848 Central African CFA francs to information management and research.[18][45][42]
• Mobilise at least 80% of the funds required for strategy interventions through increased budget lines, development partners, enterprise corporate social responsibility, local-authority financing, Universal Health Insurance, fundraising and proposed taxes on tobacco industries and telecommunications mast installations.[7][6][26][8][38][39]
• Address financing constraints including inadequate domestic and external resource mobilisation, limited disbursement of operating allocations, exclusion of cancer care from Universal Health Insurance benefit packages, insufficient investment financing, high medicine costs and non-disbursement of State counterpart contributions.[29][3][46]
• Support financial protection through Universal Health Insurance coverage, free radiotherapy and nuclear-medicine examinations, potential free provision of anticancer medicines, and measures to reduce catastrophic household expenditure from direct out-of-pocket payment.[47][38][48][34]

Activity-level costs cover legal and regulatory development, coordination, workforce development, medicines, diagnostic equipment, radiotherapy, prevention, vaccination, surveillance and research.[23][10][11][17][19]Several extracts do not specify currencies, financing sources, periods, funding commitments, economic assumptions or quantified funding gaps for individual activities.[6][32][40][42]