National Cancer Control Plan 2025 - 2030

Objectives

Zimbabwe’s National Cancer Control Plan aims to reduce cancer morbidity and mortality by 2030 through equitable, quality and evidence-based prevention, early detection, diagnosis, treatment, palliative care, rehabilitation, survivorship, surveillance and research.[1]Its vision is quality cancer control services for all by 2030, contributing to universal health coverage and alignment with national development, health-sector and global cancer commitments.[2][1]

• Improve access to affordable, available and standards-based cancer services across the continuum of care, particularly beyond the currently concentrated tertiary and quaternary service levels.[2][3][1]
• Reduce exposure to cancer risks including infectious agents, tobacco, alcohol, unhealthy diets, physical inactivity, occupational hazards, air pollution and other environmental risks.[4]
• Expand vaccination against human papillomavirus and hepatitis B virus, high-risk screening, public awareness, healthy-lifestyle programmes and supportive policy and research.[4]
• Strengthen prevention, screening, early diagnosis and management of cervical, prostate, breast, colorectal, childhood and lung cancers, while giving urgent attention to preventable lung and liver cancers.[5][6][1]
• Achieve cervical cancer targets of 90% human papillomavirus vaccination coverage, 70% screening coverage, 90% treatment coverage and 90% management coverage for women with invasive cancer by 2030.[7]
• Improve childhood cancer outcomes in alignment with the World Health Organization Global Initiative for Childhood Cancer, which seeks 60% global childhood cancer survival by 2030.[8]
• Increase competent and retained cancer workforce capacity, equitable access to infrastructure and products, reliable cancer data, sustainable financing, effective governance and research capacity.[1][9]
• Develop a Cancer Communication Strategy to encourage healthier lifestyles, social behaviour change and awareness of cancer risks, warning signs, symptoms and available services.[4][7]

Implementation

The Plan adopts a population-wide, integrated health-system approach led by the Ministry of Health and Child Care, combining decentralised service delivery, coordinated governance, workforce development, infrastructure investment, surveillance and results-based implementation.[2][10][11]Cancer prevention, screening and early detection are to be integrated with sexual and reproductive health, human immunodeficiency virus and acquired immunodeficiency syndrome services, immunisation, maternal and child health, occupational and environmental health, and lifestyle-modification programmes.[4]

• Implement the Plan through the Integrated Results-Based Management Framework, quarterly Operational Plans, Departmental Integrated Programme Agreements, Ministry Annual Strategic Plans and the National Health Strategy.[11]
• Coordinate financing, planning, implementation, monitoring and evaluation through Ministry platforms under the Health Sector Coordination Framework, including Technical Working Groups and a Cancer Technical Working Group.[11]
• Engage government facilities, public and private hospitals, provincial, district, rural and mission hospitals, professional associations, non-governmental organisations, insurers, development partners, cancer organisations, universities, research institutions and United Nations technical agencies.[10][12][11]
• Strengthen policies, strategies, guidelines, regulation and coordination mechanisms for cancer services at national and subnational levels.[13][10]
• Scale up and introduce screening programmes, improve cervical screening through human papillomavirus DNA testing, decentralise treatment of precancerous lesions, train health workers and strengthen referral pathways linked to diagnosis, treatment, palliative care, rehabilitation and survivorship services.[4]
• Use low-dose computed tomography screening for appropriate high-risk populations to support earlier lung cancer detection, alongside smoking cessation, tobacco control and reduction of second-hand smoke exposure.[8][14]
• Decentralise multidisciplinary treatment, including chemotherapy, palliative care, surgical oncology, radiation oncology, medical oncology, haematology and paediatric oncology, while maintaining links with central hospitals providing specialised oncology services.[14][15][16]
• Replace obsolete radiotherapy machines, expand radiotherapy capacity towards one machine per million people, maintain equipment through service contracts, improve imaging and laboratory capacity, and strengthen availability of medicines, reagents, consumables, blood and blood products.[15][17][16]
• Develop workforce capacity through local and overseas training, mentorship, task shifting, staff rotation, safer working environments, improved conditions of service and retention incentives for specialised personnel.[15][17][1][9]
• Strengthen the Zimbabwe National Cancer Registry through financial, human-resource and technical investment, active and passive case-finding, phased surveillance decentralisation and collaboration with the Bulawayo Cancer Registry.[12]
• Monitor performance through a results chain covering inputs, activities, outputs, outcomes and impact, using a Performance Framework with priority indicators, baselines and targets.[10]
• Conduct routine reporting, rapid assessments, process evaluations, mid-term evaluations and end-term evaluations under the Directorate responsible for monitoring and evaluation, supported by data from registries, the District Health Information Software 2 system, surveys and sentinel surveillance.[10][12]
• Disseminate findings through reports, dashboards, portals, websites, workshops and meetings, with accountability anchored in the Permanent Secretary’s Performance Contract.[12][11]
• Mobilise sustainable funding for comprehensive services, supply chains, palliative and survivorship care, surveillance and research, including use of ring-fenced sugar-tax revenue for non-communicable diseases and cancer care.[10][9]

Financing remains constrained by low dedicated cancer funding, limited insurance coverage, substantial out-of-pocket expenditure and underfunding of cancer registration; the available extracts do not provide a total Plan budget, costed activity schedule, quantified funding gap or comprehensive financing allocation.[10][12][9][11]

Monitoring & Evaluation

The Plan establishes a results-based monitoring, evaluation and surveillance approach to generate reliable cancer data, track implementation across the care continuum and strengthen accountability for cancer control. It combines routine information systems, cancer registries, surveys and formal evaluations, while recognising persistent weaknesses in data quality, registry capacity and monitoring systems.[10][12][1][9]

• Use a Performance Framework structured along the results chain from inputs and activities to outputs, outcomes and impact, including priority indicators, baselines and targets.[10]
• Report routine progress through existing and new mechanisms, and conduct rapid assessments, process evaluations, mid-term evaluations and end-term evaluations under the Directorate responsible for monitoring and evaluation.[10]
• Implement the Plan through the Integrated Results-Based Management Framework, quarterly Operational Plans, Departmental Integrated Programme Agreements, Ministry Annual Strategic Plans and the National Health Strategy.[11]
• Anchor performance accountability in the Integrated Results-Based Management Framework and the Permanent Secretary's Performance Contract.[11]
• Coordinate monitoring and evaluation through Ministry of Health and Child Care platforms under the Health Sector Coordination Framework and the Cancer Technical Working Group.[11]
• Collect quality cancer data systematically, timely and cost-effectively to inform policy-making, prevention, management and research by 2030.[13][9]
• Strengthen the national health information management system, electronic health technology, the Monitoring and Evaluation Directorate, research capacity and dissemination through reports, dashboards, portals, websites, workshops and meetings.[12][1][9]
• Use the Zimbabwe National Cancer Registry and Bulawayo Cancer Registry to support cancer incidence, mortality and pattern monitoring, including through active and passive case-finding and phased decentralisation of surveillance.[6][8][12]
• Draw data from the Zimbabwe Demographic and Health Survey, District Health Information Software 2, the World Health Organization STEPwise approach to non-communicable disease risk-factor surveillance, the School Based Health Survey and sentinel surveillance.[10][12]
• Monitor operational service information, including availability of services, equipment functionality and downtime, workforce levels, training completion, medicine access, diagnostic access, referrals, treatment capacity and decentralisation.[4][14][15][17][16]
• Address incomplete registry coverage, limitations in cervical cancer burden data, gaps in childhood cancer data and unavailable information on paediatric oncology services outside main centres.[6][8][17][16]
• Track cervical cancer elimination targets of 90% human papillomavirus vaccination coverage, 70% screening coverage, 90% treatment coverage and 90% management coverage for women with invasive cancer by 2030.[7]

A Cancer Prevention and Control Monitoring and Evaluation Framework is identified as Table 8, but the supplied extract does not provide its full indicator set, detailed targets, reporting procedures, surveillance protocols or accountability matrix.[11]

Costing & Financing

The Plan identifies sustainable financing as essential for comprehensive cancer services, but cancer control has historically been underfunded amid competing health priorities and the supplied material does not provide an overall costed budget or quantified funding gap.[3][13][9]

• Mobilise adequate and sustainable funding for prevention, screening, diagnosis, treatment, palliative care, rehabilitation, survivorship, surveillance and research by 2030.[13][9]
• Increase dedicated support for cancer prevention and control, including equipment, medicines, reagents, consumables, infrastructure, supply chains, workforce development, registry capacity and research.[3][12][9]
• Use domestic and external health resources, noting that cancer and non-communicable diseases have been included in the Ministry of Health and Child Care budget and that sugar-tax revenue has been ring-fenced for non-communicable diseases and cancer care.[10]
• Seek external support, including Bristol Myers Squibb Foundation grants for multiple myeloma and lung cancer, diagnostic and patient-management equipment, and lung-cancer policy and programme support.[10]
• Advocate taxation on unhealthy foods, drinks and other harmful substances associated with cancer as a potential resource-mobilisation measure.[9]
• Prioritise prevention, identified as the most cost-effective intervention in resource-constrained settings, while integrating screening and early detection into existing programmes where this has minimal cost implications.[3][4]
• Address affordability barriers arising from high diagnostic costs, centralised services, transport and accommodation expenses, catastrophic out-of-pocket payments, expensive privately purchased chemotherapy and imaging, and high equipment-maintenance costs.[14][15][17][16]
• Reduce financial hardship because Zimbabwe has no national health insurance or Universal Health Coverage package for cancer, most patients pay out of pocket, and private insurance covers less than 10% of the population while rationing some services.[10]
• Strengthen financial, human-resource and technical capacity for the severely underfunded and understaffed Zimbabwe National Cancer Registry.[12]
• Finance radiotherapy and imaging replacement, service contracts, blood and blood products, laboratory infrastructure, medicines, training and specialist workforce retention.[15][17][16]

The supplied material does not specify financing totals, programme allocations, unit costs, costing methodology, funding-gap values, economic assumptions or a complete resource-mobilisation plan.[13][16][1][9][11]