Sara Stulac 1 , Agnes Binagwaho 2 , Neo M Tapela 3 , Claire M Wagner 4 , Marie Aimee Muhimpundu 2 , Fidele Ngabo 2 , Sabin Nsanzimana 2 , Leonard Kayonde 2 , Jean Bosco Bigirimana 5 , Adam J Lessard 6 , Leslie Lehmann 6 , Lawrence N Shulman 6 , Cameron T Nutt 7 , Peter Drobac 3 , Tharcisse Mpunga 8 , Paul E Farmer 9
Despite an estimated 456,000 deaths caused by cancer in sub-Saharan Africa in 2012 and a cancer burden that is predicted to double by 2030, the region accounts for only 0·3% of worldwide medical expenditure for cancer. Challenges to cancer care in sub-Saharan Africa include a shortage of clinicians and training programmes, weak healthcare infrastructure, and inadequate supplies. Since 2011, Rwanda has developed a national cancer programme by designing comprehensive, integrated frameworks of care, building local human resource capacity through partnerships, and delivering equitable, rights-based care. In the 2 years since the inauguration of Rwanda's first cancer centre, more than 2500 patients have been enrolled, including patients from every district in Rwanda. Based on Rwanda's national cancer programme development, we suggest principles that could guide other nations in the development of similar cancer programmes.