Background
The Cancer Moonshot initiative in the United States coordinates a tremendous outlay of funding, initiatives, and policy priorities meant to galvanize efforts to reduce cancer incidence and mortality. In December 2022 at the US-Africa Leaders Summit, The White House issued a Cancer Moonshot announcement detailing an array of financial commitments “from U.S. departments and agencies and the private sector of over $300 million to drastically improve cancer outcomes in Africa”. It is not known how this set of simultaneous investments may affect global cancer health system development across Africa.
Methods
Programs were categorized by a) sector providing support (Academic/Professional, Government, NGO, Private); b) area of focus per official press release; c) relevant Core Domains for National Cancer Control Plan checklists as defined by a comprehensive WHO and OECD policy review framework (Oar et al Lancet Oncology 2019; 20: e645-52).
Results
The announced portfolio includes 44 programs, 64% (n=28) of which are supported from a single sector and 9% (n=4) from >3 sectors. 23% (n=10) are solely private sector and 18% (n=8) solely U.S. government funded. Of the ten substantive Core Domains comprising an evidence-based cancer control plan checklist, these programs covered 9/10. 48% (n=21) of programs covered more than one domain. The most frequently covered domains were Research (n=18), Health Workforce (n=12), Treatment and Service Delivery (each n=10). Domains with the least investment were Finance (n=0), Health Information Systems (n=3), Palliative Care/Survivorship (n=3), and Prevention (n=4).
Conclusions
The 2022 Cancer Moonshot announcement detailed investments across Africa with a heavy focus on research and workforce training, closely followed by treatment and service delivery. Coordinated implementation tactics and additional strategic programming will be needed to maximize investment impact and avoid unintended imbalances in cancer detection capacity and healthcare financing that could inadvertently stunt the sustainable growth of global oncology care.