Professor Aisha Kuliya-Gwarzo, Clinical Director of Haematology Services, African Medical Centre of Excellence (AMCE), Abuja

A Growing Cancer Challenge Across Africa

Across much of Africa, delayed diagnosis and limited treatment access continue to place multiple myeloma patients at significant risk.

The burden of cancer across the continent continues to rise steadily, placing increasing pressure on patients, families, and healthcare systems that are often already operating under significant strain.

Among these conditions, multiple myeloma remains one of the more complex and less widely understood cancers affecting patients across Africa. It is a cancer of plasma cells within the bone marrow that typically progresses gradually, with early symptoms such as fatigue, recurrent infections, bone and back pain, weakness, recurrent fever, and unexplained anaemia, all of which are often non-specific and easily overlooked in routine clinical practice. Consequently, many patients are only diagnosed once the disease has reached an advanced stage.

According to the International Agency for Research on Cancer(IARC) GLOBOCAN 2022 estimates, multiple myeloma accounted for approximately 187,952 new cases and 121,388 deaths globally in 2022. In Africa, an estimated 8,978 new cases and 7,632 deaths were recorded during the same period, highlighting the significant burden of the disease on the continent. These figures reflect both the scale of the disease and its impact on patients and families affected by a condition that is often diagnosed late in its course, following a period of clinically silent progression.

The Challenge of Delayed Diagnosis

Delayed diagnosis remains one of the most significant barriers to effective multiple myeloma care in Africa.

Within the body, abnormal plasma cells multiply in the bone marrow, disrupting normal blood production and leading to anaemia, infections, kidney impairment, bone destruction, and pathological fractures.

Across many African healthcare systems, diagnosis is often delayed due to limited awareness, constrained access to specialist haematology services, weak referral pathways, and inadequate diagnostic infrastructure.

Evidence from Nigeria reflects this pattern, with research published in the Nigerian Journal of Clinical Practice indicating that a high proportion of patients present at advanced stages of disease. Bone pain and anaemia are among the most common presenting features, reported in approximately 80 per cent and 70 per cent of cases respectively, while pathological fractures are frequently observed at diagnosis, significantly complicating care delivery. At this stage, treatment is often more complex and resource-intensive, with increased financial and clinical burden on patients and their families.

Expanding Access to Advanced Treatment

Despite these challenges, advances in therapy are gradually improving outcomes for patients with multiple myeloma.

Stem cell transplantation, in particular, has become an increasingly important treatment option for eligible patients. The procedure involves collecting healthy stem cells from the patient, delivering intensive therapy to eliminate diseased cells, and then reinfusing the stem cells to rebuild healthy blood production.

Evidence published in Blood Journal demonstrates improved long-term survival outcomes in patients undergoing autologous stem cell transplantation alongside modern chemotherapy and immunotherapy-based regimens.

However, access to and understanding of this treatment remains uneven. In many settings, stem cell transplantation is still perceived as a high-risk intervention or a procedure only available outside the continent, contributing to delayed or missed treatment opportunities.

At African Medical Centre of Excellence, the successful completion of the Centre’s first stem cell transplant for a patient with multiple myeloma represents an important milestone in expanding access to advanced cancer care within Africa. This achievement goes beyond a single procedure, demonstrating the growing capacity to deliver complex cancer care closer to patients who need it.

With integrated multidisciplinary teams spanning haematology, oncology, specialised nursing, laboratory medicine, and supportive care, patients are increasingly able to receive complex treatment locally, with improved coordination of care and reduced need for treatment abroad.

Families are no longer required to navigate prolonged delays or travel long distances before treatment initiation. Patients gain earlier access to care, benefit from closer clinical monitoring, and recover in more controlled environments, reducing the risks associated with fragmented care pathways, including infection and other complications.

Strengthening Africa’s Cancer Care Systems

Closing the gap in multiple myeloma care across Africa will require sustained investment in diagnostic infrastructure, specialist workforce development, referral systems, and early detection pathways.

Public awareness also remains a critical component of the response, as late presentation is often driven by limited recognition of symptoms and delayed engagement with healthcare services.

At a systems level, strengthening local capacity to deliver complex oncology care will be essential to improving long-term outcomes. Expanding specialist centres, improving laboratory and diagnostic capability, and reinforcing multidisciplinary collaboration will all play a key role in improving survival and quality of care across the continent.

Ultimately, cancer outcomes are determined not only by the availability of treatment, but also by the effectiveness of the systems that deliver it. Across Africa, the priority is therefore to expand access, strengthen capacity, and bring advanced care closer to patients who need it most.

Across institutions such as African Medical Centre of Excellence, important progress is already underway. AMCE is helping to strengthen access to specialist cancer care in Africa by bringing together advanced diagnostics, multidisciplinary expertise, research and treatment under one roof, reducing the need for patients to seek care abroad. The broader goal remains clear: ensuring that no patient loses access to potentially life-extending treatment simply due to where they are treated.