# Radiotherapy access and the global machine gap

Source: https://onco.cc/technologies/radiotherapy-access-gap/  
OnCo record `radiotherapy-access-gap` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

About half the people who need radiotherapy will need it as part of curing their cancer, yet many countries have one machine per several million people or none at all. Closing the gap is one of the highest-return investments in cancer care.

## Summary

The Lancet Oncology Commission on radiotherapy (2015) estimated that scaling radiotherapy capacity in low- and middle-income countries would save millions of lives and pay for itself in economic benefit. Dozens of countries have no radiotherapy at all, and many more have far fewer machines than the roughly one per 250,000 people that high-income countries operate. The IAEA's DIRAC database tracks installed machines, its Rays of Hope initiative funds new centres, and low-cost linac designs, remote planning and training networks are the main levers. Workforce, maintenance and brachytherapy shortages compound the machine gap.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-16
- Tags: radiation-wave1
- Principle: Radiotherapy is needed in about half of cancer cases; access is limited by machines, physicists, therapists, maintenance and geography rather than by knowledge.
- Since: 2015
- Strengths: Large, well-measured benefit per machine; Established funding channels through the IAEA; Low-cost linac designs emerging
- Limitations: Capital and workforce constraints; Maintenance and power reliability; Brachytherapy gap is even larger

## Sources

- IAEA DIRAC directory of radiotherapy centres: https://dirac.iaea.org/
- Lancet Oncology Commission 2015: https://doi.org/10.1016/S1470-2045(15)00222-3

## Connected records

- fronts: [Radiation Therapy](https://onco.cc/fronts/radiation/)
- technologies: [Cobalt-60 teletherapy](https://onco.cc/technologies/cobalt-60-teletherapy/), [Global oncology and access in low- and middle-income countries](https://onco.cc/technologies/global-oncology-access/), [Palliative radiotherapy](https://onco.cc/technologies/palliative-radiotherapy/)

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