🇪🇹 Cancer in Ethiopia

The GLOBOCAN 2024 fact sheet gives 18,840 breast cancers (8,812 deaths), 8,159 cervical cancers (5,007 deaths), 7,372 colorectal cancers (4,108 deaths), 3,494 prostate cancers (2,134 deaths) and 2,967 leukaemias. Breast cancer is 36.0% of cancers in women and 23.8% of all cancers. In men the leading cancers by cases are colorectum (3,518), prostate (3,494) and leukaemia (1,615); by deaths prostate, colorectum and liver. The risk of developing a cancer before age 75 is 7.5% for men and 12.1% for women, and an estimated 142,431 people are living within five years of a diagnosis. Deaths divided by new cases give 0.59 for 2024. The Ministry of Health's Integrated National Cancer Control Plan 2025 to 2029 states that about 80% of cancer cases are diagnosed at advanced stages and that an estimated 12,000 cancer patients are treated each year; elsewhere it puts the share of cases identified at advanced stages at 70%. It counts an estimated 6,000 new childhood cancers a year, with survival of 20 to 30% because care is largely limited to national referral hospitals.

The 2025 to 2029 plan reports that comprehensive cancer treatment centres increased from 1 to 7, and its list of treatment centres for December 2024 names them: Tikur Anbessa and St Paul's in Addis Ababa, and Ayder (Mekelle), Gondar, Hawassa, Hiwot Fana (Harar) and Jimma, each labelled comprehensive with radiotherapy. The same list has 10 hospitals treating all cancers with at least one clinical oncologist and 13 giving breast cancer chemotherapy only. The Ministry opened the country's second radiotherapy centre at Jimma University Hospital on 20 February 2022, saying radiotherapy had until then been available only at Tikur Anbessa. The IAEA wrote in March 2024, after its imPACT Review mission of November 2023, that radiotherapy was possible at only three public hospitals, that waits were sometimes more than a year, and that five more radiotherapy centres were under construction in Addis Ababa, Gondar, Hawassa, Harar and Mekelle, one of them at St Paul's built through a public and private partnership. The plan says four centres are now equipped with linear accelerators, operational since November 2020, replacing two-dimensional cobalt-60 machines in use since 1999. OnCo could not confirm how many of the seven centres were giving radiotherapy in November 2026; see the gaps.

The registry's page on the African Cancer Registry Network, last updated in October 2014, describes its start in September 2011 with funding from the German Federal Ministry of Education and Research until March 2014 and then the American Cancer Society, technical support from Martin Luther University Halle-Wittenberg and the American Cancer Society, more than 20 contact persons trained in health institutions across the city, and a rule that a person must have lived in the city for six months to count. Its first paper covered 4,139 cancers in 2012 and 2013 from 22 hospitals, clinics and diagnostic facilities; its 2018 to 2022 report counted 14,053. The Ministry's 2025 to 2029 plan names the absence of a national registry and of accurate mortality surveillance as weaknesses, says the registry depends on donors, and plans population-based registries in all five university-affiliated cancer treatment centres, facility-based registries in every treatment centre, and advocacy for a law mandating cancer reporting. The imPACT reviewers of November 2023 recommended complete coverage of the city so its data could be accepted in Cancer Incidence in Five Continents, a Ministry budget line for registration, absorbing the registry's staff into Ministry structures, and making cancer a notifiable disease by law.

In May 2025 the Deputy Director General of the Ethiopian Health Insurance Service said community-based health insurance, piloted in 13 districts in four regions in 2011, now covered 1,195 districts, with 65 million beneficiaries, 50 million making payments and 15 million covered although unable to pay. Its July 2025 news page reported the Health Minister giving 63 million beneficiaries in 13.67 million households for the 2017 Ethiopian fiscal year, and its Director General more than 63 million. In August 2025 a consultant presenting for the service said community-based insurance covers 80% of citizens and social health insurance for the formal sector will cover the remaining 20%; read beside the 65 million members and the 115 million population he cited (about 57%), the 80% describes the share of the population the scheme is meant for, not the share enrolled. The Ministry of Health's 2025 to 2029 cancer plan puts the premium at 921 birr per family per year and says members can use all services available at government facilities, but that because services are unavailable there, 60 to 70% of member families still pay out of pocket, including for medicines. National Health Accounts for 2019/2020 split health spending between donors (33.9%), government (32.2%) and households paying out of pocket (30.5%). The imPACT reviewers named high out-of-pocket costs, and the shortage of public cancer services that pushes patients to private care, as a major challenge.

The 2019 revision of the essential health services package, described by Eregata and colleagues, used 35 workshops and seven criteria: disease burden, cost-effectiveness, equity, financial risk protection, budget impact, public acceptability and political acceptability. Of 1,018 interventions evaluated, 594 were ranked high priority, 213 medium and 211 low; 570 are to be free of charge, with the rest under cost-sharing or cost-recovery. The cancer plan records about 218 priority non-communicable disease interventions, 70 of them for neoplastic conditions and 10 high-priority interventions for cervical cancer, and notes that cryotherapy is listed only from secondary hospitals upward, which limits screen-and-treat at lower levels. The national essential medicines list (6th edition, 2020) includes 54 essential cancer medicines; the imPACT reviewers recommended adding important oncology drugs such as anti-HER2 treatment for breast cancer, and oral morphine for palliative care. Researchers costing the paediatric oncology unit at Tikur Anbessa found it cost about 361 US dollars per disability-adjusted life year averted and asked for childhood cancer treatment, ranked low and medium priority, to be reassessed. OnCo found no official cost-effectiveness threshold.

The Ethiopian Food and Drug Authority is an autonomous federal body under Proclamation No. 1263/2021, with its powers set by Council of Ministers Regulation No. 531/2023, and regulates medicines, medical devices, food, cosmetics, alcohol and tobacco. Its announcement dated 29 September 2025 says the World Health Organization assessed it with its Global Benchmarking Tool and rated it at maturity level 3 for medicine regulation, making Ethiopia the ninth country in Africa to reach that milestone. Its reliance guideline for GMP inspection (EFDA/GDL/052, issued July 2024) states that EFDA has relied on stringent regulatory authorities for medicine registration and GMP inspection since 2014, and acknowledges that unprecedented shortages of critical and essential medicines, a limited number of registered medicines and relatively long waiting times for registration remain challenges. A 2025 study drawing on focus groups with regulatory experts reported application backlogs at EFDA. EFDA publishes no target or measured time for registering a new medicine that OnCo could find; this is named under gaps.

The Guideline for Clinical Trial Authorization (EFDA/GDL/005, version 5, approved 2 June 2025 and issued 9 June 2025) sets a screening decision within seven working days for a routine application and four for a non-routine one, and a routine review time of 45 working days for first feedback on a complete application including the fee; the review of a high-risk trial may be extended to 90 calendar days, and a non-routine application is reviewed in no more than 30 calendar days. Further replies are reviewed within 20 working days, or 15 calendar days for non-routine applications, and the applicant has six months to respond. Reviews may be joint with other countries' regulators, and EFDA may recognise and use clinical trial decisions, reports or information from other national regulators and from bodies such as WHO, the African Vaccine Regulatory Forum (AVAREF), the EMA and the US FDA. The guideline's history dates the first version to December 2009. The Ministry of Health's cancer plan asks for collaboration with regulators on the quality of oncology products and for local manufacturing and pooled procurement to make them affordable.

The Ministry's 2015 Guideline for Cervical Cancer Prevention and Control set the target population at women aged 30 to 49, earlier for women living with HIV, with cryotherapy as the treatment of choice for eligible precancerous lesions offered without a biopsy (screen and treat). The 2025 to 2029 plan reports screening in more than 1,500 public health facilities and more than 1 million women aged 30 to 49 screened, projects coverage of 20% by the end of 2024, and sets targets of 70% of women aged 30 to 49 screened with a high-performance test and 90% of women with cervical disease treated, with HPV DNA testing adopted as the preferred method, self-sampling for remote areas, and thermal ablation or LEEP alongside cryotherapy. The imPACT reviewers recommended allowing midwives to perform cryotherapy. In a review of 2017 to 2020 logbooks from 14 facilities in Addis Ababa and Oromia, about 13,800 women were screened by VIA and 5.9% were positive; over 90% of those were treated, but only about half returned for follow-up.

WHO's immunisation data record HPV vaccine introduced in Ethiopia in 2018, and the routine schedule reported to WHO for 2025 is one dose for girls at age 9. The cancer plan describes a large-scale campaign launched in November 2024 to vaccinate over 7.4 million girls aged 9 to 14 through schools and community outreach. In the programme coverage rows Ethiopia reported to WHO, 58% of a target of 9,051,554 girls received the vaccine in 2024, and 51% of 1,612,309 in 2025; for 2020 to 2023 last-dose coverage was between 22% and 29%. The plan's baseline for full vaccination by age 14 is 80%, rising to a target of 90%, figures that differ from the WHO rows. For breast cancer, the plan's baselines are 35% of cancers found at stage I or II, 120 days to complete diagnosis and 30% of patients completing multimodality treatment, with 2029 targets of 60%, 60 days and 80% under WHO's Global Breast Cancer Initiative. The plan says Ethiopia has introduced screening programmes for breast and cervical cancer but gives no breast screening coverage figure; the imPACT reviewers recommended a national plan for breast cancer screening and suggested clinical breast examination for women aged 45 and over. Hepatitis B vaccine is part of childhood immunisation, and the plan reports over 85% of infants receiving three doses.

The 2025 to 2029 plan describes a national initiative to decentralise breast cancer chemotherapy, given that breast cancer makes up 32% of cancer cases in its figures, and reports that 30 regional peripheral hospitals are equipped to provide it. Its list of cancer treatment centres for December 2024 has 30 entries: 7 comprehensive centres with radiotherapy, 10 hospitals treating all cancers with at least one clinical oncologist, and 13 hospitals, from Ambo, Assela and Axum to Jijiga, Nekemte and Dubti, defined as centres that focus exclusively on treating breast cancer using chemotherapy, along with follow-up care. The plan's workforce table counts 20 clinical oncologists across these 30 chemotherapy centres and 60 nationally, against an estimated need of 480 for 120 million people, 6 breast surgeons against a need of 1,200, and no oncology pharmacists. It also lists oncology-trained general practitioners (60) and nurses (56), the cadres task-sharing relies on. Its 2029 target for breast cancer is 80% of patients completing multimodality treatment, from a baseline of 30%.

The 2025 to 2029 plan reports that, in collaboration with the Aslan Project and St. Jude Global Health, 5 paediatric haematology-oncology centres and 8 satellite clinics have been established, and that the country has 20 paediatric haemato-oncologists with 7 more in fellowship. It folds the National Childhood and Adolescent Cancer Control Plan 2019 to 2023 into the integrated plan and sets targets of 60% survival for children with cancer, from a baseline of 30%, and a 60% fall in treatment abandonment by 2029. The IAEA wrote in March 2024 that WHO had flagged Ethiopia as a CureAll priority focus country, that treatment abandonment ran at 20 to 50%, and that 75% of children reaching a paediatric cancer unit already had advanced disease, citing the Aslan Project. The plan names civil society groups that house and feed families: the Mathiwos Wondu-Ye Ethiopia Cancer Society at Tikur Anbessa, and the Tesfa Addis Parents Childhood Cancer Organization across all five paediatric programmes. A 2023 study costed the paediatric oncology unit at Tikur Anbessa at about 361 US dollars per disability-adjusted life year averted.

Counted from ClinicalTrials.gov participation data in OnCo's graph on 4 November 2026: 0 trials list Ethiopia among their countries. That reflects the trials OnCo holds, mostly large industry and academic trials of new medicines, not every study in Ethiopia; when OnCo built its country file on 8 September 2026, ClinicalTrials.gov counted 364 studies of any condition with a site in Ethiopia, and the search linked below shows the cancer studies among them. OpenAlex, counting works whose primary topic is oncology and counting a paper for every country among its authors' affiliations, gives Ethiopia 224 works in 2021, 256 in 2022, 252 in 2023, 299 in 2024 and 327 in 2025, 1,358 in total, of which 1,077 are open access and 85 highly cited. The Addis Ababa registry, based at Addis Ababa University, has had technical support from Martin Luther University Halle-Wittenberg, and researchers from both universities wrote the two registry papers and the screening follow-up study listed on this page. Before a trial opens, EFDA authorises it under its 2025 guideline, with a first answer due within 45 working days for a routine application.

The Integrated National Cancer Control Plan 2025 to 2029 builds on the first costed National Cancer Control Plan (2016 to 2020) and the National Childhood and Adolescent Cancer Control Plan (2019 to 2023), and was grounded in the recommendations of the IAEA, WHO and IARC imPACT Review of November 2023. Its goal is to reduce premature mortality from cancer by 15% by 2029, with four priority areas (breast cancer, cervical cancer, childhood and adolescent cancer, and other cancers including colorectal, prostate, non-Hodgkin lymphoma and liver) and five pillars from prevention to palliative care. It is costed at 141,026,900 US dollars over 2025 to 2029: 46.75% for diagnosis and treatment, 18.03% for prevention, 10.45% for supportive and palliative care and 7.71% for surveillance and research; by category, medical equipment is 35.3% and medicines 23.5%. It sets a target of keeping stock-outs of oncology commodities below 30%. The plan notes that the 2016 to 2020 National Cancer Control Committee, co-chaired by the First Lady, is no longer in place, and that the Ministry has two designated cancer officers and no regional cancer focal points yet.

OnCo found no published imPACT Review report for Ethiopia, only the IAEA's news article of 26 March 2024, which returned HTTP 403 to a plain request on 4 November 2026 and was read from the Internet Archive's copy, and the summary of recommendations reprinted in appendix 2 of the national plan. The reviewers' own counts of radiotherapy machines, oncologists, pathology and imaging, which the full report would hold, are therefore not on this page except as quoted by the plan or the article.

The Ministry's news page records the Jimma centre opening on 20 February 2022 as the country's second. The plan's statement that four centres are equipped with linear accelerators and operational since November 2020 is hard to square with the Ministry's own 2022 page, which says that before Jimma radiotherapy was available only at Tikur Anbessa. The plan's appendix 6 labels Ayder, Gondar, Hawassa, Hiwot Fana, Jimma, St Paul's and Tikur Anbessa comprehensive with radiotherapy, while its appendix of imPACT recommendations asks to complete construction at Gondar, Mekelle and St Paul's. OnCo could not find a dated official count of working machines for 2025 or 2026; ask the referring hospital which centre is treating and how long the wait is.

EFDA's guidelines page did not list a marketing authorisation guideline for new human medicines that OnCo could reach; its renewal guideline sets times for renewing an existing authorisation, not for a first registration, and is not used here. Third-party regulatory consultancies and university theses quote registration times; they are not used. The essential health services package and the 54 essential cancer medicines on the 6th national list are named in the plan, but the list itself was not read here; the plan's appendix 4 reprints part of a cancer medicines list. Whether a medicine is registered, stocked by the Ethiopian Pharmaceutical Supply Service, or free under the package is a separate question this page cannot answer medicine by medicine.

No population-based survival figures for adults in Ethiopia were found in the sources read; the 20 to 30% survival for childhood cancer is the plan's statement. The cervical guideline read here is the 2015 edition; parts of its screening section are encoded in a font that extracts as unreadable text, and a 2021 edition is cited by researchers but was not found. The 20% cervical screening coverage is the plan's projection for the end of 2024, not a measured figure. The plan's HPV vaccination baseline (80%) and WHO's coverage rows (51% to 58% in 2024 and 2025) differ, and both are quoted. The Addis Ababa registry has no website of its own, its African Cancer Registry Network page was last updated in October 2014, and only the abstract of its 2018 to 2022 paper was read. IARC's detailed data sources and methods page for Ethiopia was not read; the method is taken from the fact sheet.