Africa Has 1.1 Million New Cancer Cases a Year and Barely Enough Oncologists to Treat Them. One Foundation Is Trying to Change That.

The Merck Foundation, the philanthropic arm of Merck KGaA Germany, has, as of June 2026, provided 269 scholarships for healthcare providers from 34 countries as part of its Cancer Access Program. The scholarships cover one-year clinical fellowships in specialties ranging from medical and surgical oncology to paediatric oncology, haemato-oncology, palliative care, radiation oncology, and oncology nursing. For postgraduate academic training, the foundation funds one and two-year diplomas and master's degrees through UK universities including the University of South Wales, University of Buckingham, Queen Mary University of London, and Cardiff University.

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The foundation has described its work in The Gambia, Sierra Leone, Burundi, Liberia, Guinea Conakry, the Central African Republic, Chad, Niger, Malawi, Namibia, Zambia, and Zimbabwe as training the "first" oncologists in each country. That claim deserves to be taken seriously. These are not countries with underserved oncology departments. These are countries that, before these scholarships, had no trained oncologist at all. A person diagnosed with cancer in The Gambia was, within recent memory, facing treatment abroad at prohibitive cost or no treatment at all.

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The WHO data framing the problem is not contested: Africa sees roughly 1.1 million new cancer cases annually and approximately 700,000 cancer deaths. The disproportion between incidence and mortality — roughly 64 per cent of cases result in death — compares to roughly 47 per cent in high-income countries. That gap is not biological. It is structural. Two-thirds of cancer cases globally are treatable when caught early. In Africa, most cases are caught late, after symptoms have become impossible to ignore, because primary care services are not equipped to screen for or suspect cancer, because diagnostic infrastructure is limited, and because the specialists to whom a primary care worker might refer a suspicious case do not exist.

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The Merck Foundation's scholarship programme addresses one link in that chain: the absence of trained specialists. Its most recent communications initiative, the "Rays of Hope" animation film and children's storybook, addresses a different link: community awareness and early help-seeking behaviour. The storybook and film, released in three languages in partnership with African First Ladies, are targeted at parents and children, framing childhood cancer around the themes of early detection and access to care teams.

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The First Ladies partnership is worth examining as a strategic choice. African First Ladies occupy a specific position in the political economy of health communication on the continent. They have high visibility, cross-border reach through AU wives' forums, and proximity to state resources without formal accountability for policy outcomes. They are effective mobilisers for awareness campaigns where the message is uncontroversial — childhood cancer awareness is — but they are not the appropriate mechanism for systemic health reform. The Merck Foundation's model correctly uses them for what they can do and does not ask them to do what they cannot.

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What the 269-scholarship programme has not addressed, and what no private foundation programme can address alone, is the health system infrastructure that specialists return to. A surgical oncologist trained in India on a Merck scholarship who returns to the Mzuzu Central Hospital in Malawi — as one Foundation alumna described — operates in a facility that was, before her return, without oncology services. She has now become the only female chief surgeon at the hospital. Her presence is a transformation for the patients she can reach. Her absence would mean those patients have no option. One surgeon is not a system.

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Scaling from 269 scholarships across 34 countries to the level of specialist coverage needed to address 1.1 million annual cases requires a different order of investment, led by states rather than foundations, funded by domestic health budgets rather than European pharmaceutical philanthropy. The Merck Foundation is building proof of concept and demonstrating that training is feasible and impactful. The harder question — how African governments shift domestic health budgets, train more specialists, and build the multidisciplinary infrastructure around them — is the one that needs answering next.