Cancers au Sahel : un fléau à l’ombre des épidémies

---

Résumé

This introduction presents cancer in the Sahel and West Africa as a growing but still under-recognized public health crisis, overshadowed by long-standing priorities such as infectious diseases and maternal and child health. The authors frame cancer within the broader “double burden” faced by many low- and middle-income countries: persistent infectious diseases alongside a rapid rise in non-communicable diseases. Although cancers are increasingly visible in global health discourse, they remain underfunded, poorly documented, and politically marginalized compared with vertical programs targeting infectious diseases.

The text emphasizes that cancer incidence and mortality in sub-Saharan Africa are likely underestimated because of weak cancer registries and incomplete mortality data. Despite this invisibility, several West African countries are beginning to organize cancer responses through national cancer control plans, free or subsidized treatment policies, new oncology infrastructure, and growing civil society mobilization. Yet access to diagnosis and treatment remains highly unequal, especially for poor, rural, and socially vulnerable patients.

A central argument is that cancer care in West Africa is marked by precarious medical infrastructures and major ethical tensions. Late diagnosis, limited specialists, fragile access to chemotherapy, radiotherapy and palliative care, high out-of-pocket costs, and frequent reliance on improvised or adapted protocols shape the everyday reality of oncology services. Health professionals must often make difficult decisions in contexts where treatments are technically possible but financially inaccessible or unlikely to lead to remission.

The introduction also highlights the heterogeneous and difficult care pathways experienced by patients. Cancer often becomes a long “trial” involving plural medical recourse, financial sacrifice, family negotiations, bodily transformation, stigma, and uncertainty. In settings where survival remains low, cancer is often associated with death rather than chronic illness, while palliative care remains insufficiently developed despite the intensity of suffering.

The special issue of L’Ouest Saharien seeks to make these realities visible. Its first section examines political and health-system responses to cancer in Senegal and Côte d’Ivoire, including national cancer policies, gynecological cancer care, and innovations in cervical cancer screening. Its second section focuses on lived experiences of cancer, especially among women with breast and gynecological cancers in Mali, Côte d’Ivoire and Mauritania, and among children with cancer in Mali and Togo. Across the contributions, the issue explores how gender, poverty, health-system constraints, family economies, medical uncertainty and ethical dilemmas shape cancer care and experience in the Sahel and West Africa.

Mots-clés

Cancer, Sahel