JCO Global Oncology
American Society of Clinical Oncology
Travails of Delivering Effective Radiotherapy in Nigeria
Volume: 6
DOI 10.1200/GO.20.00070
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Dawson: Travails of Delivering Effective Radiotherapy in Nigeria


This letter is written in response to the recent article in JCO Global Oncology by Leng et al1 entitled “Infrastructural Challenges Lead to Delay of Curative Radiotherapy in Nigeria.”

It is well known that Nigeria is the most populous nation in sub-Saharan Africa and has oil reserves for the next 200 years. Furthermore, Nigeria’s predominant income as a nation, besides foreign remittances, is petrodollars.2,3 With regard to petroleum exports, this accounts for 91% of Nigeria’s export earnings.4 As to the importance of remittances from diaspora Nigerians to Nigeria, certainly the disparate impact of exportation of Nigeria’s intellectual capacity (MD brain drain) will continue unabated.5 As such, its health care manpower dilemma will remain unchanged for the foreseeable future.

The authors acknowledge the extent of problems related to Nigeria’s electrical grid. As a solution to electrical infrastructure problems and the delivery of effective radiotherapy, Nigeria’s teaching hospitals must increasingly be used as centers of effective radiotherapy delivery. These teaching centers, of which there are now 20,6 would be excellent starting points for improving cancer care capabilities and availability regarding radiotherapy. Leng et al1 and I7 have mentioned the solution of Kumar and Bhasker8 with modernized cobalt-60 treatment machines. However, another seemingly workable option is to develop/construct off-grid local microgenerating capacity for each teaching hospital.9 This may lead to reliable electricity delivery for the effective operation of treatment machines.

Of cancers mentioned by the authors (breast, prostate, uterine cervical, and head and neck), most have effective vaccines (eg, for human papilloma virus in cervical and head and neck cancers) and screening tools (eg, for prostate-specific antigen). Optimum use of the vaccine for human papilloma virus, for example, could mitigate the need for expensive, complicated equipment requirements in the meantime.

There is a tendency to become paralyzed by over-analysis. Therefore, at some point, Nigeria’s medical professionals and political leaders must regain control of the narrative of poor health care delivery in cancer care by rationally using its oil wealth,10 for example, to improve health outcomes of its citizens.


The following represents disclosure information provided by the author of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO’s conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/site/misc/authors.html.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

No potential conflicts of interest were reported.



Leng J, Ntekim AI, Ibraheem A, et al. Infrastructural challenges lead to delay of curative radiotherapy in NigeriaJCO Glob Oncol6, pp.2692762020


Adesoji BS. Nigeria received $96 billion diaspora remittances inflow in 6-yearshttps://nairametrics.com/2019/10/11/nigeria-received-96-billion-diaspora-remittances-inflow-in-6-years/


Asu ’F : . Nigeria earns $236bn from petroleum exports in five yearshttps://punchng.com/nigeria-earns-236bn-from-petroleum-exports-in-five-years/


Trading Economics. Nigeria exportshttps://tradingeconomics.com/nigeria/exports


Olaniran OG. Brain drain and the Nigerian economyhttps://www.vanguardngr.com/2020/02/brain-drain-and-the-nigerian-economy/


High Faculty. List of teaching hospitals in Nigeriahttps://highfaculty.com/teaching-hospitals-in-nigeria/


Dawson GA. Low- to middle-income nations: Resource rich in people but resource poor in reliable utility (electrical grid) infrastructure for effective delivery of high-impact supportive care modalities—Some thoughts on the radiotherapy perspectiveJ Glob Oncol10.1200/JGO.18.00082


Kumar RV, Bhasker S. Is the fast-paced technological advancement in radiation treatment equipment good for Indian scenario? NoJ Cancer Policy4, pp.26302015



Batovic A. How corruption and oil crime are tearing Nigeria aparthttps://oilprice.com/Energy/Crude-Oil/How-Corruption-And-Oil-Crime-Are-Tearing-Nigeria-Apart.html

https://www.researchpad.co/tools/openurl?pubtype=article&doi=10.1200/GO.20.00070&title=Travails of Delivering Effective Radiotherapy in Nigeria&author=George Dawson,&keyword=&subject=Correspondence,