Radiation therapy is part of cancer care for more than 50% of patients, yet access to the machines and specialists needed to deliver it remains highly uneven. The following statistics describe worldwide capacity, projected demand, workforce requirements, and the particularly large gaps reported in sub-Saharan Africa. These figures can help caregivers understand why treatment availability, travel, waiting times, and support needs differ so widely between regions.
Contents
- Global radiation therapy capacity
- Access gaps between countries
- Future cancer and workforce demand
- Hypofractionation and treatment capacity
- Sub-Saharan Africa workforce statistics
- Equipment and machine density
- Country-level capacity in the AFROG survey
Global radiation therapy capacity
The International Atomic Energy Agency’s Directory of Radiotherapy Centres (IAEA DIRAC) reports nearly 8,800 radiotherapy centres worldwide. Those centres use more than 16,000 teletherapy machines, which deliver radiation from a source outside the patient’s body. The same source reports more than 3,000 brachytherapy resources, a form of treatment in which the radiation source is placed inside or close to the treatment area. These are global counts, not measures of equal access: the existence of a centre or machine does not show how many people it serves, whether it is operating, or how far patients must travel.
The distribution of machines is especially unequal. In high-income countries, one teletherapy machine serves more than 130,000 people on average. In low-income countries, one machine serves 15.6 million people on average. This difference matters for patients and caregivers because a lower machine-to-population ratio can mean longer travel distances, fewer appointment options, and greater dependence on family members for transport and daily support.
The IAEA DIRAC data also estimate that low-income countries would need more than eight times their current number of machines to meet a target of one radiotherapy machine for every 500 cancer patients. In 2022, only 20.9% of countries met the minimum resource requirement for radiotherapy, according to IAEA DIRAC reporting through the World Intellectual Property Organization’s Global Innovation Index 2023.
Access gaps between countries
The World Health Organization and IAEA equipment guidance states that around one-third of countries still do not have radiotherapy available. Of the countries without availability, 28 are in Africa. This statistic describes country-level availability, so it should not be read as proof that every patient in countries with a service can reach or afford treatment.
More than half of cancer patients require radiotherapy as part of cancer care, according to the same WHO/IAEA equipment guidance. When a country lacks a service, patients may need referral to another region or country. For caregivers, that can add accommodation, transport, coordination, and time away from work to an already demanding period of support.
Radiotherapy infrastructure also has a replacement cycle. The usual lifespan of radiotherapy equipment is 10 to 15 years, according to WHO/IAEA equipment guidance. Capacity therefore depends not only on purchasing machines, but also on maintaining, replacing, and safely operating them over time.
Future cancer and workforce demand
The global cancer burden is projected to reach 32.6 million new cases and 16.9 million deaths in 2045, according to IAEA DIRAC. These are projections for a future year, not counts of cases or deaths already recorded. Rising demand places pressure on treatment infrastructure, oncology services, and the people who help patients navigate care.
The Lancet Oncology Commission survey cited by the IAEA drew on 200 radiotherapy centres across 55 countries. Its workforce analysis indicates that, by 2050, the radiotherapy workforce must exceed:
| Role | Workforce needed by 2050 |
|---|---|
| Radiation oncologists | 84,000 |
| Medical physicists | 47,000 |
| Radiotherapy technologists | 141,000 |
These figures refer to workforce requirements, not the number of professionals currently employed. Radiation oncologists prescribe and oversee radiation treatment, medical physicists help ensure accurate and safe delivery, and radiotherapy technologists operate treatment equipment and support patients through sessions. Each role affects how reliably a patient can receive care.
Hypofractionation and treatment capacity
Hypofractionation delivers radiotherapy in fewer treatment sessions by using a different dose pattern. The IAEA’s summary of the Lancet Oncology Commission reports that implementing hypofractionation for prostate and breast cancer could provide radiotherapy for an additional 2.2 million patients. This is an estimated capacity effect, not a count of patients already treated through the approach.
The same analysis estimates financial savings when conventional radiotherapy is substituted with hypofractionated radiotherapy. For prostate cancer, a 50% substitution could save $1.28 billion, while an 80% substitution could save $2.04 billion. For breast cancer, the estimated savings are $1.48 billion with a 50% substitution and $2.37 billion with an 80% substitution.
| Cancer type | Estimated savings at 50% substitution | Estimated savings at 80% substitution |
|---|---|---|
| Prostate cancer | $1.28 billion | $2.04 billion |
| Breast cancer | $1.48 billion | $2.37 billion |
These estimates concern modeled substitution levels and should not be interpreted as a guarantee that every patient is eligible for a shorter course. Treatment decisions remain specific to the cancer, the patient, and the clinical setting. For caregivers, fewer visits may reduce travel and scheduling demands when a clinical team determines that the approach is appropriate.
Sub-Saharan Africa workforce statistics
An IARC/AFROG survey reported about 260 radiation oncologists, 180 medical physicists, and 700 radiotherapy technologists in sub-Saharan Africa. The survey estimated that 450,000 cancer cases in the region could benefit from radiotherapy but were served by the non-South African share of the workforce.
To meet cancer-incidence demand, the region requires at least 2,000 radiation oncologists and at least 1,250 medical physicists, according to the same survey. It characterized the current radiotherapy workforce gap as almost tenfold versus need. This gap can affect treatment access, service continuity, technical support, and the amount of navigation help families must provide.
The cancers most commonly identified in sub-Saharan Africa include cervical, breast, head and neck, prostate, colorectal, liver, and oesophageal cancers. More than 70% of treatments in the survey were palliative. That percentage describes treatments in the survey and should not be generalized to every country or cancer service in the region.
The survey’s basic staffing guideline for one MV unit was 4 to 5 radiation oncologists, 3 to 4 medical physicists, and 7 radiotherapy technologists. This provides a staffing benchmark for one unit, not a count of staff available at every facility.
Equipment and machine density
The IARC/AFROG survey total covered a population of 660.4 million and reported an average density of 0.37 teletherapy units per million population. Its regional equipment total included 34 cobalt-60 units, 98 linear accelerators, and 47 brachytherapy units.
The country figures below show why a regional average can conceal substantial variation. “Machines per million” is the reported density measure; it does not describe utilization, uptime, staffing, treatment quality, or the geographic distance between patients and services.
South Africa had a population of 50.0 million, with 8 cobalt-60 units, 77 linear accelerators, 25 brachytherapy units, and 1.70 machines per million population. Mauritius had 1.3 million people, 2 cobalt-60 units, 1 linear accelerator, 1 brachytherapy unit, and 2.43 machines per million population.
Namibia had 2.3 million people, 1 cobalt-60 unit, no linear accelerators, 2 brachytherapy units, and 0.44 machines per million. Ghana had 24.4 million people, 2 cobalt-60 units, 1 linear accelerator, 1 brachytherapy unit, and 0.12 machines per million. Kenya had 40.5 million people, 2 cobalt-60 units, 4 linear accelerators, 3 brachytherapy units, and 0.15 machines per million.
Nigeria had 158.4 million people, 2 cobalt-60 units, 3 linear accelerators, 3 brachytherapy units, and 0.03 machines per million. Sudan had 30.9 million people, 5 cobalt-60 units, 5 linear accelerators, 2 brachytherapy units, and 0.32 machines per million. Uganda had 33.4 million people, 1 cobalt-60 unit, no linear accelerators, 1 brachytherapy unit, and 0.03 machines per million.
Zambia had 12.9 million people, 1 cobalt-60 unit, 1 linear accelerator, 1 brachytherapy unit, and 0.15 machines per million. Zimbabwe had 12.6 million people, no cobalt-60 units, 2 linear accelerators, 1 brachytherapy unit, and 0.16 machines per million.
Country-level capacity in the AFROG survey
Angola had 19.1 million people, no cobalt-60 units, 1 linear accelerator, no brachytherapy units, and 0.05 machines per million. Botswana had 2.0 million people, 1 cobalt-60 unit, no linear accelerators, 1 brachytherapy unit, and 0.50 machines per million.
Cameroon had 19.6 million people, 2 cobalt-60 units, no linear accelerators, 2 brachytherapy units, and 0.10 machines per million. The Democratic Republic of Congo had 71.7 million people, no cobalt-60 units, 1 linear accelerator, no brachytherapy units, and 0.01 machines per million.
Ethiopia had 83.0 million people, 2 cobalt-60 units, no linear accelerators, no brachytherapy units, and 0.02 machines per million. Gabon had 1.5 million people, 1 cobalt-60 unit, no linear accelerators, no brachytherapy units, and 0.67 machines per million.
Madagascar had 20.7 million people, 1 cobalt-60 unit, no linear accelerators, 1 brachytherapy unit, and 0.05 machines per million. Mali had 15.4 million people, no cobalt-60 units, 1 linear accelerator, no brachytherapy units, and 0.07 machines per million.
Mauritania had 3.5 million people, no cobalt-60 units, 1 linear accelerator, 1 brachytherapy unit, and 0.73 machines per million. Senegal had 12.4 million people, 1 cobalt-60 unit, no linear accelerators, no brachytherapy units, and 0.08 machines per million.
Tanzania had 44.8 million people, 2 cobalt-60 units, no linear accelerators, 2 brachytherapy units, and 0.04 machines per million. Together, these figures show that machine counts and densities vary sharply across the countries included in the IARC/AFROG survey. For caregivers, the practical consequences of that variation can include different referral pathways, travel burdens, and needs for help with appointments, lodging, and treatment-day logistics.