African scientists want research to be more equitable as a cancer crisis looms

The Nature Index: Exploring the Existence of Cancer-Research Research in Sub-Saharan Africa via the Dimensions from Digital Science Database

A description of the terminology and methodology used in this supplement, and a guide to the functionality that is available free online at natureindex.com.

Count and Share are used in the Nature Index. A country/territory or an institution is given a Count of 1 for each article that has at least one author from that country/territory or institution. This is the case regardless of the number of authors an article has, and it means that the same article can contribute to the Count of multiple countries/territories or institutions.

The total number of articles in Nature Index journals varies from one year to the next. It’s done by dividing the number of articles in the Index by the number in a base year to arrive at a percentage difference.

TheCS of the two institutions is the sum of their shares on the papers to which both contributed. The Nature Index shows that any two institutions or countries can co-author an article in a journal.

Each query will return a profile page which contains information about the country, and can be used to find more information. The journal can display the articles. The research outputs are organized by subject area The pages list the institution or country’s/territory’s top collaborators, as well as its relationship with other organizations. They can track an institution’s performance over time, create their own indexes and export table data.

A total of 57 natural-science journals in the Nature Index were searched via the Dimensions from Digital Science database to extract cancer-research articles, using both keyword and fields-of-research (FoR) searches. Cancer-related keywords curated by the Nature Index team were used to search article abstracts and titles. The FoR query looked for articles in the research field ‘3211 Oncology and Carcinogenesis’. The supplement does not include any health-science journals.

There are several factors contributing to this discrepancy. Cancer research lacks domestic support across most of sub-Saharan Africa, says Violet Kayamba, a gastroenterologist who studies stomach cancers at the University of Zambia in Lusaka. The lack of funding and infrastructure for locally relevant priorities coupled with a lack of mentors for young Africans wanting to go into cancer research translate into this. “We need our local governments to take ownership and to take the lead in supporting African scientists,” says Kayamba.

There are signs that Africa is expanding its cancer research capacity. A scientist at Covenant University in Nigeria states that more young African researchers are interested in the topic. AORTIC is a non-profit organization that promotes cross- African collaboration in cancer research, education and care delivery. Before 2021, when AORTIC held its first dedicated international conference on cancer genomics, very few African countries had cancer-genomics experts presenting at the organization’s conferences, says Rotimi. Out of Africa, roughly 40% of countries have not published any research in cancer-genomics in the last year. For the first time, a number of countries with no output in cancer-genomics before the year 2020 were represented at AORTIC’s second cancer-genomics conference.

In high-income countries, there are new collaborations between African researchers and their colleagues. The problem of maintaining equity is a result of the fact that there is a vicious cycle of challenges in the research environment, said Rubagumya.

African health-care personnel are in need of helping to access specialist expertise. The tool was developed with funding from the Swedish Program forICT in Developing Regions, a research centre at the Royal Technical University in Stockholm and Makerere University in Uganda. In many African countries, cancer screening involves using visual inspection methods, such as examining the cervix with the naked eye using a focus lamp or torch light, rather than the lab-based PAP smears that are common in high-income countries. The smartphone-based telemedicine system connects a portable colposcope (a microscope with a strong light that is used to examine a patient’s cervix) with an app that connects non-specialists who carry out cervical-cancer screenings with gynaecologists to gain a second opinion. Users can use artificial intelligence to compare their observations with thousands of medical images. A trial deployment of a device was conducted at the Uganda Cancer Institute and four satellite clinics throughout the country in 2019.

The United States is a major player in cancer research around the world, and is included in the leading bilateral country collaborations in the Nature Index. The United States and China had a lot of partnerships. But a steep decline since 2018, probably reflecting the impact of rising political tensions and the COVID-19 pandemic, has hugely reduced the gap with other US partnerships.

The Japan Society for the Promotion of Science allocated the most money for cancer research from 2018 to 2022 among Asia-Pacific funders listed in the Dimensions database. Its 15,665 grants were worth a total of around $860 million. The National Natural Science Foundation of China gave 11,910 grants worth about $810 million.

The chart below shows some outliers. Specialist cancer centres unsurprisingly have a high proportion of Nature Index output related to cancer research. But two in the United States, the Memorial Sloan Kettering Cancer Center in New York City and University of Texas MD Anderson Cancer Center in Houston, Texas, are clear of other specialist institutions on Share.