How Data Collection Led to Malawi’s First Public Radiotherapy Centre

(This article was originally published in the April 2025 IAEA Bulletin)

Malawi is putting the finishing touches to its new public radiotherapy centre in Lilongwe and preparing to diagnose and treat cancer patients domestically for the first time in its history. 

“The opening of this treatment centre marks the beginning of a new era for my country,” said Sanderson Kuyeli, Deputy Director of Planning (Health Infrastructure Management) in Malawi’s Ministry of Health. “We no longer need to send our cancer patients abroad, but can look after them right here, close to their families.”

The new radiotherapy centre, which is expected to open by the end of this year, is guided by an evidence based approach and backed by IAEA expertise and support.

Malawi’s landmark success owes much to its rigorous data collection efforts, the sustained commitment of the Ministry of Health, and the support of the IAEA and its partners. The country’s evidence based approach enabled it to develop a strategic funding proposal and consequently secure a loan from the OPEC Fund for International Development in 2018.

“It all started with an imPACT Review mission in 2012,” said Shaukat Abdulrazak, Director of the IAEA Division for Africa. “This first fact-finding mission, conducted jointly by the IAEA, the World Health Organization and the International Agency for Research on Cancer, provided Malawi with a baseline situation analysis and a set of recommendations to guide cancer control planning and investments across the spectrum, from prevention to palliative care.”

“For over 65 years, our human health specialists have collected data on radiotherapy access through our Directory of Radiotherapy Centres (DIRAC). They have also helped countries establish and expand their capacities in using ionizing radiation to tackle pressing health challenges safely and effectively,” said May Abdel-Wahab, Director of the IAEA Division of Human Health. “The IAEA’s extensive support to Malawi is an example of the effective support our specialists provide through their expertise — assistance that is now being delivered through Rays of Hope, the IAEA’s initiative to expand cancer care access globally.”

Based on the data collected, the IAEA’s Human Health Programme provided technical support to build the radiotherapy centre. This covered all steps from bunker design to equipment specifications, procurement and coordination with vendors to ensure that installation and commissioning were completed in a timely manner.

Malawi’s new facility has 4 radiotherapy bunkers and 2 brachytherapy bunkers, and will commence operations with 2 linear accelerators, a cobalt-60 unit, a computed tomography simulator and a brachytherapy suite. The IAEA has also trained over 20 specialized medical staff and Atomic Energy Regulatory Authority personnel responsible for inspecting and licensing the new radiotherapy facility.

 “We are a testimony of what the IAEA is doing in terms of training young scientists in nuclear-related fields, providing expert services and procuring radiotherapy equipment,” said Malawi’s Minister of Health, Khumbize Kandodo Chiponda, at the 67th IAEA General Conference in 2023. “As a country, we are delighted that very soon we will be able to treat our cancer patients in Malawi.”

“The IAEA helps its Member States to gain a full understanding of their country’s cancer control capacity and needs,” said Lisa Stevens, Director of the IAEA’s Programme of Action for Cancer Therapy. For example, the IAEA’s global radiotherapy availability map, which was developed using data from DIRAC and other sources, compares the availability of radiotherapy machines in each country with the need for radiotherapy treatment, which half of all adult cancer patients require.

“Tools such as these remind us of the unequal access to cancer care and how it affects patients in low- and middle-income countries more markedly than in other parts of the world,” added Stevens.

DIRAC, the world’s most comprehensive database on radiotherapy resources, supports countries in taking evidence based decisions to improve access to cancer care. It can be used to assess existing infrastructure in radiotherapy, plan new radiation oncology centres, and analyse the performance and quality of radiotherapy services. Data on all forms of cancer control is collected during imPACT Reviews and provides insights that are crucial to Rays of Hope and its efforts to close the global gap in cancer care.