Local radiopharmaceutical production reduces therapy costs by 93% to 96% across 54 African nations
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Key Takeaway
Consider local production to reduce radionuclide therapy costs by 93% to 96% in Africa.
This systematic review and quantitative infrastructure analysis assesses the availability, accessibility, and economic feasibility of radionuclide therapies across 54 African nations. The review compares local production of I-131 and Lu-177-PSMA against imported agents. Data were drawn from 47 studies included in the analysis.
The analysis found that I-131 therapy for thyroid cancer is available in 28 out of 54 countries. In contrast, Lu-177-PSMA for prostate cancer is available in only 7 countries. These figures represent 51.9% and 13.0% availability rates respectively.
Economic analysis indicates that local production reduces therapy costs by 93% to 96%. For Lu-177-PSMA specifically, the cost ratio between local and imported agents is 1:28.3. Local costs range from US$1,500 to US$3,000 versus US$42,500 for imports. Physician density for nuclear medicine is 0.18 per million population compared to 3.1 in other contexts.
The authors conclude that targeted investment in cyclotron infrastructure and workforce development is urgently needed. Limitations regarding the review are not reported in the source text.
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View Original Abstract ↓
Africa faces a projected doubling of cancer burden by 2040, yet access to radionuclide therapies remains critically limited. This systematic review quantifies the availability, accessibility, and economic feasibility of therapeutic nuclear medicine across 54 African nations.
This study combined a PRISMA 2020-compliant systematic literature review with secondary database analysis. A comprehensive search was conducted across PubMed/MEDLINE, Scopus, Web of Science, and African Journals Online (January 2022–March 2026). Epidemiologic and infrastructure data were additionally obtained from GLOBOCAN 2022 and the International Atomic Energy Agency (IAEA). Risk of bias was assessed using the modified Newcastle–Ottawa Scale for peer-reviewed studies and the AACODS checklist for gray literature.
Of 2,847 records identified, 47 studies met the inclusion criteria. I-131 therapy for thyroid cancer is available in only 28/54 countries (51.9%), while Lu-177-PSMA for prostate cancer is available in only seven countries (13.0%). Local radiopharmaceutical production reduces therapy costs by 93%–96% compared with imported agents. Africa has approximately 0.18 nuclear medicine physicians per million population vs. 3.1 in Europe. The cost reduction ratio for local vs. imported Lu-177-PSMA is 1:28.3 (US$1,500–3,000 vs. US$42,500).
Radionuclide therapy availability in Africa is profoundly inadequate relative to disease burden. Economic modeling demonstrates that local production and regional hub models can achieve cost reductions exceeding 90%, making therapies economically feasible for resource-limited settings. Targeted investment in cyclotron infrastructure and workforce development is urgently needed.
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