This essay considers the possibilities for and challenges of oncology in southern Africa, where there is a cancer epidemic rapidly emerging, part of the cancer pandemic escalating across the global south. Already, more than half of all new cancer cases and two thirds of cancer deaths occur in the developing world, and epidemiologists tell us that these figures are steadily rising [1]. This epidemic will profoundly shape the future of oncology, raising fundamental challenges for patients, their clinicians, and the research community. This is not an epidemicthat will be solved by a magic bullet, or by a simple program of technology transfer. It is a multidimensional, long-term problem that will necessitate dynamic, sustainable, context-specific solutions-solutions that take social and economic realities fully into account. These dynamics are magnified in southern Africa, especially given that cancer there is emerging in the shadow of HIV/AIDS.
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