Inside Nairobi’s push to fix cancer care before it overwhelms the system

A few days ago, as global health leaders gathered for the World Health Summit Regional Meeting, a quieter but more urgent conversation was unfolding in Nairobi: how to fix a cancer care system that many experts say is under growing strain.In consultation rooms across the city, the consequences are already visible.

Clinicians speak of late-stage presentations, tumours advanced, options limited, outcomes poorer than they should be. These are not failures of science. They are failures of timing.Cervical and breast cancers remain the leading causes of cancer-related deaths among Kenyan women. Yet both are, in many cases, preventable or highly treatable when detected early.

The paradox is stark: the tools exist, but too many patients arrive too late.“Awareness, acceptability and affordability are still the biggest barriers today,” says TishaBoatman, Executive Vice President of External Affairs and Healthcare Access at Siemens Healthineers, speaking on the sidelines of the summit.Her diagnosis is clinical. Kenya’s cancer burden, she suggests, is shaped less by a lack of innovation than by systemic bottlenecks; gaps between policy and practice, detection and diagnosis, access and uptake.

A system under pressure.

The numbers offer a sobering baseline.

Only 48% of eligible women in Kenya have ever been screened for cervical cancer. In epidemiological terms, this is not just a coverage gap; it is a missed opportunity for prevention at scale.The result is predictable: a steady flow of patients presenting with advanced disease, where treatment becomes more complex, more expensive, and less likely to succeed.

At the centre of efforts to recalibrate the system is the City Cancer Challenge (C/Can), which has been working with Nairobi since 2022 to map and strengthen its oncology landscape.The approach is deliberately diagnostic before it is prescriptive. More than 100 health professionals, alongside civil society groups and patients, have contributed data, clinical insight, and lived experience.

The outcome is a set of 11 locally defined project plans, a blueprint for improving detection, treatment pathways, and system coordination.“What has changed is alignment,” Boatman says. “Stakeholders are now working from a sharedunderstanding of the gaps and the direction of travel.”Moving beyond fragmentationCancer care in Kenya has long been fragmented across public and private sectors, across levels of care, and across geography. Patients often navigate this landscape sequentially, losing time at each step.

The Nairobi model attempts to reverse that fragmentation.Rather than importing solutions, the process is city-led. Institutions commit to reform, bringing both intent and accountability.“C/Can doesn’t choose cities; cities apply,” Boatman explains. “It’s about the willingness and capacity to drive meaningful change.”That principle matters. In global health, pilot projects are abundant; sustained system reform isnot. Nairobi’s effort is, in part, an attempt to close that gap.Where the system breaksThe most critical failure point remains at the beginning of the clinical pathway.“Early diagnosis is still a major challenge,” Boatman says.Primary care, where symptoms are first recognised, or missed, remains underpowered.Screening is inconsistent. Referral pathways are often slow or unclear. By the time patients reach specialist care, the disease has progressed.But the barriers are not purely clinical.In many households, health-seeking behaviour is mediated by social dynamics.

Decisions about when, or whether to seek care, may rest with spouses or older family members. This complicates traditional public health messaging.“It’s not just about targeting women,” Boatman notes. “Awareness has to extend to the entire family.”The promise and limits of technologyDigital health is increasingly positioned as a solution, a way to connect fragmented services, track patients, and improve decision-making.But its impact, experts caution, depends on integration.“Digital tools cannot sit in isolation,” Boatman says. “They must run across the continuum of care, from screening to diagnosis to treatment, if they are to deliver real patient benefit.”Kenya has signalled ambition in this space, but execution remains uneven.

Without system-wide adoption, technology risks becoming another layer rather than a unifying thread.A window for reformThere are, however, signs of momentum.Kenya’s National Cancer Control Strategy is aligning with global frameworks, while newpartnerships are emerging to strengthen workforce capacity and research. Training programmesare expanding the pool of skilled professionals, a critical constraint in oncology care.There is also a perceptible shift in policy tone.“The environment is evolving,” Boatman says. “There is increasing space for collaboration,including private sector engagement. That’s essential for sustainability.”Programmes such as Afya Dada — focused on women’s cancer detection and care — areattempting to bridge the gap between community awareness and clinical services, linking demand creation with system capacity.Through initiatives linked to the World Economic Forum, programmes such as Afya Dada are testing integrated models that combine awareness, training, screening, and monitoring in counties such as Uasin Gishu and Machakos.The stakesThe trajectory is not yet fixed.If current gaps persist, the clinical picture is clear: continued late-stage diagnoses, rising treatment costs, and preventable mortality. In public health terms, the system risks being overwhelmed by a burden it already struggles to manage.But there is an alternative pathway.If early detection improves, if primary care is strengthened, if coordination replaces fragmentation, Nairobi could begin to bend the curve, not through breakthrough therapies, butthrough better use of what already exists.For now, the work remains incremental. Plans are in place. Systems are being tested.Outcomes are still emerging.The question, as the conversations at the World Health Summit Regional Meeting fade, iswhether this moment of alignment can translate into measurable change.In cancer care, timing is everything.For Nairobi’s patients, it may determine not just how they are treated, but whether they arrive in time to be treated at all.