The Hammamet Declaration (Signed on behalf of the African Oncogenetics Network, Hammamet, Tunisia, November 2, 2025)

The Hammamet Declaration on Oncogenetics in Africa:

African genetic diversity bringing solutions to the growing cancer burden

 

Advancing Cancer Clinical Genetics (Oncogenetics) in Africa

Cancer is rapidly emerging as a critical public health threat in Africa. Current projections estimate that cancer mortality across the continent will double within the next 20 years, driven by demographic shifts, changing lifestyles, environmental exposures, and gaps in healthcare infrastructure. In addition, cancer in African populations often presents with distinct clinical characteristics compared to other regions. In many African countries, cancers are typically diagnosed at more advanced stages. There is also a higher prevalence of infection-related cancers—such as cervical cancer linked to HPV, or liver cancer associated with hepatitis B. Furthermore, cancers in African populations often occur at younger ages and with more aggressive tumor types. These disparities reflect both the continent’s genetic diversity and inequities in healthcare systems, underscoring the urgent need for tailored cancer control strategies—particularly through investment in oncogenetics, the clinical application of genetics to cancer risk assessment, diagnosis, treatment, and prevention.

In most high-income countries, comprehensive oncogenetics is now standard practice. It offers personalized insights that shape clinical decisions, enhance prevention strategies, and guide targeted therapies. In Africa, however, access to these essential services remains extremely limited. Integrating oncogenetics into cancer care is not just an opportunity—it is a necessity for addressing the continent’s rising cancer burden effectively and equitably.

 

The Transformative Potential of Oncogenetics in African Cancer Care

Oncogenetics holds transformative promise across the entire cancer care continuum—from identifying individuals at high risk of hereditary cancers to informing prognosis and guiding therapy through tumor genomic profiling. Embracing oncogenetics is key to addressing several systemic challenges:

• Prevention and Early Detection: Genetic risk assessments allow for targeted screening and prevention among individuals with familial cancer syndromes, such as BRCA1/2 mutations linked to breast, ovarian, prostate, and pancreatic cancers. Identifying common (founder) mutations can make testing more affordable and early intervention more feasible—saving lives and reducing long-term healthcare costs.

• Precision Therapy: Molecular profiling of tumors supports the use of targeted therapies, improving outcomes even in advanced cancers. Without access to oncogenetics, African patients miss out on today’s and tomorrow’s life-saving treatments.

• Population-Specific Research: African populations harbor unique genetic diversity that remains underrepresented in global studies. This data gap undermines the relevance of international genetic tools in African settings and withholds insights that African genetic research could contribute to global knowledge. Strengthening local oncogenetics capacity enables research that is directly relevant to African populations—improving diagnostics, treatment, and understanding of cancer biology. African scientists have already made crucial advances, from BRCA testing programs to population sequencing and innovative solutions tailored to local cancer burdens. The foundation is in place, and African researchers and institutions are poised to lead this transformation.

 

 

Building Future-Ready Technology, Capacity, and Care Pathways

Integrating oncogenetics into African health systems is achievable—even in resource-constrained settings—through strategic investments and coordinated actions:

1. Workforce Development: Building capacity starts with training oncologists, genetic counselors, molecular pathologists, and clinical geneticists. Regional centers of excellence can serve as hubs for education and mentorship. Training programs must also incorporate culturally responsive models of genetic counseling that reflect Africa’s diverse social norms, family structures, and belief systems—rather than replicating Western approaches that may not translate effectively.

2. Technology and Infrastructure: Affordable, scalable sequencing technologies and partnerships with academic institutions can enable local genetic testing. Mobile health (mHealth) tools and digital health records can facilitate data collection and support clinical decision-making.

3. Research Translation and Implementation: Strengthening basic and applied genetics research will generate insights into region-specific genetic variants. Translating these findings into clinical tools—such as locally relevant risk models and diagnostic panels—adds substantial value, particularly when aligned with national health strategies.

4. Policy and Care Pathways: Policies and clinical guidelines for integrating oncogenetics into routine cancer care are essential. This includes establishing referral systems, informed consent processes, genetic counseling protocols, and ethical oversight. Public education and engagement, as well as the inclusion of individuals with lived experience of cancer, must be central to this process.

5. International Collaboration and Advocacy: African expertise must be an equal partner in the global genomics revolution. Advocacy at national and international levels can help mobilize funding, promote equitable data sharing, and ensure African voices shape the global oncogenetics agenda.

 

Why Now?

Oncogenetics has become a routine part of cancer care in many countries, supported by rapidly declining costs and a growing body of evidence demonstrating its clinical value. Meanwhile, Africa’s cancer burden is accelerating. At the same time, the continent is witnessing the emergence of trained scientists, growing biobank networks, and expanding digital infrastructure. These converging factors make this a pivotal moment for African leadership in cancer genetics—an opportunity to drive locally led innovation, with associated gains in job creation and economic growth.

 

Why This Matters for the Future of Health in Africa—and the World

Investing in oncogenetics is more than a technical advancement—it is a moral, scientific, and strategic imperative for African nations. The long-term success of cancer control across the continent depends on the ability to deliver comprehensive, personalized, and equitable care. Oncogenetics bridges science and service, offering tools to understand not only the molecular drivers of cancer, but also the social, familial, and environmental factors that shape its impact.

Moreover, building capacity in cancer genetics can catalyze broader health system transformation. It fosters innovation, strengthens research ecosystems, drives evidence-based policy, and positions Africa as a leader in emerging fields such as precision medicine, bioinformatics, and global health equity. Training a new generation in these fields can fuel public and private innovation and strengthen local economies.

The insights gained from African cancer genetics will benefit not just the continent but the world. Africa’s exceptional genetic and clinical diversity offers critical opportunities to improve cancer prevention, detection, treatment, and care worldwide. Lessons from African-led efforts will also inform oncogenetics implementation in other low-resource settings.

 

We, the undersigned, call for urgent investment in the development of oncogenetics in Africa. The future of cancer care across the continent depends on integrating genetic knowledge at every level of the health system. Let this Declaration be a commitment to act—to train, to build, to research, and to care—so that every African, regardless of geography or means, may benefit from the promise of modern cancer genetics. This vision reflects the expertise and aspirations of African scientists and institutions, grounded in ongoing achievements and united by a shared commitment to equitable, locally driven solutions to cancer.

 

 

On Behalf of the African Oncogenetics Network, Hammamet, Tunisia, November 2, 2025: 

 

 Prisca Adejumo University College Hospital, Ibadan, Nigeria

 Temidayo Fadelu, Dana-Farber Cancer Institute, Boston, USA

 Yosr Hamdi, Institut Pasteur, Tunis, Tunisia

 Wijden Mahfoudh, Université de Tunis, Tunisia

Achille Manirakiza, King Faisal Hospital, Kigali, Rwanda

Rokhaya Ndiaye, Université Chiekh Anta Diop, Dakar, Senegal

 Olufunmilayo Olopade, University of Chicago, Chicago, USA

Timothy R. Rebbeck, Dana-Farber Cancer Institute, Boston, USA

Julie Torode, The Institute of Cancer Policy, King's College London, UK      Mohamed Zahir Alimohamed, Muhimbili University, Dar es Salaam, Tanzania