WCBIP 2026 · Melbourne · 6 December 2026

Bridging the Gap

Access to Innovation in Interventional Pulmonology and Lung Cancer Care Across Africa

Innovation or Inequality: The Global Economics of Interventional Pulmonology

Dr Lamya CHRIF MORAND

Interventional Pulmonology Unit

International Hospital Kenitra

Ibn Tofail University, Kenitra, Morocco

lamya.chrif1@uit.ac.ma

Disclosure: no relevant financial relationship.

Good morning, everyone. First, I would like to thank the organizers for inviting me to contribute to this important discussion on the global economics of interventional pulmonology. Today, I have the privilege of bringing an African perspective to this conversation. When we talk about innovation in interventional pulmonology, we often focus on what technology can achieve: smaller nodules, better navigation, more accurate biopsies, and increasingly sophisticated diagnostic tools. But today, I would like to take you to a different reality. Imagine a patient with lung cancer who has never had access to screening. A patient whose symptoms were initially considered benign, whose CT scan was delayed, and who had to travel hundreds of kilometers to obtain a biopsy. By the time the diagnosis is finally established, the opportunity for curative treatment may already have been lost. This is not simply a question of technology. It is a question of access, organization, healthcare economics, and ultimately, equity. Coming from Morocco, and working closely with colleagues across Africa, I have seen how much progress is possible when expertise, technology, and institutional commitment come together. But I have also seen how difficult it can be to translate innovation into real access for patients. So today, I would like to focus on three questions. Why are so many opportunities for early lung cancer diagnosis missed? How can interventional pulmonology help close the diagnostic gap? And perhaps most importantly, how can we make these advances accessible and sustainable across African healthcare systems? ---- TO CONFIRM: slot length (script: 18 minutes). TO CONFIRM: the WCBIP 2026 logo on the cover is the official lockup published on wcbip2026.com (og:image, 1172 px); replace it with the speaker kit version if the PCO supplies one. TO CONFIRM with Lamya before release: the disclosure "no relevant financial relationship", no off label use, and the exact wording required by WCBIP 2026 (not published; ATS wording used).

Lung Cancer in Africa: The Burden Behind the Numbers

8,825

estimated new lung cancer cases

Morocco fact sheet: International Agency for Research on Cancer. Global Cancer Observatory, GLOBOCAN 2022 (fact sheet v1.1).

IARC, World Health Organization, Global Cancer Observatory, Cancer Today GLOBOCAN 2022: Morocco

7,970

estimated lung cancer deaths

The leading cause of cancer death in Morocco. Outcomes improve long before treatment.

2

Lung cancer remains one of the greatest challenges in cancer care worldwide. But the burden becomes particularly concerning when we look at healthcare systems where access to early detection and specialized diagnosis remains limited. Let me begin with Morocco, as an example of the challenges we face in Africa. According to GLOBOCAN 2022, Morocco had an estimated 8,825 new lung cancer cases and 7,970 lung cancer deaths. Lung cancer is the leading cause of cancer-related mortality in the country. These figures are alarming. But what concerns me even more is what happens before the diagnosis is established. Are patients being detected early enough? Are they referred to the appropriate specialist? Can they access a diagnostic biopsy? And when a suspicious nodule is discovered, do we have the resources to investigate it without unnecessary delay? Because improving lung cancer outcomes begins long before treatment. It begins with access to early detection and an efficient diagnostic pathway. Reference: IARC, GLOBOCAN 2022 — Morocco. ---- Verified 2026-11-14: 8,825 new cases and 7,970 deaths, GLOBOCAN 2022 (v1.1) Morocco fact sheet, p.2; lung cancer ranks first for cancer deaths, p.1 (research/sources/FACTCHECK.md). The live IARC site now serves GLOBOCAN 2024 (6,101 cases, 5,763 deaths): the slide cites the 2022 edition explicitly. The band on the navy pane is the header of the official GLOBOCAN 2022 Morocco fact sheet (IARC, archived copy).

Too Many Patients, Too Late

Article capture: Pan African Medical Journal 2022, Clinical and histopathological pattern of lung cancer in Morocco, Erefai O, Soulaymani A, Mokhtari A, Hami H, doi 10.11604/pamj.2022.42.283.35593

Erefai O, et al. Pan Afr Med J. 2022;42:283. doi:10.11604/pamj.2022.42.283.35593

Article capture: BJC Reports 2026, A comprehensive analysis of lung cancer status changes over 10 years: results of Moroccan cohort, Tafenzi HA, AIT Takniouine Y, Essadi I, Belbaraka R, doi 10.1038/s44276-026-00245-7

Tafenzi HA, et al. BJC Rep. 2026;4(1):45. doi:10.1038/s44276-026-00245-7

79.55%

at stage IV: 606 patients, two university hospitals in Rabat

72%

metastatic: 949 of 1,320 staged patients, Marrakech

Why so late?

Late consultation

Limited imaging

Few trained bronchoscopists

Costly tissue diagnosis

►

Late diagnosis

3

The second major challenge is the stage at which patients are diagnosed. In a Moroccan hospital-based study published by Erefai and colleagues in 2022, almost 80% of patients were diagnosed at stage IV. A more recent cohort from Marrakech, including over 1,300 patients, reported that approximately 72% of patients with documented staging had metastatic disease. These are different hospital populations, and they should not be interpreted as national estimates. Nevertheless, they reveal a deeply concerning pattern. A large proportion of patients are entering the lung cancer pathway when their disease is already advanced. At that point, many opportunities for curative treatment have been lost. And this raises an essential question. Why are we diagnosing so many patients so late? Is it because patients consult late? Because access to imaging is limited? Because there are not enough trained bronchoscopists? Or because obtaining a tissue diagnosis is too expensive or too complicated? The answer is probably not one single barrier. It is the accumulation of barriers throughout the diagnostic pathway. References: Erefai et al., Pan African Medical Journal, 2022; Moroccan lung cancer cohort, BJC Reports, 2026. ---- Verified 2026-11-14: 79.55% at stage IV, 606 patients, Ibn Sina and Moulay Youssef university hospitals, Rabat, diagnosed 2014 to 2017 (Erefai, PAMJ, abstract and Results); 72% metastatic = 949 of the 1,320 patients with a documented stage, cohort of 1,369, Marrakech, 2013 to 2022 (Tafenzi, BJC Rep, p.1). Changed 2026-11-14 (voice note): the line "Hospital cohorts, not national estimates" left the slide (it is said in the speech); the four questions of the speech are the four boxes of the diagram. Changed 2026-11-14 (review P1-1): the article headers are cropped to journal and title and shown 480 px wide; the takeaway line "Not one barrier: barriers add up along the diagnostic pathway" left the slide for room (it is said in the speech). Changed 2026-11-15 (Lamya's rule): each cited article is one capture of the original (journal, title, authors, DOI); no reference line under the slide for it (the citation stays in a hidden source line of the capture, for the lint and the alt text).

123 Days: Where Are We Losing Time?

Article capture: Clinical Epidemiology and Global Health 16 (2022) 101105, Diagnostic delay in lung cancer in Morocco: a 4 year retrospective study, Erefai O, Soulaymani A, Mokhtari A, Obtel M, Hami H, doi 10.1016/j.cegh.2022.101105

Erefai O, et al. Clin Epidemiol Glob Health. 2022;16:101105. doi:10.1016/j.cegh.2022.101105

123 days

median, first symptom to diagnosis: 81 patients, Rabat

81.82% with a delayed total time

75 days

8 days

21 days

First consultation

Referral

Imaging

Biopsy access

Pathology

▲ ▲ ▲

No patient should wait weeks for a technique or an operator.

Interventional pulmonology

Arrows: where interventional pulmonology shortens the delay.

Intervals: medians of the study. Arrows: speaker's synthesis.

4

One of the most revealing Moroccan studies was published by Erefai and colleagues in 2022. In this retrospective study of 81 patients, the median interval between the first symptoms and histological diagnosis was 123 days. Four months. Four months between the moment a patient first experiences symptoms and the moment we finally establish the diagnosis. The study also identified delays at different stages of the pathway, including the time before the first medical consultation, referral to a specialist, and diagnostic confirmation. This is particularly important because it demonstrates that delayed diagnosis is not simply a patient-related issue. It is also a healthcare organization issue. We need to improve symptom recognition and referral, but we also need faster access to diagnostic procedures. And this is precisely where interventional pulmonology becomes essential. Because when a suspicious lesion has been identified, the patient should not have to wait weeks simply because an appropriate biopsy technique or a trained operator is unavailable. Reference: Erefai et al. Diagnostic delay in lung cancer in Morocco: A 4-year retrospective study. Clinical Epidemiology and Global Health, 2022. ---- Verified 2026-11-14 (full text): 123 days median, IQI 63 to 202, and 81.82% of patients with a delayed total time (p.4); 81 patients, Moulay Youssef University Hospital, Rabat, 2014 to 2017; interval medians 75 days (first symptom to first contact with a GP), 8 days (GP to first specialist visit), 21 days (specialist visit to diagnosis), p.2 to p.4 and Fig. 1. TO CONFIRM: the diagram is the speaker's synthesis, not a result of the study: interventional pulmonology acts on referral, biopsy access and pathology (adequate sample); first consultation and imaging are outside its reach. Changed 2026-11-14 (review P1-1): the article header is cropped to journal and title and shown 420 px wide, the title on two lines; the delay factors run across the full slide width. Changed 2026-11-15 (Lamya's rule): each cited article is one capture of the original (journal, title, authors, DOI); no reference line under the slide for it (the citation stays in a hidden source line of the capture, for the lint and the alt text).

The Missing Workforce: Who Will Perform the Biopsy?

Between lesion and diagnosis, someone has to take the sample.
Not every lesion is reachable by conventional bronchoscopy.
Expertise is uneven, concentrated in a few referral centres.
The result: waiting, travel, cost and delay.

Building the IP workforce is early lung cancer care.

Linear EBUS frame: needle inside a mediastinal lymph node

Linear EBUS: needle inside a mediastinal node.

Image: Interventional Pulmonology Unit, International Hospital Kenitra, clinical case series 2025. Anonymised, device banner removed.

5

Now, I would like to focus on an obstacle that is particularly important to our specialty. The shortage of trained interventional pulmonologists. When we discuss lung cancer diagnosis, we often focus on CT scanners, pathology, or molecular testing. But there is a critical step between detecting a suspicious lesion and obtaining a diagnosis. Someone has to perform the biopsy. And not every lesion can be approached using conventional bronchoscopy. Mediastinal lymph nodes may require EBUS. Peripheral pulmonary nodules may require radial EBUS, navigation bronchoscopy, image-guided sampling, or transthoracic biopsy. These procedures require trained operators and dedicated teams. Across Africa, access to such expertise is uneven, and in some settings, highly specialized procedures are concentrated in a small number of referral centers. The result can be long waiting times, additional travel, increased costs, and delayed diagnosis. We need to recognize that building the interventional pulmonology workforce is not simply an educational objective. It is an essential component of improving early lung cancer care. ---- TO VERIFY: consent and origin of the EBUS image (cropped from the 2025-06-20 EBUS-TBNA clinical cases deck: patient fields and scope model removed).

The Technology Gap: Innovation Exists,
Access Does Not

Article capture: J Thorac Oncol 2026;21(5):103561, Lung Cancer in Morocco, Tafenzi HA, Essadi I, Belbaraka R, doi 10.1016/j.jtho.2026.103561

Tafenzi HA, et al. J Thorac Oncol. 2026;21(5):103561. doi:10.1016/j.jtho.2026.103561

Scientific progress does not automatically translate into equitable clinical access.

Access in Morocco

A handful

of university and military hospitals and a few private clinics perform CT guided and endobronchial biopsy

2 to 4 weeks

public CT appointment, down from 1 to 6 months

6 to 9 months

PET/CT wait for uninsured patients on subsidised public slots

We need accessible, functional, and sustainable diagnostic capacity.

6

Today, the technological capabilities of interventional pulmonology are remarkable. We can stage the mediastinum using EBUS-TBNA. We can approach peripheral pulmonary nodules using radial EBUS, navigation bronchoscopy, and cone-beam CT. We can obtain additional tissue in selected situations using cryobiopsy. But the question is: how widely are these techniques available to African patients? The recent review on lung cancer in Morocco, published in the Journal of Thoracic Oncology in 2026, describes the concentration of specialized biopsy services, limitations in pathology workflows, unequal access to molecular testing, and persistent financial barriers. This illustrates a fundamental problem. Scientific progress does not automatically translate into equitable clinical access. And we should be careful not to confuse innovation with the acquisition of expensive equipment. A hospital may purchase an advanced system, but without maintenance, consumables, technical support, and trained staff, the technology may remain underused. What we need is not simply more technology. We need accessible, functional, and sustainable diagnostic capacity. Reference: Tafenzi et al. Lung Cancer in Morocco. Journal of Thoracic Oncology, 2026. ---- Figures (Tafenzi JTO full text, checked 2026-11-14): p.3, CT guided and endobronchial biopsy "confined to a handful of university and military hospitals and a few private clinics"; p.6, non urgent contrast CT in the public sector "traditionally carried appointment windows of 1 to 6 months. Recent optimizations have reduced this interval to 2 to 4 weeks"; p.6, "Uninsured patients reliant on subsidized public slots endure waits of 6 to 9 months" for PET/CT. Changed 2026-11-14 (voice note): the techniques table left the slide; the two key phrases of the speech are on it. Changed 2026-11-15 (Lamya's rule): each cited article is one capture of the original (journal, title, authors, DOI); no reference line under the slide for it (the citation stays in a hidden source line of the capture, for the lint and the alt text).

The Training Gap: Equipment Is Not Expertise

Not learned by watching: simulation, supervision, assessment, mentorship.
Training abroad costs travel, money and time away from patients.
Break the cycle: regional centres, certification, partnerships.

Equipment without training is not sustainable innovation.

Hands on CryoEBUS training.

Photo: hands on CryoEBUS course, 2025. Name on the scrubs and device brand blurred.

7

There is another barrier that is sometimes underestimated: the lack of structured training opportunities. Advanced bronchoscopy cannot be learned through observation alone. It requires simulation, supervised clinical experience, competency assessment, and continuous mentorship. Yet access to these opportunities remains unequal. For many African physicians, advanced training may require international travel, personal financial investment, and time away from their clinical practice. This creates a cycle of dependence. Hospitals cannot develop advanced services because they lack trained operators, while physicians cannot acquire experience because the necessary equipment and training environments are unavailable. We need to break this cycle. We need regional training centers, accessible simulation programs, standardized competency-based certification, and long-term international partnerships. And training must include the entire multidisciplinary team. Investing in equipment without investing in training is not sustainable innovation. ---- TO VERIFY: consent of the people in the training photo (from the closing collage of the 2025-02 Bronchus deck; tutor name and scope brand blurred).

When Diagnosis Is Not Reimbursed

Available

A suspicious lesion, EBUS indicated
The equipment is in the hospital
A trained bronchoscopist on site

Tafenzi HA, et al. J Thorac Oncol. 2026;21(5):103561. doi:10.1016/j.jtho.2026.103561

Accessible?

Fragmented reimbursement, out of pocket costs
Imaging, immunohistochemistry, molecular tests
Repeated visits, travel to centres

Availability is not accessibility. Accessibility without affordability is not equity.

8

Even when the expertise and equipment are available, another barrier remains. The financial barrier. A patient may have a suspicious pulmonary lesion. An EBUS procedure may be clearly indicated. The hospital may have the equipment, and a trained bronchoscopist may be available. But if the procedure is not adequately reimbursed, the patient may still be unable to access it. The 2026 Journal of Thoracic Oncology review on Morocco highlights fragmented reimbursement mechanisms, high out-of-pocket costs, and inequalities in access to advanced diagnostics. And the cost of the diagnostic pathway does not stop at the biopsy. Patients may also need imaging, immunohistochemistry, molecular testing, repeated consultations, and transportation to specialized centers. For some families, these expenses represent a major financial burden. This is why we must advocate not only for access to equipment but also for reimbursement policies that recognize advanced diagnostic procedures as essential components of lung cancer care. Availability is not accessibility. And accessibility without affordability is not equity. Reference: Tafenzi et al. Lung Cancer in Morocco. Journal of Thoracic Oncology, 2026. ---- No economic amount in Tafenzi JTO (checked full text): no price for EBUS, biopsy, CT, PET/CT, immunohistochemistry or molecular tests, and no reimbursement rate; costs are described in words only (p.3, p.5, p.6, p.12, p.14, p.15). Changed 2026-11-15 (Lamya's rule, one capture per cited article): the slide shows the JTO capture; the Pan-African reimbursement figures (6.1% full, 18.2% none) moved to slide 11, which shows the survey capture (no room here for a second capture of 400 px). The costs listed on the navy side are all in the JTO full text (imaging p.6, immunohistochemistry and molecular tests p.5, travel p.14), so the former "speaker's synthesis" note is dropped.

The Tissue Gap: From Diagnosis to Precision Oncology

Tafenzi HA, et al. BJC Rep. 2026;4(1):45. doi:10.1038/s44276-026-00245-7

Tested for biomarkers, 2013 to 2022

6%

EGFR

4.4%

ALK

5%

PD-L1

ROSE smear, adenocarcinoma cluster. One adequate sample serves diagnosis, staging and biomarkers.

ROSE smear: courtesy of Dr Amal HARMOUCH.

Diagnostic procedure: the gateway to personalised treatment.

9

Today, obtaining a diagnosis of lung cancer is no longer enough. We need to identify the histological subtype, establish the stage, and obtain sufficient material for molecular profiling. But what happens when the first biopsy is insufficient? What happens when EBUS is unavailable, when peripheral lesions cannot be sampled safely, or when molecular testing is not accessible? The patient may need another procedure, another referral, and another period of waiting. A Moroccan cohort published in 2026, covering patients treated between 2013 and 2022, reported very low rates of biomarker testing. These figures reflect a historical cohort and should not be interpreted as the current national situation. Nevertheless, they demonstrate how diagnostic limitations can affect access to precision oncology. For us, as interventional pulmonologists, this means that the quality of tissue acquisition is becoming increasingly important. We should aim not simply to obtain a positive biopsy, but to obtain an adequate sample that supports diagnosis, staging, and appropriate biomarker testing. The diagnostic procedure is the gateway to personalized treatment. Reference: A comprehensive analysis of lung cancer status changes over 10 years: results of Moroccan cohort. BJC Reports, 2026. ---- TO VERIFY: permission of Dr Amal HARMOUCH for the ROSE image (credited to her in the 2025-06-20 EBUS-TBNA clinical cases deck). Verified 2026-11-14: "Molecular testing was limited to EGFR in 6% of cases, ALK in 4.4%, and PD-L1 in 5%" (BJC Rep abstract, p.1; whole cohort of 1,369). Not shown on purpose: the NSCLC subgroup (EGFR 8%, ALK 5.8%, p.5) and the PD-L1 split (internally inconsistent in the paper). Changed 2026-11-15 (Lamya's rule): each cited article is one capture of the original (journal, title, authors, DOI); no reference line under the slide for it (the citation stays in a hidden source line of the capture, for the lint and the alt text). The takeaway moved under the picture.

What Our Pan-African Survey Can Teach Us

Figure 1: map of Africa, the 16 respondent countries in the five subregions

51

IPs

16

countries

5

subregions

Article capture: Journal of Bronchology and Interventional Pulmonology 33(4), October 2026, The First Pan-African Survey of Interventional Pulmonology: Current Practice, Training Gaps, and Barriers, Chrif Morand L, et al., doi 10.1097/LBR.0000000000001087

Chrif Morand L, et al. J Bronchology Interv Pulmonol. 2026;33(4):e01087. doi:10.1097/LBR.0000000000001087

What is missing

25 of 51

respondents have a dedicated IP unit at their institutionNorth 75.0%, West 33.3%, East 12.5%, Central 0.0%, South 100.0%

49.0%

of respondents have no structured IP training

56.0%

cited lack of equipment

40.0%

cited high cost of equipment, procedures

36.0%

cited lack of training

We cannot close a gap that we have not measured.

Units and training: 51 respondents. Barriers: 50 respondents, multiple mentions.

10

To address these inequalities, we first need to understand them. This was one of the motivations behind our first Pan-African Survey of Interventional Pulmonology. We collected responses from 51 interventional pulmonologists across 16 African countries, representing five geographical subregions. This initiative represents an important first step toward mapping the practice of interventional pulmonology across the continent. But we need to go further. We need reliable information about the distribution of trained bronchoscopists, access to EBUS and peripheral nodule sampling, availability of structured training, and the financial barriers faced by patients and healthcare institutions. Without these data, it is difficult to develop effective policies or evaluate progress. Our survey is not a complete representation of the continent, but it offers a starting point for collaboration and future research. We cannot close a gap that we have not properly measured. Reference: First Pan-African Survey of Interventional Pulmonology, 2026. ---- Published: Chrif Morand L, Fdil S, Graham A, Mekhaiel E, Mbaye FBR, Kagima JW, Hussein SA. The First Pan-African Survey of Interventional Pulmonology: Current Practice, Training Gaps, and Barriers. J Bronchology Interv Pulmonol. 2026;33(4):e01087. doi:10.1097/LBR.0000000000001087 (header captured from the publisher page). TO VERIFY: the figures against the published full text (paywalled); the slide uses the manuscript v3 pages. Figures (manuscript): dedicated IP unit 49.0% of 51 respondents; Northern 75.0%, Western 33.3%, Eastern 12.5%, Central 0.0%, Southern 100.0% (Table 1, p.7; Central n = 5 and Southern n = 2 are exploratory, p.6); no structured training 49.0% (p.8); barriers among 50 respondents, multiple mentions counted: lack of equipment 56.0%, high cost of equipment or procedures 40.0%, lack of training 36.0% (Table 3, p.9). The abstract's 34.0% is the primary barrier, not the share of mentions: the slide says "cited". Map: Figure 1, p.6. Changed 2026-11-14 (review): the unit line reads "25 of 51" so that 49.0% appears once (no structured training); the map moved to the navy pane; the header is cropped to journal and title, 440 px wide. Changed 2026-11-15 (Lamya's rule): each cited article is one capture of the original (journal, title, authors, DOI); no reference line under the slide for it (the citation stays in a hidden source line of the capture, for the lint and the alt text).

Pan-African Survey: More Key Data

Chrif Morand L, et al. J Bronchology Interv Pulmonol. 2026;33(4):e01087. doi:10.1097/LBR.0000000000001087

Table 1: regional distribution of respondents and institutional interventional pulmonology capacity

Table 1: dedicated IP units by subregion, 49.0% overall.

84.6%

of the trained IPs were trained outside Africa

62.7%

rate junior doctor training insufficient or nonexistent

6.1%

report full reimbursement of IP procedures; 18.2% none

98%

rate local demand for IP medium to very high

Table 1 and junior training: 51 respondents. Trained abroad: 26 with structured training. Reimbursement and demand: denominator not reported in the article.

11

NEW SLIDE: no script text, to validate Table 1 shows how unevenly interventional pulmonology units are distributed: 75.0% of respondents in Northern Africa reported a dedicated unit, against 33.3% in Western Africa, 12.5% in Eastern Africa and none in Central Africa. Among the 26 respondents who received structured training, 84.6% were trained in a non-African country. 62.7% of respondents rated the training of junior doctors in interventional pulmonology as either insufficient or non-existent. Only 6.1% of respondents reported full reimbursement for IP procedures, while 18.2% reported no reimbursement at all. These barriers coexist with strong perceived demand: 98% of respondents rated local demand for interventional pulmonology as either medium or very high. ---- TO CONFIRM: this new slide and its notes (built only from the article Results: Table 1 p.7, training p.8 to 9, reimbursement and demand p.9 of manuscript v3), and the time it takes in the 18 minute slot. Caution (article p.6 and p.9 to 10): 47.1% of respondents are from Northern Africa; Central (n = 5) and Southern Africa (n = 2) are exploratory signals, not estimates. Reimbursement figures moved here from slide 8 on 2026-11-15 (one capture per cited article): manuscript p.9, "only 6.1% of respondents reported full reimbursement for IP procedures, while 18.2% reported no reimbursement at all"; reimbursement is national, so indicative only (article p.14). Denominator of 6.1%, 18.2% and 98%: not stated in the article. 6.1% is not a share of 51 (3 of 51 = 5.9%); 3 of 49 gives 6.1% but 18.2% is not a share of 49 (9 of 49 = 18.4%). Both figures, and the 39.4% wait figure of the same block, match 33 respondents (2, 6 and 13 of 33). TO VERIFY with the authors: the number of respondents to the reimbursement item. Changed 2026-11-15 (Lamya's rule): each cited article is one capture of the original (journal, title, authors, DOI); no reference line under the slide for it (the citation stays in a hidden source line of the capture, for the lint and the alt text).

From Barriers to Solutions: Building the African Lung Cancer Diagnostic Pathway

Every patient, the right procedure, without delay.

01

Detection and referral

Screening where feasible, fast nodule work up

02

Essential IP services

EBUS and peripheral lesion sampling

03

Structured training

Simulation, supervision, mentorship

04

Sustainable financing

Reimbursement, consumables, maintenance

05

Integrated pathways

Radiology, pathology, surgery, oncology

06

African collaboration

Regional centres, shared training

12

So, what should our priorities be? First, we must strengthen early detection and referral pathways, including risk-based screening where feasible and rapid investigation of suspicious symptoms or nodules. Second, we need to expand access to essential interventional pulmonology services, particularly EBUS and appropriate peripheral lesion sampling techniques. Third, we must invest in training. Africa needs structured programs combining simulation, supervised clinical practice, competency assessment, and mentorship. Fourth, we need sustainable financing. This means reimbursement of essential diagnostic procedures, reliable access to consumables, and realistic models for equipment maintenance. Fifth, we need integrated multidisciplinary pathways connecting pulmonologists, radiologists, pathologists, thoracic surgeons, and oncologists. And finally, we need stronger African collaboration. Regional centers of expertise, shared training resources, multicenter research, and equitable international partnerships can help us move forward. The objective is not for every hospital to own every advanced technology. The objective is for every patient to have access to the appropriate diagnostic procedure, without unnecessary delay.

Early Lung Cancer Diagnosis Should Not Be a Privilege

It should be a realistic opportunity for every patient.

I would like to conclude with one simple message. We cannot improve lung cancer outcomes without addressing the barriers that prevent early diagnosis. We need more trained bronchoscopists. We need better access to essential diagnostic technologies. We need structured training programs, sustainable financing, and reimbursement mechanisms that make these procedures accessible. And we need healthcare systems that connect early detection to timely diagnosis and appropriate treatment. Africa does not lack talent, commitment, or ambition. What we need is the opportunity to transform that expertise into accessible care. The future of interventional pulmonology should not be measured only by how advanced our technologies become, but by how many patients can actually benefit from them. Because early lung cancer diagnosis should not be a privilege. It should be a realistic opportunity for every patient. Thank you.

Sources

References

1International Agency for Research on Cancer. Morocco fact sheet, GLOBOCAN 2022 (v1.1). Global Cancer Observatory. gco.iarc.who.int
2Erefai, et al. Diagnostic delay in lung cancer in Morocco: a 4 year retrospective study. Clin Epidemiol Glob Health. 2022;16:101105. doi:10.1016/j.cegh.2022.101105
3Erefai, et al. Clinical and histopathological pattern of lung cancer in Morocco. Pan Afr Med J. 2022;42:283. doi:10.11604/pamj.2022.42.283.35593. PMID 36405659.
4Tafenzi, et al. Lung cancer in Morocco. J Thorac Oncol. 2026;21(5):103561. doi:10.1016/j.jtho.2026.103561. PMID 42108075.
5Tafenzi, et al. A comprehensive analysis of lung cancer status changes over 10 years: results of Moroccan cohort. BJC Rep. 2026;4(1):45. doi:10.1038/s44276-026-00245-7. PMID 42706377.
6Chrif Morand L, et al. The First Pan-African Survey of Interventional Pulmonology: Current Practice, Training Gaps, and Barriers. J Bronchology Interv Pulmonol. 2026;33(4):e01087. doi:10.1097/LBR.0000000000001087

14

Thank you

for your attention

#SharingIsGrowing