Published today in Frontiers in Nuclear Medicine : a systematic review quantifying the availability, cost barriers, and economic feasibility of radionuclide therapies across Africa.

The uncomfortable truth: Africa's cancer burden will double by 2040. Lu-177-PSMA — which extends survival in metastatic prostate cancer — is available in 13% of countries. The cost reduction for local production vs. import is 93%. The problem is not science. The problem is procurement.

The uncomfortable journey: This manuscript was rejected by multiple journals. Reviewers called my framing "harsh" for stating that a 23-fold workforce disparity between Africa and North America reflects systemic resource allocation, not natural scarcity. I revised to meet academic norms. The core argument survived but softer than I would have preferred.

The invitation: To every nuclear medicine physician, physicist, and radiopharmacist working in Africa: this paper was written alone because institutional collaboration across continents remains structurally difficult. I want the next one to be written with you. If you have unpublished data, local cost figures, or simply the perspective of someone working in an under-resourced center, your contribution is essential.The full paper is here: [Frontiers in Nuclear Medicine, 2026]