**Cancer and COVID-19: Global Perspective on Pandemic Impacts (Malawi Context)** [Watch the talk here][1] [Presentation slides available here][2] Dr Jonathan Chiwanda is the National Cancer Program manager for the Ministry of Health in Malawi. In his talk, he gives an overview how the COVID-19 pandemic has impacted cancer care in Malawi. - Malawi is classed as a LMIC (low and middle income country) with a population of 19.6 million. Whilst the information discussed here is specific to Malawi, some themes are generalizable to other LMICs. - Cancer contributes to 47.7% of non-communicable disease premature deaths in Malawi, with the most common cancers including cervical cancer, Kaposi's sarcoma and oesophageal cancer. - In March 2020, Malawi launched its first national cancer strategy: a ten-year plan focused on building a national radiotherapy centreand developing a comprehensive cancer control program involving cancer prevention, screening, diagnosis, research and both curative and palliative management. The same month a national state of emergency was declared in response to the COVID-19 pandemic. - Malawi closed schools and limited public gatherings to restrict COVID-19 spread almost two weeks before the country’s first confirmed case on April 2nd 2020. - As of October 17th 2020, the country has seen 5852 confirmed cases and 181 deaths (3%). The mortality rate was higher in males (3.48%) than in females (2.27%) and was also higher in those of aged over 40, similar to trends observed in the UK. - The majority (93%) of patients diagnosed with COVID-19 did not have any comorbid illnesses. Cancer was not a common co-morbidity and it has subsequently been difficult to characterise COVID-19 outcomes in cancer patients in Malawi. - As healthcare resources were diverted to deal with the emerging pandemic, routine cancer care and cancer research were downscaled in Malawi. In particular, implementation the country’s national cancer strategy was affected, with screening services reduced, outreach programmes suspended and commission of the national radiotherapy centre delayed. - Use of herbal remedies as COVID-19 prophylaxis and treatment has been seen across Malawi. The potential for these remedies to interact with on-going cancer treatment, or indeed to be carcinogenic themselves, is unknown. - Within Malawi’s population, there has been resistance towards measures implemented to control the pandemic. There are concerns this will impact the way communities relate to healthcare and mean people become less inclined to visit hospital. In terms of cancer care, this could potentially result in reduced screening attendance, delayed diagnosis and poor engagement with treatment, ultimately resulting in lower cancer survival rates in the country. [1]: https://osf.io/4kdp8/ [2]: https://osf.io/fjm6c/