Sub-Saharan Africa is facing a childhood cancer crisis. Annually, nearly 90% of the more than 100 000 children who develop cancer in sub-Saharan Africa die. By contrast, 85% of paediatric patients with cancer survive in high-income countries, where advanced paediatric cancer care is available. Additionally, the burden of paediatric cancer in sub-Saharan Africa is compounded by substantial population growth, which is rapidly increasing the number of patients. The causes of this staggering inequity are multifactorial and include a paucity of paediatric cancer care expertise, inadequate paediatric medical facilities, and a general absence of childhood cancer awareness.