TASK PACT: a framework for exploring opportunities to expand pharmacists’ roles in supporting equitable cancer control in low-income countries in sub-Saharan Africa

Cancer is a complex global health issue that continues to overburden healthcare systems worldwide. Estimates suggest that the burden of cancer will double in the next decade, further straining healthcare systems if effective interventions are not scaled up. One critical barrier to scaling up cancer interventions is the shortage of the cancer workforce, which is particularly severe in low- and middle-income countries (LMICs) in sub-Saharan Africa, many of which do not have a single oncologist. Task shifting offers a potential strategy to expand the cancer workforce. However, there is limited evidence on task shifting to advanced clinical professionals, such as pharmacists, who could help improve access to cancer control services. Pharmacists are integral members of the healthcare team and possess advanced clinical knowledge that can be leveraged to enhance cancer care. In many LMICs, pharmacists serve as the first point of contact for health complaints and minor ailments, positioning them to aid in early diagnosis and intervention for cancer.The objective of this study is to develop a conceptual framework, TASK PACT (Task Shifting Concepts for Pharmacists to Advance Cancer Control and Treatment), to systematically assess the feasibility of task shifting selected cancer control services to pharmacists. The framework was developed through an integrative review of the literature on task shifting, and is grounded in a synthesis of intellectual capital, organizational readiness for change, motivation, and change theories, and the theoretical domains framework. It provides a structured approach to explore the perspectives of pharmacists, oncologists, policymakers, and patients regarding the acceptability, readiness, and practical implementation of expanding pharmacists' roles in cancer control.The TASK PACT framework could serve as a practical tool for research that informs policy, guides implementation research, and supports the design of scalable, context-specific collaborative models of cancer care in sub-Saharan Africa. Its application could strengthen the oncology workforce, improve access to cancer control services, and generate evidence to inform broader health system strategies in LMICs.