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Seventy percent of cancer deaths occur in low- and middle-income countries, where radiotherapy machines, pathologists, essential medicines and palliative care are scarce. Global oncology works on affordable, adapted care and the systems to deliver it.
The Lancet Oncology Commissions (2010, 2015 radiotherapy GTFRCC, 2020 sustainable care) quantified the gaps: ~28 African countries have no radiotherapy, one pathologist per million people in parts of Africa, and cancer survival for children ~20% versus ~80% in high-income countries. Responses include the WHO Global Initiative for Childhood Cancer (2018, target 60% survival by 2030), the WHO Cervical Cancer Elimination Initiative (2020: 90-70-90 targets), the WHO Global Breast Cancer Initiative, the WHO Essential Medicines List for cancer (updated 2023-25 to include trastuzumab, PD-1 inhibitors), the Access to Oncology Medicines Coalition (ATOM, UICC/2022), pooled procurement (St Jude-WHO Global Platform for childhood cancer medicines, delivering to 50 countries from 2025), differential pricing and generic/biosimilar entry, treatment protocols adapted for resource levels (NCCN Harmonized Guidelines for Africa, SIOP PODC), twinning programmes, telepathology and AI-assisted screening, and workforce training (AORTIC, ASCO International). Rays of Hope (IAEA, 2022) targets radiotherapy expansion. Cancer is increasingly part of universal health coverage debates.
Match the delivery system to the resource level without abandoning evidence: prioritise high-cure, low-cost interventions (cervical screening/vaccination, childhood cancer protocols, essential chemotherapy and surgery, palliative care) while building pathology, radiotherapy and workforce capacity.
Buying power, not new science, is the fastest lever on cancer drug prices in a decentralised, under-funded system. The Grid's model is being extended across its 360-plus centres and offers a template for other middle-income countries and for pooled buying of newer, patented drugs.
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Shares Oncology drug pricing and price transparency, What recovery costs in the rest of the world, Telehealth and hospital-at-home in oncology, Where rehabilitation is commissioned, and who misses out and the tag equity.
Shares V. Shanta, Cancer Institute of Iran, Imam Khomeini Hospital Complex, Kidwai Memorial Institute of Oncology, Dharmais National Cancer Center.
Shares Dharmais National Cancer Center, Institut National d'Oncologie, Rabat, Institut Salah Azaïez, Ocean Road Cancer Institute.
Shares What recovery costs in the rest of the world and the tag equity.
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Shares Cervical cancer, Acute lymphoblastic leukaemia and the tag equity.
Shares Acute lymphoblastic leukaemia and the tag equity.
Shares Devi Shetty, Expanding global access to radiotherapy, A National Cancer Grid pooled procurement initiative, India, The new AIIMS network (PMSSY).