Expansion of cancer care and control in countries of low and middle income: a call to action

Lancet. 2010 Oct 2;376(9747):1186-93. doi: 10.1016/S0140-6736(10)61152-X. Epub 2010 Aug 13.


Substantial inequalities exist in cancer survival rates across countries. In addition to prevention of new cancers by reduction of risk factors, strategies are needed to close the gap between developed and developing countries in cancer survival and the effects of the disease on human suffering. We challenge the public health community's assumption that cancers will remain untreated in poor countries, and note the analogy to similarly unfounded arguments from more than a decade ago against provision of HIV treatment. In resource-constrained countries without specialised services, experience has shown that much can be done to prevent and treat cancer by deployment of primary and secondary caregivers, use of off-patent drugs, and application of regional and global mechanisms for financing and procurement. Furthermore, several middle-income countries have included cancer treatment in national health insurance coverage with a focus on people living in poverty. These strategies can reduce costs, increase access to health services, and strengthen health systems to meet the challenge of cancer and other diseases. In 2009, we formed the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, which is composed of leaders from the global health and cancer care communities, and is dedicated to proposal, implementation, and evaluation of strategies to advance this agenda.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antineoplastic Agents / economics*
  • Antineoplastic Agents / therapeutic use*
  • Colombia
  • Developing Countries / economics*
  • Early Detection of Cancer
  • Global Health
  • Haiti
  • Health Policy*
  • Health Services Accessibility / economics*
  • Health Services Accessibility / standards
  • Health Services Accessibility / trends
  • Health Services Needs and Demand
  • Hepatitis B Vaccines / administration & dosage
  • Humans
  • Incidence
  • Income
  • Insurance Coverage
  • Insurance, Health
  • Jordan
  • Malawi
  • Mass Screening
  • Mexico
  • Neoplasms* / diagnosis
  • Neoplasms* / economics
  • Neoplasms* / epidemiology
  • Neoplasms* / mortality
  • Neoplasms* / prevention & control
  • Neoplasms* / therapy
  • Papillomavirus Vaccines / administration & dosage
  • Poverty*
  • Public Health
  • Risk Factors
  • Rwanda
  • Smoking Cessation
  • Socioeconomic Factors


  • Antineoplastic Agents
  • Hepatitis B Vaccines
  • Papillomavirus Vaccines