Closing cancer care gaps in LMICs requires patient-centered systems

By 2030, roughly three-quarters of all cancer deaths will occur in low- and middle-income countries, or LMICs. These countries also shoulder the majority of the global noncommunicable disease, or NCD, burden. NCDs — including cancer, cardiovascular disease, and diabetes — accounted for 75% of all non-pandemic-related deaths in 2021, with 73% of these occurring in LMICs.

A high-level roundtable discussion at the 80th U.N. General Assembly — hosted by Devex in partnership with The Max Foundation — saw global health leaders explore ways multi-sector partnerships can drive long-term health system strengthening in LMICs to help close the cancer and NCD care gap.

“You can say your drugs are available for free, [but there’s] still no access, because you have to put all the other things in place,” Pat Garcia-Gonzalez, cofounder and CEO of The Max Foundation, said, highlighting the difficulty of addressing care gaps. “You have to take a holistic approach. Unless the system is sustainable for the patient and their family, it’s never going to work. We have to think about … how can we all, together, coming from different places, put all the systems in place to overcome all the barriers to make sure every patient can have access.”

Drawing on lessons from successful programs in other disease areas, the discussion highlighted barriers to access in LMICs, practical approaches for building resilient and patient-centered health systems, and opportunities for partnerships that can scale sustainable solutions.

Overcoming barriers with systems thinking and data

Participants underscored the scale of systemic barriers that keep care out of reach. Many of the best medicines are not registered or commercialized in LMICs, while diagnostics remain scarce and underfunded. Patients often encounter stigma, high out-of-pocket costs, and health facilities ill-equipped to meet growing demand.

At a broader level, NCDs and cancer have historically been seen as inevitable rather than prioritized for investment, limiting political momentum. Demonstrating impact through data and cost-effectiveness can shift government buy-in and integrate NCDs into insurance and care frameworks.

Data is only valuable if collected properly, a challenge the global health sector has long struggled with, as one participant noted. Strengthening data systems is critical to demonstrating results and proving the impact of investments which, in turn, is essential for attracting funding and securing government support. And participants emphasized that framing NCDs and cancer as both health and economic priorities is necessary — especially given the trillions in projected costs if current gaps remain unaddressed.

Moving toward patient-centered health systems

Strengthening health systems in LMICs requires a multi-pronged approach, including filling workforce gaps with better-trained professionals and sustainable financing.

Participants noted that even where infrastructure exists, it is often underutilized due to workforce shortages. Sector leaders see an opportunity to integrate NCD care into primary health care systems, supported by “right-on-time” training and the smart use of technology.

At the same time, philanthropy must move away from currently siloed funding structures — where only one disease is addressed at a time, regardless of comorbidities — that undermine patient-centered systems. Funders need to support cross-cutting approaches, allow flexibility, and enable resources to flow down to the community level.

But real progress ultimately comes down to creating patient-centered health systems, which requires “listening to the patients, partnering up with them on the care, and understanding any physical, mental, socio-economic needs that they have,” according to one participant.

Prioritizing partnerships

Multi-sector partnerships emerged as another central theme of the discussion. With global health funding in decline, collaborative approaches that align around country leadership are essential.

Participants emphasized that effective partnerships go beyond simply bringing organizations together — they require well-defined roles, shared goals, a clear definition of success from the outset, and bi-directional learning. Several speakers noted that collaboration across sectors — including governments, NGOs, the private sector, and communities — enables the integration of diverse skills and resources.

The discussion concluded with a clear message: Closing the cancer and NCD care gap in LMICs requires more than resources. It demands shared commitment, integrated systems, and partnerships that put patients at the center of every solution.