Cancer is rising as a global health challenge, but political attention and financing remain uneven. A recent analysis published in The Lancet Global Health examines why oncology still lacks the coordination, financing and shared narrative that have supported other global health priorities. Cancer receives less than 2% of development assistance for health despite causing more deaths annually than HIV/AIDS, tuberculosis and malaria combined. Its care pathway spans prevention, diagnosis, surgery, radiotherapy, medicines, palliative care and survivorship support, making global prioritisation difficult across diverse health systems.
Fragmented Leadership Limits Global Momentum
Global oncology contains a growing number of organisations, initiatives and partnerships, but coordination remains limited. Professional societies, including the Union for International Cancer Control, the American Society of Clinical Oncology and the European Society for Medical Oncology, contribute to agenda setting, access initiatives, global networks and normative frameworks. The Global Initiative for Childhood Cancer, the Global Strategy to Eliminate Cervical Cancer, City Cancer Challenge and the Access to Oncology Medicines coalition also form part of the international landscape. The International Atomic Energy Agency supports radiotherapy and imaging infrastructure and training, while the International Agency for Research on Cancer contributes evidence generation.
This activity has not produced a single clear governance platform for cancer. Organisations often operate in siloes, with initiatives centred on particular cancers, interventions or delivery models. The World Health Organization has a mandate relevant to global oncology, especially after the 2017 World Health Assembly resolution on cancer, but limited autonomy, financing, internal siloes and competing priorities restrict its overall capacity to lead. Civil society mobilisation is also fragmented and disease-specific when compared with HIV/AIDS and tuberculosis. High-profile advocacy can increase visibility, but episodic attention does not create sustained political pressure across the wider cancer agenda. The result is a crowded field with many active contributors but limited collective direction.
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Narrow Agendas Shape Cancer Investment
Cancer struggles to fit global health models built around discrete, low-cost and easily measurable interventions. Affordability and access to cancer medicines dominate much of the global discourse, while earlier framings treated cancer as a systemic challenge requiring investment across the full care continuum. Surgery and radiotherapy face particular difficulty because they depend on infrastructure, specialist workforce, referral pathways and long-term health system capacity. Cost-effective modalities can remain marginal when countries lack the resources needed to implement and sustain them. Cancer priorities also tend to cluster around breast, cervical and childhood cancers, even where other cancers account for a larger share of premature death.
Commercial influence also shapes the cancer policy space. Pharmaceutical companies, device manufacturers, academic publishers, data analytics actors and industries linked to tobacco and food all appear in the wider global oncology environment. Public–private partnerships can expand short-term access and mobilise resources, but they can also structure solutions around commercially acceptable interventions. Donor preferences further narrow priorities. Funding often gravitates towards interventions that deliver immediate and quantifiable results, including vaccines, screening or treatment using inexpensive medicines. Cervical cancer and childhood cancer have gained momentum partly because their interventions align more easily with existing institutional structures, major funding and vertical delivery models.
System Needs Clash with Short-Term Policy Logics
Cancer care requires mature and sustained systems. Diagnosis, pathology, surgery, radiotherapy, medicines, data systems, survivorship and palliation must function together over time. The chronic nature of many cancers, with recurrence, relapse and progression, creates needs that extend beyond one-off interventions. This complexity contrasts with global health approaches that favour rapid delivery, visible outputs and short-term returns. It also makes cancer less politically urgent than infectious diseases, which gain attention because transmissibility can create risks across borders. Cancer rarely carries the same transnational threat framing, even though care increasingly crosses borders when patients travel for treatment.
Data gaps weaken prioritisation further. Many countries lack cancer registries and context-specific national cancer control plans. Screening data can count tests without tracking positive results or subsequent care. Limited information on incidence, stage at diagnosis, survival and treatment access makes planning harder and constrains resource mobilisation. Cancer also lacks dedicated Sustainable Development Goal indicators and comparable global financing mechanisms. World Health Assembly resolutions and UN High-Level Meetings have symbolic value, yet limited accountability and financing allow momentum to dissipate. Without a unified platform, clear indicators, sustained financing and stronger domestic resource mobilisation, global oncology remains vulnerable to fragmented action and shifting political attention. Prioritisation frameworks that favour short-term cost-effectiveness can further disadvantage investments whose benefits depend on long time horizons.
Cancer has gained visibility as its burden grows, but visibility has not translated into coherent global priority. Fragmented leadership, narrow intervention agendas, commercial influence, donor preferences, limited data and weak financing all constrain progress. The strongest momentum appears where cancer priorities align with existing institutional structures, measurable interventions and focused advocacy. A more coherent response depends on better coordination across institutions, financing that supports health system capacity, stronger domestic resource mobilisation and strategies that reflect national epidemiology, infrastructure and fiscal realities.
Source: The Lancet Global Health
Image Credit: iStock
References:
Jenei K, El Bairi K, Parkes J et al. (2026) Factors shaping the priority of cancer in global health: a qualitative policy analysis. The Lancet Global Health: 14.
