Shaping the Future of Global Oncology: A Call for Innovation, Collaboration, and Equity

On February 23rd I was honoured to speak at the Canadian Global Oncology Network Conference in Montreal.  I was asked to talk about the role of agencies, medical associations and industry in carrying the flag for advancing global health, specifically in the world of cancer care.  The following is a summary of my talk.  Thank you for reading!

In an era defined by global instability, economic constraints, and widening disparities in healthcare, the need for transformative action in oncology has never been greater. The battle against cancer is not confined to high-income nations; it is a global fight that demands innovative, sustainable, and scalable solutions.

The Harsh Reality of Oncology in a Changing World

The world is facing unprecedented challenges. Climate change, geopolitical conflicts, sudden reductions in global aid as announced south of our border, economic crises, and trade and tariff wars are exacerbating existing disparities in healthcare. Low- and middle-income countries (LMICs) bear the brunt of these crises, with rising costs, dwindling resources, and healthcare infrastructure that is often in shambles due to political corruption, armed conflicts and economic instability. The war in Ukraine, ongoing strife in Gaza, and civil 56 (at last count) conflicts worldwide illustrate how fragile healthcare systems can collapse, leaving cancer patients without access to diagnosis or treatment and of course zero attention being paid to prevention.

In conflict zones, hospitals are destroyed, healthcare workers are displaced or killed, and supply chains are disrupted. Even outside of conflict zones, patients in LMICs face catastrophic health expenditures that push them further into poverty, worsened by high inflation and ongoing changes in technology. The stark reality is that delayed or absent cancer treatment significantly increases mortality rates and morbidity during the disease. In many regions, a four-month delay in care can be deadly—what happens when the delays span years?

Canada’s Role: A Moral and Strategic Imperative

Canada has long been a leader in global healthcare partnerships. Our healthcare institutions, research organizations, and public health agencies have the potential to contribute to sustainable cancer care solutions worldwide. However, this requires a shift in how we approach global oncology, moving beyond conventional models of aid to innovative, self-sustaining systems.

1. 

   Strengthening Global Partnerships: Canadian institutions must deepen collaborations with LMICs to co-develop resilient cancer prevention and control systems. These partnerships should not be top-down but rather cooperative efforts where knowledge, resources, and best practices are shared.

2. Innovative and Scalable Solutions: The future of global oncology lies in digital health, telemedicine, mobile clinics, and cross-border care. Technology can bridge gaps in cancer care in conflict zones and remote areas where traditional infrastructure is failing.  Canadian technology innovation is very scalable globally.
3. Sustainable Funding Models: With traditional government funding under pressure, we must explore new funding pathways, including public-private partnerships, corporate social responsibility initiatives, and innovative financing models that ensure equitable resource allocation. Canada must advocate for equitable care offerings using products like the Canadian Strategy for Cancer Control and the focus we have placed on care for our First Nations, Inuit and Metis peoples as an example of equity based care, ensuring that investments are targeted at sustainable solutions.

Who Will Lead the Charge?

Historically, governments have been at the forefront of healthcare funding and policy development. However, in the face of political uncertainty, a move to self protectionism and economic constraints, we must look beyond traditional structures. The future of cancer care equity will rely on a multi-sectoral approach involving:

• Government agencies: Despite funding challenges, national and provincial health authorities still play a vital role in shaping policy and ensuring regulatory frameworks support global initiatives.  Every development project using Canadian dollars should have a health lens attached to it.
• Universities and Hospitals: These institutions have the expertise, data, and training capacity to support workforce development and research partnerships.  They are often funded by federal grants or philanthropy.  A innovative approach to partnering to ensure cash flow needs to be considered.
• Non-Governmental Organizations (NGOs): NGOs can drive grassroots-level change, providing care, advocacy, and policy influence where governments and industry cannot.
• Corporate Sector: While traditionally profit-driven entities, pharmaceutical, biotech, and technology companies must be part of the solution. They often have global readh and efficient and effective processes that the heatlh care system can learn from.  Leveraging industry partnerships to produce affordable medicines, streamline logistics, and develop innovative diagnostics is critical.

The Role of Medical Associations: A Sleeping Giant?

Medical associations, both national and international, are uniquely positioned to drive change in global health care. Their potential, however, remains largely untapped as many times they do not see this as their priority.  Advocacy is often limited to local issues.  Increasingly, whether acting as our union or not, our medical associations are looking down at their toes, rather than up at the horizon and beyond our borders.

• Advocacy for Policy Reform: Organizations like the Canadian Medical Association (CMA) should actively lobby for streamlined regulatory processes to accelerate drug approval and distribution, especially in underserved regions.  They also have a role to play in calling atrocities “NO ZONES”\ in armed conflicts, when they see them happening.  Physicians and nurses, hospitals and community care facilities should never be targets for bombs or guns.
• Capacity Building: Providing training for healthcare workers in LMICs and collaborating with international organizations to develop evidence-based treatment guidelines is critical.  We have to be careful that this does not take a traditional colonial approach of “we know what is best for you, not let us show you”, but rather a learning heatlh system approach where local solutions are sought and celebrated.
• Research and Data Sharing: Facilitating global research collaborations and clinical trials that include diverse patient populations can help identify the most effective and accessible treatments for different regions.  There is a bidirectional share of knowledge and insight here.

Some organizations have already set a precedent:

• American Society of Clinical Oncology’s (ASCO) Global Oncology Leadership Task Force has successfully developed training programs for LMICs.
• The Union for International Cancer Control (UICC) leads the Access to Oncology Medicines Coalition (ATOM), improving access to essential cancer drugs in low-resource settings.

These examples show what is possible when medical associations take an active role in global oncology equity.

The Role of Industry: Beyond Profits, Toward Impact

Industry partners—pharmaceutical companies, biotech firms, and digital health innovators—are often viewed with skepticism in the global health landscape and sometimes for good reasons historicallyt. However, their role in expanding access to affordable and innovative treatments cannot be ignored. And they must be encouraged to think compassionately when considering LMICs, acting more as social enterprises.  They can be both for-profit and not for profit at the same time.  Key strategies include:

• Developing Affordable Medicines: Expanding the production of generic and biosimilar drugs, as seen in successful HIV/AIDS treatment models, could dramatically reduce the cost of cancer treatment worldwide.
• Innovative Pricing Models: Implementing tiered pricing strategies based on a country’s income level ensures that essential cancer medicines remain accessible.
• Technology Transfer and Supply Chain Resilience: Partnering with local manufacturers in LMICs to produce affordable medicines and diagnostics fosters self-sufficiency and reduces dependence on foreign aid.

We need to move away from the traditional view of industry as the antagonist and instead see it as a potential ally in driving sustainable solutions.  We have to move toward partnerships that meed the needs of all, and compromises in traditional funding models to make this happen.

Overcoming Barriers to Cancer Medicines

One of the most pressing challenges in global oncology is the accessibility of cancer medicines. Only 15% of LMICs have comprehensive cancer care services compared to over 90% in high-income countries. The reasons include:

• Limited availability of essential drugs
• High costs due to patent protections
• Regulatory and logistical barriers

The solution? Collaborative strategies such as public-private partnerships (PPPs), streamlined procurement processes, and regional medicine distribution hubs. Successful models already exist, such as:

• The ATOM Coalition in Zambia, which has improved medicine access through sustainable health financing strategies.
• ACS Navigation Programs in Kenya & Uganda, demonstrating the power of patient navigation programs in low-resource settings.

Leveraging Technology & Innovation

The future of oncology will be shaped by digital health solutions, artificial intelligence, and telemedicine innovations that can bridge gaps in care and create more equitable access to treatment.

• AI & Telemedicine: AI-driven diagnostics are revolutionizing cancer care by enabling early detection through imaging analysis and biomarker identification. AI-powered tools such as PathAI and Tempus are already improving the accuracy of pathology readings, helping oncologists make faster, more precise decisions. Telemedicine platforms allow specialists to reach remote areas, providing virtual consultations and second opinions to physicians in LMICs. Organizations like Project ECHO have successfully implemented tele-mentoring programs that connect experts with healthcare workers in underserved areas.
• Point-of-Care Diagnostics: Advances in portable diagnostic tools are critical for LMICs, where access to full-scale hospital laboratories is limited. Portable biopsy devices, low-cost liquid biopsy tests, and rapid HPV screening kits have the potential to improve early cancer detection dramatically. For example, the GeneXpert system, initially designed for tuberculosis diagnosis, is now being adapted for detecting oncological markers in resource-limited settings.
• Supply Chain Resilience: Strengthening supply chain logistics ensures the timely delivery of life-saving medicines and equipment. Blockchain technology is being explored to improve drug traceability, prevent counterfeiting, and streamline procurement processes. Companies like MediLedger are working on decentralized platforms that enhance pharmaceutical supply chains worldwide.
• 3D Printing for Cancer Care: The use of 3D printing technology in global oncology is expanding, from printing customized prosthetics for cancer patients to producing affordable surgical tools in low-resource hospitals. Researchers are also exploring bio-printed tissues that could one day revolutionize personalized medicine and organ transplants for cancer treatment.

These technological advancements, when combined with collaborative implementation efforts, have the power to bridge critical gaps in cancer care worldwide.

 

A Call to Action: Canada Must Lead

Canada has the expertise, the resources, and the moral obligation to lead in global health and oncology equity. To do so, we must:

• Strengthen international partnerships to drive sustainable change, using government, agencies, associations and the private sector.
• Invest in workforce development, ensuring that local healthcare systems are equipped to deliver cancer care.
• Promote research & innovation, focusing on cost-effective treatments and digital health solutions.
• Advocate for global equity, lobbying for policy changes that prioritize affordable cancer care worldwide.

In a world that often prioritizes self-preservation over collective well-being, we must be bold. If the world suffers, we are also suffering.  We must be innovative. We must be relentless in our pursuit of a world where cancer care is not a privilege but a right for all. This is not just about global health—it’s about global justice.

It is time to act in opposition to forces that we see around us which value individualism over collective impact. The world is watching.