Richard Sullivan and colleagues propose ways to improve cancer care globally (Nature 549, 325–328; 2017). For lower-income countries, we suggest that local measures could contribute if they were promoted and developed globally with the help of high-income countries.

'Frugal innovation' in medicine in low-resource settings can suggest cost-effective strategies that are adapted to local constraints to meet an area's needs (see go.nature.com/2hqsyqz). Clinical trials funded by wealthier nations could test the repurposing of inexpensive drugs, such as statins and aspirin, for cancer care (F. Bertolini et al. Nature Rev. Clin. Oncol. 12, 732–742; 2015). This would help to build medical infrastructure in poorer countries.

Clinicians in low-to-middle-income countries have generated data to support drug repurposing, for example using the β-blocker propranolol to treat blood-vessel cancer (angiosarcoma; see E. Pasquier et al. EBioMedicine 6, 87–95; 2016). High-income nations should show much greater interest in such findings, especially in view of the financial burden of cancer treatment. By investing in co-development, they can help to ensure that care is effective, affordable and equitable globally.