Conceptual illustration showing 5 people wearing white coats standing around a petri dish, cancer cells floating above

Illustration: Eva Vázquez

There is a stark mismatch when it comes to cancer-research investment in high-income nations and the needs of low- and middle-income countries, which bear the brunt of the millions of cancer-related deaths that occur each year. One study published in June states that just 4.2% of the US$24.5 billion in public and philanthropic grants for cancer research went to surgery and radiotherapy research in 2016–20, despite estimates from 2015 that 80% of new cancer cases worldwide require surgery, and up to 50% require radiotherapy (S. A. McIntosh et al. Lancet Oncol. 24, 636–645; 2023). By contrast, almost 20% of funding during this period was spent on drug-treatment research, which has historically conferred only modest improvements on patients. Even the most promising new treatments, including those discussed in this supplement, might be decades away from having a meaningful impact.

This suggests that global cancer research is in need of a reset, one that accounts for the capacity-building that is needed in parts of the world that are facing unprecedented challenges. Sub-Saharan Africa, for instance, expects to see cancer deaths double this decade. But many African researchers and health-care workers deal not only with a scarcity of facilities and tools, but also a lack of proper data collection. Elsewhere, conflict is threatening hard-won progress. Before the Russian invasion, Ukraine was a key site for cancer clinical trials, which not only provide a lifeline for patients, but have supported a flourishing medical industry that now faces isolation.

Cancer research, of course, has immense value, underlined by a fall in cancer mortality rates in high-income countries. But allowing such inequalities in cancer science and health care to widen risks blunting the potential of research to save lives.