Feb 5, 2019 - Health
Expert Voices

Poorer countries are falling further behind on cancer outcomes

Data: Institute for Health Metrics and Evaluation; Chart: Harry Stevens/Axios

Between 2007 and 2017, cancer deaths increased from 7.6 million to 9.6 million globally — but the vast majority of that increase was in low- and middle-income countries.

The big picture: In wealthy nations, lower smoking rates, personalized medicine, and novel treatments like immunotherapy are reducing cancer rates and improving survival, even among aging populations. The opposite is true in poorer nations, which saw 80% of the increase, especially in South Asia and sub-Saharan Africa.

What's happening: Population growth and aging are fueling a rise in cancers and noncommunicable diseases in poor countries, which are ill-prepared to handle them.

  • In Bangladesh, for example, the median age increased from 19 to 26 between 1990 and 2015, even as the population grew nearly 50%. As a result, Bangladesh gained 38 million more adults between the ages of 25 and 64.

Where it stands: Such dramatic demographic changes are accelerating a shift from the infectious and nutritional diseases that mostly affect children to cancer and the other noncommunicable diseases that mostly afflict adults. Treating cancers requires more health infrastructure like clinics, labs and hospitals, and skilled workforces to make accurate diagnoses and perform radiotherapy, chemotherapy and surgery.

  • Yes, but: That infrastructure is expensive, far beyond most countries’ health budgets. All 48 governments in sub-Saharan Africa together spent less on health in 2014 ($67 billion) than the government of Australia ($68 billion). Many developing countries cannot keep up with the pace and scale of the health changes in their populations.

The bottom line: Much of the progress being made on cancer is not reaching poor countries. International investment would be needed to improve their health infrastructure, but in the meantime, efforts to increase tobacco controls and vaccinations that prevent cervical cancer could help to slow the global rise of cancer.

Thomas J. Bollyky is senior fellow at the Council on Foreign Relations and the author of “Plagues and the Paradox of Progress: Why the World is Getting Healthier in Worrisome Ways.”

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