Ahead of this year’s International Women’s Day on March 8th, Unjela Kaleem highlights the disproportionate impact of cancer on women, especially those in developing countries. Kaleem – drawing on 20+ years of experience in healthcare strategic communications – argues that celebrating women’s economic empowerment while ignoring the cancers that take them out of classrooms, workplaces, and leadership roles is a false victory. She instead suggests that all stakeholders take the opportunity offered by IWD 2026 to expand the conversation on equality.
On this International Women’s Day, we will rightly celebrate women’s leadership and economic contribution – yet for millions of women in low‑ and middle‑income countries (LMICs), a silent question sits underneath the progress: what is the value of economic gains if women’s health, and especially cancer care, is left behind, as highlighted by the World Health Organization (WHO) and the Union for International Cancer Control (UICC).
Cancer is now a leading cause of death worldwide, and the fastest growth in cancer deaths is projected in LMICs, where health systems and financing are already under strain, according to WHO and recent Global Burden of Disease (GBD) cancer projections published in The Lancet. Between 2020 and 2050, cancer deaths are expected to nearly double globally, but the largest relative increase will occur in LMICs. For women, this shift is already a lived reality. Analysis from the American Cancer Society and the International Agency for Research on Cancer (IARC) show that the majority of new cases and deaths from several key cancers that disproportionately affect women are now occurring in LMICs, where diagnosis is late and access to treatment is limited.
The paradox is stark. WHO reports that women in countries with lower Human Development Index scores are about 50% less likely to be diagnosed with breast cancer than women in high‑HDI countries, yet their risk of dying from the disease is much higher, largely because of late diagnosis and inadequate access to quality treatment. The World Ovarian Cancer Coalition’s ‘Every Woman Study’ for LMICs estimates that around 70% of women diagnosed with ovarian cancer each year now live in LMICs, where data, specialist services and medicines are often scarcest. As infection‑related deaths fall and life expectancy rises, women in LMICs are living long enough to develop cancer, but, as the American Cancer Society notes in its Global Cancer Facts & Figures, their health systems are not yet designed or funded to help them survive it.
Access to diagnosis and medicines is where the promise of universal health coverage often breaks down. A 2024 WHO survey of more than 100 countries found that most do not adequately finance priority cancer and palliative care services under their universal health coverage benefit packages, leaving patients to shoulder catastrophic out‑of‑pocket costs. In many LMICs, screening for breast and cervical cancer is patchy, pathology and oncology specialists are concentrated in urban centres, and radiotherapy or advanced surgery may be available only in a handful of facilities. For women, these systemic barriers are compounded by gendered constraints, ranging from needing permission to travel, unpaid care responsibilities, fear of stigma or abandonment, and limited control over household finances – patterns echoed in gender and NCD research published in BMJ Open and the Journal of Global Health.
Even when women reach treatment, the price they pay is not only biological but also financial and social. A body of work on ‘financial toxicity’ of cancer care in LMICs, including systematic reviews in Cancers and JAMA Network Open, shows that patients routinely experience severe financial hardship, debt and distress due to treatment costs. For breast cancer, a recent meta‑analysis in JAMA Network Open estimates that around four in five patients in LMICs experience financial toxicity, compared with roughly one in three in high‑income countries. Families sell assets, withdraw children from school or forgo essential spending to keep mothers and daughters in treatment. For many women, the choice becomes brutally simple: pay for chemotherapy, or pay for food, rent and school fees.
This is not just a health issue; it is an economic one. Global modelling and other economic analyses estimate that cancers will cost the world trillions of dollars in lost productivity and other economic losses between 2020 and 2050, with low‑income countries losing a higher share of their GDP despite already constrained fiscal space. Breast cancer alone accounts for a significant share of productivity losses, with particularly heavy projected impacts in South Asia, East Asia and Southeast Asia where large numbers of women are in the workforce. When women cannot work, or must leave the labour force prematurely because of untreated or poorly treated cancer, the economic gains from better education and labour participation are quietly eroded.
Global campaigns are beginning to name this injustice more clearly. UICC’s World Cancer Day 2025–2027 theme, “United by Unique”, calls for people‑centred cancer care that responds to individual needs and tackles inequities in access, particularly in under‑served communities. The World Ovarian Cancer Coalition’s Every Woman Study underscores that women in LMICs often face longer delays to diagnosis, fewer treatment options and weaker financial protection than their counterparts in high‑income settings.
So what would it look like to align economic and health justice for women? For governments and multilateral partners, WHO and the American Cancer Society have consistently argued for investment in basic cancer infrastructure including pathology, surgery, radiotherapy, and for essential cancer medicines to be included and financed within universal health coverage benefit packages, not left to out‑of‑pocket payment. It means scaling up HPV vaccination and cervical cancer screening, and integrating early detection for breast cancer into primary care, especially in rural and low‑income communities.
For pharmaceutical companies, global health agencies and civil society, it requires differential pricing, (or other access and partnership programs), voluntary licensing, and better procurement and funding mechanisms, so that new and established cancer medicines reach women in LMICs at affordable prices, coupled with support for stigma reduction and psychosocial care,
For all of us, International Women’s Day is a chance to expand the conversation on equality. Standing with women means standing for their right not only to participate in economies, but to access timely, dignified and affordable cancer care, so that the hard‑won gains in education, leadership and income are not undone by a preventable and treatable disease.
