Public-private partnerships are emerging as a powerful strategy to address unmet breast cancer care needs in low- and middle-income countries, where rising cancer incidence, limited clinical trial access, and under-resourced health systems continue to drive global inequities in oncology care.

This article summarizes the transcript of a presentation from Session 5 of the 2025 Binaytara Global Oncology Summit. It has not been reviewed by the speaker and may contain errors.

The topic “Unmet Need & Global Opportunity for Public/Private Partnership” was presented by Cathyryne Manner, PhD, Vice President at BIO Ventures for Global Health.

The Global Burden of Breast Cancer

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer deaths among women worldwide. According to the International Agency for Research on Cancer, approximately 60% of the 2.3 million new breast cancer cases diagnosed in 2022 occurred in low- and middle-income countries (LMICs), with 70% of the 660,000 breast cancer deaths occurring in these regions.

The mortality-to-incidence ratio—a key indicator of patient outcomes—is 66% higher in LMICs versus high-income countries, reflecting weaker healthcare systems and poorer outcomes. Projections through 2050 show that both incidence and mortality will rise more steeply in LMICs. These statistics likely underestimate the true burden due to incomplete registries and under-resourced health systems.

Underlying Drivers of Breast Cancer Burden in LMICs

The factors driving breast cancer burden in LMICs are complex and multifaceted. Demographic shifts, including aging populations, increased life expectancy, later childbearing, fewer pregnancies per woman, and rising rates of physical inactivity and obesity, all contribute to increased breast cancer risk.

Tumor biology differences compound these challenges, with a higher prevalence of aggressive subtypes requiring targeted therapies often inaccessible in LMICs. Under-resourced health systems and delayed care-seeking create additional barriers. Limited public awareness, mistrust of conventional healthcare, transportation challenges, and prohibitive costs prevent timely care.

These factors create significant unmet needs while presenting opportunities for development and broad access to new healthcare products.

The Clinical Trial Landscape in Africa: Untapped Potential

Validating new healthcare products requires high-quality clinical trials in the populations intended to benefit. Africa represents about 20% of the global population with high genetic diversity and carries 25% of the global disease burden, yet African participants and facilities were involved in only 1.1% of clinical trials as of 2023.

For industry-sponsored trials—particularly important as companies prioritize market access where trials have been conducted—nearly three-quarters have been conducted in South Africa alone. One in three African countries has posted no clinical trials for any indication. Oncology trials represent only 3% of trials conducted in Africa between 2015 and 2025.

Expanding Clinical Trial Capacity Across Africa

Organizations are employing a three-pronged approach to expand clinical trial conduct across Africa. First, efforts focus on increasing awareness of existing capacity beyond usual sites. The African Consortium of Cancer Clinical Trials offers a free database with information on over 60 sites across West, East, Central, and Southern Africa. The Clinical Trials Community platform provides similar resources.

Second, initiatives are underway to expand capabilities through African and international organizations investing in training and infrastructure development. Third, partnering with organizations working on awareness-raising and capacity development helps companies overcome barriers to trial expansion.

Key players include the Clinical Trials Community Africa Network, the Africa Clinical Research Network, and the European and Developing Countries Clinical Trial Partnership.

Driving Product Adoption and Market Integration

Clinical trials are necessary but not sufficient for product adoption. Key drivers include awareness; communities must understand that products work and offer value. Trust in both the product and the promoting organizations is essential. Sustainable and affordable access is critical for integration into existing healthcare systems.

Best practices include early access planning integrated into product development, with course correction as development proceeds. Education about product value should occur through trusted local partners to build acceptance. Conducting gap analyses of infrastructure and training requirements, followed by programs to place necessary equipment and train healthcare providers, ensures appropriate product use and patient monitoring.

Future Directions: Equitable Partnerships and Integrated Approaches

Awareness of cancer and non-communicable diseases in LMICs has increased significantly. While infectious diseases remain critical, growing emphasis is being placed on addressing rising cancer burdens. The African Access Initiative, founded in 2017, takes a holistic approach through four pillars: sustainable access to medicines and technologies, building infrastructure and capabilities, promoting clinical trials to generate safety and efficacy data, and increasing public awareness of cancer.

Success drivers include focusing on LMIC-defined priorities, creating equitable partnerships where all voices are heard equally across sectors, and integrating research and development with access planning and capacity building. By addressing these interconnected challenges through collaborative, community-centered approaches, the global oncology community can transform breast cancer outcomes in low- and middle-income countries.