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Leveraging existing public health infrastructure is an important strategy for cancer control in low- and middle-income countries, where resources to address the burden of chronic disease are limited. Building public health capacity in developing countries has historically stemmed from efforts to combat infectious diseases—responses to HIV/ AIDS, tuberculosis, malaria, and natural disasters have strengthened the infrastructure and workforce for health and laboratory services, disease surveillance, and public health training programs.

The United States Centers for Disease Control and Prevention (CDC) works with ministries of health and other partners to establish sustainable Field Epidemiology Training Programs (FETPs), which help to build and strengthen workforce capacity for disease detection, laboratory services, and outbreak response. Since 1980, 50 of these programs have produced more than 2,800 graduates in 69 countries, with more than 80% of graduates serving as public health leaders in their home countries. There is great potential to leverage FETP infrastructure and expertise to build capacity and leadership for the prevention and control of cancer and other chronic diseases.

Collaborations with existing infectious disease programs around the world are increasing capacity for cancer control.

Field epidemiology training programs and select public health infrastructure initiatives, 2014

Download High Res Text alternative: Field Epidemiology Training Programs (FETPs), 2014
Map depicting which countries have Field Epidemiology Training Programs in 2014

Leveraging existing public health infrastructure is an important strategy for cancer control in low- and middle-income countries, where resources to address the burden of chronic disease are limited.

Established in 2003 in response to the AIDS pandemic, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) has enabled the development of an increasingly important platform for the control of a number of diseases, including cervical and breast cancer — PEPFAR-facilitated infrastructure has served as a springboard for women’s cancer initiatives in more than 15 countries. Among these is the Pink Ribbon Red Ribbon (PRRR) initiative, an innovative public-private partnership that uses evidence-based approaches to deliver healthcare services for women’s cancers. PRRR-supported programs increase access to cervical cancer screening and treatment, human papillomavirus (HPV) vaccine, and breast and cervical cancer education for underserved women.

There are many opportunities to leverage existing public health workforce and infrastructure across infectious and chronic diseases. Amidst an increasing burden of cancer and limited funding for cancer programs, this strategy can increase the impact of resources devoted to cancer prevention and control in low- and middle-income countries.

“Poor people endure a double burden of communicable and non-communicable chronic illness, requiring a response that is well integrated into the health systems of low-income and middle-income countries. Extension of cancer prevention, diagnosis, and treatment to millions of people with or at risk of cancer is an urgent health and ethical priority.”

Farmer P, et al. Lancet 2010.