The Global Breast Cancer Initiative: a strategic collaboration to strengthen health care for non-communicable diseases

Because most breast cancers cannot be attributed to modifiable risk factors, global breast cancer control efforts cannot rely solely on risk factor reduction,2 and will require systematic improvements in access to resource-appropriate, quality services to meet the Sustainable Development Goals for non-communicable diseases (target 3.4) and universal health coverage (target 3.8). For decades, there has been a steady escalation in the recognition of breast cancer as a public health priority through multiple political declarations, the most recent of which is the WHO 2017 Cancer Prevention and Control Resolution calling for broader investments in cancer, among other non-communicable diseases, as leading efforts to improve women's health. Breast cancer prevention through public education about risk-reduction strategies (eg, encouraging lactation, avoiding obesity, and limiting alcohol intake) is a foundational step for cancer control, but must be implemented alongside early-detection programmes.2 Late-stage presentation is unfortunately common throughout low-income and middle-income countries, where women are first diagnosed when their malignancy is already locally advanced (stage III) or metastatic (stage IV), at which point improving survival is both less likely and resource-intensive.