In LMIC national cancer control programs are barely existent. Emphasis is mainly focused on fighting infectious disease, maternal child mortality and now fighting the Covis-19 catastrophe.

Pakistan is a LMIC with allocation of only 2.7% of the GDP to health. We have approximately 173,937 new cancers and a mortality of 118,442. Health expenditures do not correlate with outcomes especially for the marginalized population. Development and implementation of national NCD control programs for screening of common cancers and early detection are either non-existent or sporadic as a result cancers are usually diagnosed late and present challenges to therapy on all fronts especially in the indigent population.

Challenges include poverty, ignorance, lack of access to cancer centers, lack of access to basic cancer therapy and suboptimal treatment. This includes surgery, radiation and cancer therapy including supportive care. Simultaneously there is a dearth of human resource and cancer care providers to diagnose treat and provide supportive care to cancer patients.

Access to new biologics and targeted therapies present a challenge to the already strained health care budget. Current status of cancer care will be discussed in Pakistan.