This Week in Global Development: Special Episode — Breast Cancer as a Global Development Challenge April 8, 2026 | Hosted by Devex
Main Guests:

• Darren Back, President, Pfizer Foundation
• Dr. Patrick Loehrer, Founding Director, Center for Global Oncology, Indiana University & architect of AMPATH
• Dr. Eloise ("Loyce") Citine, Consultant Radiologist & Lecturer, Moi University, Eldoret, Kenya
  Host: Kate Warren, Executive Editor, Devex

Episode Overview

This special episode explores breast cancer not simply as a health issue, but as a far-reaching development challenge, particularly in low- and middle-income countries. Host Kate Warren is joined by experts and practitioners working in Kenya to discuss how breast cancer affects individuals, families, and communities, and why integrated approaches spanning medical, economic, and social systems are crucial for addressing it. The conversation highlights local experiences, the need for health system strengthening, and the transformative potential of community-embedded partnerships like AMPATH and the Pfizer Foundation’s Action and Impact Initiative.

Key Discussion Points & Insights

Breast Cancer Beyond the Diagnosis

[00:07–05:52]

• Personal story from Kenya: Dr. Eloise Citine recounts a patient’s prolonged and challenging journey to diagnosis and care, highlighting obstacles such as long delays for test results, spousal disbelief and resistance, economic hardship, and eventual loss of marriage and livelihood.
• Insight: “The economic fallout can be as devastating as the disease itself.” (Kate Warren, 00:50)
• Quote: “That's basically the journey that a Kenyan woman might make, and I see that replicating thousands of other people's lives.” (Dr. Citine, 05:52)

Health and Economic Development: Interconnected Challenges

[06:44–09:15]

• Darren Back explains The Pfizer Foundation’s approach, which frames health and economic resilience as deeply intertwined, especially visible in breast cancer.
• Action and Impact Initiative: $25M across five countries, aimed at replicable, system-aligned solutions with strong government partnership and national health system integration.
• Importance of knowledge-sharing for global impact.
• Quote: “When health and development move together, this type of work not only improves breast cancer care, but also strengthens systems and long-term prosperity.” (Darren Back, 09:04)

Building Systems from the Ground Up: The AMPATH Example

[10:17–13:57]

• Dr. Loehrer traces lessons from HIV/AIDS to cancer care: emphasizes the complexity of cancer treatment (multi-specialty coordination) and systemic stressors.
• Early efforts in Kenya built out of HIV platforms: community health, system-level interventions, and the notion that if cancer systems work, so does broader healthcare delivery.
• Stark contrast in outcomes:
  • US: 80% 5-year survival; most present at early stage
  • Sub-Saharan Africa: 80% present late; less than half survive 5 years
• Quote: “What we have seen is the possible. We know what can happen. We just need now to make it a probable experience for people in Kenya.” (Dr. Loehrer, 13:51)

Critical Gaps and Patient Navigation

[15:34–18:49]

• Dr. Citine discusses points at which women are “lost” in the system:
  • Pre-hospital: Myths, stigma, low awareness, patriarchal decision-making
  • At hospital: Diagnostic delays, turn to traditional healers
  • Financial barriers: Premiums for insurance, transport costs
  • In-care: Lack of follow-up, logistical challenges
• Solutions:
  • Community-wide education (including men)
  • Financial support for insurance premiums
  • Patient navigators and survivor support as lifelines
• Quote: “We intend to start from education… But if we can pick these diseases earlier… Cancer can be treated when it's picked early. Also, the support system… Can we also educate them to know that we need to support our women?” (Dr. Citine, 15:38)

The Role of Partnerships and Local Trust

[19:18–22:07]

• Darren Back: Importance of selecting partners who are trusted, embedded, and connect community experience, clinical practice, and policy—enabling scale and sustainability.
• Survivor narratives are vital in community outreach.
• Quote: “We're not just funding programs, we're investing in trusted partners… that connective tissue… that binds the community experience, the clinical practice and national policy.” (Darren Back, 20:23)

Quality of Care & Adapting to Context

[22:07–25:35]

• Host shares a personal story about care disparities between Mexico and the US.
• Dr. Loehrer: Emphasizes “cultural humility” — the importance of tailoring treatment to local constraints (e.g., mastectomy vs. lumpectomy where radiation isn’t available).
• Need for listening, learning, and co-creating solutions.
• Quote: “These guys in Africa are doing the same thing [as MacGyver]… You have to do the best you can with the circumstances there.” (Dr. Loehrer, 24:00)
• “When we go embark on these programs… we need to go there and listen for many months rather than going there and talking.” (Dr. Loehrer, 24:55)

Scaling Success While Honoring Local Relevance

[25:35–28:44]

• Example: Burkitt’s lymphoma project—small interventions (like transport stipends) can dramatically improve cure rates.
• System-building: Investment leads to government involvement and sustainability of oncology care, increased access to WHO essential medicines.
• Facility development: Infrastructure greatly expanded via partnerships and government buy-in.
• Quote: “Once you show that you can do this and you develop the confidence, people then start to invest.” (Dr. Loehrer, 28:07)

The Systemic Change with Most Impact

[28:44–30:11]

• Darren Back: The single biggest game-changer would be decentralized, community-rooted diagnostic services for earlier detection.
• Quote: “Bringing diagnostic services closer to the community… It’s going to have a real systemic change and help women enter the health care system much more quickly and hopefully have better health outcomes.” (Darren Back, 29:21)

The Call to Empowerment

[30:11–31:26]

• Dr. Citine: Emphasizes empowering communities to recognize, seek, and afford care; pairing knowledge with economic empowerment for true impact.
• Quote: “I can't seek a service that I don't know I need. ... There’s a lot of empowerment that needs to go along the way with the information.” (Dr. Citine, 30:32)

Notable Quotes & Memorable Moments

• “The economic fallout can be as devastating as the disease itself.” (Kate Warren, 00:50)
• “That's basically the journey that a Kenyan woman might make, and I see that replicating thousands of other people's lives.” (Dr. Citine, 05:52)
• “When health and development move together, this type of work not only improves breast cancer care, but also strengthens systems and long-term prosperity.” (Darren Back, 09:04)
• “If it does work for cancer, that means we can actually elevate the entire healthcare systems.” (Dr. Loehrer, 11:22)
• “We're not just funding programs, we're investing in trusted partners… that connective tissue… that binds the community experience, the clinical practice and national policy.” (Darren Back, 20:23)
• “These guys in Africa are doing the same thing [as MacGyver]… You have to do the best you can with the circumstances there.” (Dr. Loehrer, 24:00)
• “Bringing diagnostic services closer to the community… It’s going to have a real systemic change and help women enter the health care system much more quickly and hopefully have better health outcomes.” (Darren Back, 29:21)

Timestamps for Key Segments

• 00:07 | Episode introduction, global development framing
• 02:34 | Loyce’s story of a Kenyan breast cancer patient
• 06:44 | Pfizer’s Action and Impact Initiative overview (Darren Back)
• 10:17 | Lessons from HIV/AIDS to breast cancer systems-building (Patrick Loehrer)
• 15:34 | Where patients are lost in Kenya’s system and solutions (Dr. Citine)
• 19:52 | What makes a successful partner for systemic change (Darren Back)
• 22:07 | Cross-country disparities and adapting care (Kate Warren & Dr. Loehrer)
• 25:35 | Scaling context-aware solutions—Burkitt's lymphoma example (Dr. Loehrer)
• 28:44 | The key systemic change—community-based diagnosis (Darren Back)
• 30:28 | The imperative of empowerment (Dr. Citine)
• 31:26 | Closing thoughts on system-wide ripple effects and gratitude

Conclusion

This episode broadens the conversation around breast cancer to highlight its entwinement with economic, social, and systemic development. It underscores the value of trust-based, locally-driven partnerships, the necessity of community empowerment, and the impact of early diagnostics not only for breast cancer, but for the transformation of healthcare systems as a whole in low- and middle-income countries.