Table 1.

Summary of selected support systems for low- and middle-income countries

Resource level	Cancer plan	Coverage of financing for cancer care	Platform for breast cancer program	Essential Medicines List
Basic	Cancer included in NCD plan, e.g. Mozambique prior to 2019	Payment largely out-of-pocket	Cancer care focuses mainly on cervical cancer	Includes basic cancer medicines
Core	Separate cancer plan; e.g. Ghana plan 2012–2016 with one paragraph on breast cancer; Zambia 2016–2021 with two paragraphs on breast cancer	Selected cancers covered by growing national insurance, e.g. Ghana covers basic breast & cervical cancers treatment	Breast cancer care added onto cervical cancer platform (e.g. Zambia); or onto reproductive health platform (e.g. India pilot) in low income states	Includes basic cancer medicines and some may be publicly subsidized; includes basic hormonal therapies (e.g. Ghana)
Enhanced	Cancer plan articulated to include cancer-specific goals, e.g. Malaysia’s 2016–2020 plan with several pages specifically on breast cancer resources	Broader coverage of cancer types overall in NHI; broader coverage of breast cancer stages and therapies (e.g. Malaysia, Brazil)	Breast cancer integrated into broader health system; National Cancer Centre develops network with regional centres (India; Mexico, Cuba)	Includes more advanced therapies, on-patent and costly therapies supply is limited (Malaysia; Brazil)
Maximal	Comprehensive cancer plans with targets and metrics	NHI covers full range of cancers and therapies, subject to national clinical guidelines (e.g. Uruguay)	Includes organized mammographic screening, diagnosis and multidisciplinary treatment (e.g. Uruguay)	Full range of therapies including those on-patent, as determined by national health technology assessments