In 2024, the Movement Health Foundation committed to empowering women to live cancer-free, with the Clinton Global Initiative (CGI) serving as the commitment maker. This initiative leverages cost-effective digital technologies to enhance early detection and diagnosis of cervical and breast cancer in Peru and South Africa.

In Peru, this initiative builds upon a successful maternal and newborn health workflow model first implemented in Cusco in 2021. On February 4, 2025, the Foundation signed a collaboration agreement with Lambayeque’s regional government to expand access to early cancer detection and treatment services for breast and cervical cancer. The digital solution introduced under this agreement is expected to benefit 170,000 women, with the José Leonardo Ortiz Health Center serving as a pilot site for future nationwide scalability. In South Africa, the Foundation is collaborating with Nelson Mandela University’s Centre for Community Technologies, the Department of Health, and local organizations to develop a user-friendly Progressive Web App (PWA). This app provides accessible, evidence-based information on cervical cancer and screening procedures, aiming to bridge the gap in awareness and early detection.

In 2024, the Movement Health Foundation committed to empowering women to live cancer-free, with the Clinton Global Initiative (CGI) serving as the commitment maker. This initiative leverages cost-effective digital technologies to enhance early detection and diagnosis of cervical and breast cancer in Peru and South Africa.

In Peru, this initiative builds upon a successful maternal and newborn health workflow model first implemented in Cusco in 2021. On February 4, 2025, the Foundation signed a collaboration agreement with Lambayeque’s regional government to expand access to early cancer detection and treatment services for breast and cervical cancer. The digital solution introduced under this agreement is expected to benefit 170,000 women, with the José Leonardo Ortiz Health Center serving as a pilot site for future nationwide scalability.

In South Africa, the Foundation is collaborating with Nelson Mandela University’s Centre for Community Technologies, the Department of Health, and local organizations to develop a user-friendly Progressive Web App (PWA). This app provides accessible, evidence-based information on cervical cancer and screening procedures, aiming to bridge the gap in awareness and early detection.

Both initiatives address critical yet modifiable barriers in healthcare systems that often delay diagnosis and treatment, contributing to poorer cancer outcomes. On the occasion of World Cancer Day in February, the Movement Health Foundation shares key data on breast and cervical cancer in Peru and South Africa—statistics that underscore the urgency of interventions to improve early detection and treatment access.

Breast Cancer: The Most Common Cancer Among Women in South Africa and Peru

Globally, breast cancer remains the most frequently diagnosed cancer among women, with incidence and mortality trends varying by region. According to Globocan (2022), upper-middle-income countries reported an average of 40.8 new cases of breast cancer per 100,000 women.

South Africa exceeded this average, reporting 47.8 new cases per 100,000. Peru, in contrast, recorded a lower incidence rate of 39.3 per 100,000. However, breast cancer mortality rates reflect deeper systemic healthcare disparities. Between 1990 and 2021, South Africa’s breast cancer mortality rate more than doubled, increasing from 5.85 to 11.53 deaths per 100,000.

Breast cancer remains the leading cause of cancer-related deaths among South African women, accounting for 23.2% of all cancer cases in 2019, according to Statistics South Africa.

A stark racial disparity exists in breast cancer incidence, diagnosis, and treatment outcomes. While incidence rates are higher among White women, mortality rates remain similar across racial groups.¹ This suggests that Coloured and Black African women may experience later-stage diagnoses and limited access to specialized treatment facilities. A key factor contributing to these outcome disparities is unequal access to private healthcare. As of 2019, approximately 15.7% of South Africans overall had medical aid coverage in 2023, while a staggering 84% rely on public health care services with significant disparities among different population groups:

• White individuals: 71.9% had medical aid coverage
• Indian/Asian individuals: 48.7%
• Coloured individuals: 18.2%
• Black African individuals: 9.7%

This disparity underscores the urgent need for scalable digital health solutions that facilitate early detection, patient navigation, and continuity of care.

In Peru, breast cancer likewise ranks as the most prevalent cancer among females. Globocan data from 2022 shows its incidence rate at 1.6 times higher than cervical cancer, the second most common type. Though breast cancer maintains the highest incidence, Peru's mortality rate from 1990 to 2021 remained notably below the average for upper-middle-income countries, increasing from 3.83 to 5.84 deaths per 100,000 individuals. During this same period, while the average mortality rate for this income group was lower than South Africa's, it still exceeded Peru's, rising from 4.71 to 8.16 deaths per 100,000.

Breast cancer survival is not solely about reducing mortality—it also involves addressing the long-term disability and quality-of-life challenges that survivors face.

When examining disability-adjusted life years (DALYs)—which measure both premature mortality and years lived with disability—South Africa has seen a steep increase over the past three decades:

• 1990: 196.28 DALYs per 100,000
• 2021: 356.86 DALYs per 100,000

At the same time, years of healthy life lost to disability (YLDs)—a measure of the long-term burden of living with breast cancer—have risen, with upper-middle-income countries reaching 20.36 per 100,000 in 2021.

These statistics illustrate that surviving breast cancer often comes with chronic health challenges, reinforcing the need for improved survivorship care and rehabilitation programs. The digital solutions implemented in South Africa and Peru aim to reduce preventable long-term effects, particularly those caused by:

• Late-stage diagnoses
• Treatment interruptions due to inefficiencies in the healthcare system

By integrating early detection strategies with patient-centered digital interventions, these initiatives seek to enhance long-term health outcomes—ensuring that women not only live longer but also live healthier lives after treatment.

The Hidden Barriers to Breast Cancer Survival

In South Africa, the escalating cancer burden of disease is a result of barriers that are especially salient in rural settings. Women encounter numerous challenges, such as long distances to health facilities, limited transport options, and high travel costs. Additionally, the health system struggles with insufficient resources and extended waiting times. For instance, the median waiting time from diagnosis to mastectomy is 18.4 weeks. Cultural perceptions also play a part since there is a generalized fear about mastectomies, which nevertheless has a basis in reality; breast-conserving therapy is indeed not available to the vast majority of patients. Movement Health Foundation and its partners are working to address these obstacles to care through the Progressive Web App digital solution, which promotes early diagnoses and informed decisions by providing clear information, interactive risk assessments, and localized provider information.

Peru, despite its relatively lower mortality rates, confronts equally challenging barriers. Research has revealed that Indigenous people and Afroperuvians experience greater inequalities in access to screening services compared to white or mestizo groups. A major challenge in Peru is the severe lack of information provided to patients about breast cancer, treatment options, and post-treatment care. Many women report that their most valuable information comes from other patients rather than health providers. The concentration of cancer services in Lima creates additional barriers for rural populations, mirroring the geographic disparities observed in South Africa. To help address these gaps, the project that Movement Health supports in Peru includes a digital tool designed to improve coordination among healthcare providers, ensuring that women at risk receive timely screening and follow-up care.

Cervical Cancer: The Leading Cause of Cancer Deaths for Women in South Africa and Peru

Despite being largely preventable through vaccination and regular screenings, cervical cancer remains a major public health concern in both Peru and South Africa.

In 2022, upper-middle-income countries recorded an average of 14.2 new cervical cancer cases per 100,000 women. However:

• Peru exceeded this average, with 23.9 cases per 100,000.
• South Africa reported an even higher rate, with 33.2 cases per 100,000.

Cervical cancer is the leading cause of cancer-related deaths among women in both countries. In 2022, an estimated 83,159 women died from the disease in Peru and South Africa combined:

• Peru’s adjusted mortality rate: 12.1 deaths per 100,000.
• South Africa’s adjusted mortality rate: 19.0 deaths per 100,000.

This high burden of disease highlights the need for increased screening coverage, vaccination programs, and early intervention strategies.

The disease’s broader impact becomes even clearer when examining disability-adjusted life years (DALYs). South Africa experienced a sharp rise in DALYs in the early 2000s, stabilizing at over 700 per 100,000 people—more than double the average of upper-middle-income countries, which stayed below 300 per 100,000. Peru’s DALYs remained steadier at around 400 per 100,000, still reflecting a heavy overall burden.

The impact on survivors shows a steady increase across all regions from 1990 to 2021 of YLDs. By 2021, South Africa and Peru converged at similar levels - around 15 per 100,000, significantly higher than the upper-middle-income country average of approximately 10 per 100,000. This trend highlights the growing importance of survivorship care and long-term support systems in both countries.

Preventable Yet Persistent: Overcoming Barriers to Cervical Cancer Screening and HPV Vaccination

The cervical cancer landscape in both countries is significantly influenced by issues related to health access. In Peru, the typical clinical pathway requires at least three facility visits for screening, colposcopy, and treatment, with women often waiting up to a year between initial screening and treatment initiation. The country's HPV vaccination program, while important, currently targets only girls aged 9-13, leaving many women unprotected. Although 61.8% of women aged 30-59 have had at least one Pap smear in the past three years, access varies significantly between urban and rural areas.

Institutional challenges, such as a shortage of healthcare personnel and inadequate hospital infrastructure, further exacerbate delays in obtaining screening results and gynecological appointments and weaken educational campaigns. Patient-related barriers include domestic and work responsibilities, lack of knowledge about the disease, fear of being exposed to male health providers, and underestimation of the severity of cervical cancer. Peru’s digital project addresses delays and inefficiencies in access to screenings and treatment by enhancing coordination among health professionals. Improved coordination will also enable patients to know in advance who will be attending them, which can help ease concerns and improve their overall experience.

In the case of South Africa, cervical cancer challenges are compounded by its high HIV prevalence, which contributes to both increased cancer risk and mortality. It is estimated that 30 to 40% of cervical cancer cases occur in people living with HIV. Researchers have identified suboptimal uptake and delays in initiating screening among women living with HIV in some primary healthcare clinics, with 65% receiving their first cervical cancer screening after 48 weeks of initiating antiretroviral therapy.

The country's screening program prevented approximately 8,600 cervical cancer cases between 2000 and 2019, yet significant work remains. Projections suggest that reaching the WHO's prevention targets by 2030 could help South Africa achieve elimination (at the 10/100,000 threshold) by 2077, particularly through advancements in screening technology and HIV prevention efforts. To support these efforts, South Africa’s web app provides accessible, evidence-based information to raise awareness and alleviate concerns about the screening process, encouraging more women to seek timely care.

Technology has the potential to transform cancer care, offering new paths for equity and access

Despite the challenges facing Peru and South Africa, technology-driven solutions provide scalable, cost-effective pathways for improving cancer care equity.

The Movement Health Foundation’s digital initiatives aim to:

• Improve early detection through accessible tools
• Enhance coordination between healthcare providers
• Reduce diagnostic delays and treatment interruptions
• Expand access to cancer prevention and survivorship care

By scaling these digital solutions, the Movement Health Foundation seeks to transform cancer care, demonstrating how innovative health technologies can be leveraged globally to improve equity, access, and health outcomes for all women.