Chelsie Carvajal
Photo Courtesy of: The Movement Health Foundation
The Movement Health Foundation, with the Clinton Global Initiative (CGI) serving as commitment maker, has launched a binational campaign targeting breast and cervical cancer in Peru and South Africa. Both diseases rank among the top causes of cancer deaths in women across low- and middle-income countries (LMICs), where access to early detection and treatment remains inconsistent.
In 2023, Peru reported more than 4,000 new cervical cancer cases, making it the second most frequent cancer among women aged 15 to 44. South Africa, meanwhile, reported cervical cancer rates of 33.2 cases per 100,000 women—more than double the average for upper-middle-income countries. Late-stage diagnoses remain common in both countries, despite the availability of preventative screenings and vaccines.
Technology-Driven Responses to Longstanding Gaps
The Foundation is working with local partners in South Africa to deploy a Progressive Web App (PWA), initially focused on cervical cancer, with plans to expand to breast cancer screening and broader women’s health services during the scale-up phase. Developed in collaboration with Nelson Mandela University’s Centre for Community Technologies and the South African Department of Health, the app features multilingual educational content, offline access, and geo-tagged directories for nearby clinics. The initiative responds to a critical gap: over 75% of cervical cancer cases in South Africa are diagnosed at advanced stages.
Peru’s program builds on a 2021 maternal health model piloted in Cusco. In February 2025, the Foundation signed an agreement with the regional government of Lambayeque to expand digital cancer screening coordination tools. The initiative targets women aged 30 to 69 and aims to streamline referrals, track screening results, and manage patient follow-up. The pilot site at José Leonardo Ortiz Health Center is expected to reach 170,000 women, with a roadmap for national expansion.
Uneven Access, Uneven Outcomes
Disparities in healthcare access play a central role in cancer survival rates. In South Africa, 84% of the population relies on public healthcare. Among Black African women, only 9.7% have access to private medical coverage, compared to 71.9% of White individuals. These gaps result in longer delays between diagnosis and treatment, contributing to a breast cancer mortality rate that more than doubled between 1990 and 2021—from 5.85 to 11.53 deaths per 100,000.
In Peru, geography and ethnicity factor heavily. Cancer services are concentrated in Lima, leaving rural and Indigenous women with limited screening access. A 76% drop in cervical cancer screenings during the COVID-19 pandemic further exacerbated existing inequities. Despite having a lower overall mortality rate compared to South Africa, Peru still faces a significant burden: over 2,000 deaths from cervical cancer were reported in 2023.
From Pilot to Implementation
Both countries’ strategies emphasize local integration rather than transplanting external models. In Peru, the Foundation is co-developing digital tools with regional health authorities to map existing screening infrastructure and improve service allocation. The solution includes a digital referral system tailored to resource-constrained settings. Implementation is phased, starting with two regions—Lambayeque and Arequipa—before scaling to five additional areas by the end of 2025.
“In South Africa, the mobile-first strategy — including the ‘Take Charge, Your Health Matters’ campaign — is primarily aimed at increasing cervical cancer screening rates by raising awareness and providing digital navigation support, while also helping reduce waiting times and improve patient engagement. The median wait from diagnosis to mastectomy currently sits at 18.4 weeks, a delay that worsens outcomes. The PWA is designed to provide pre-screening education, guide users through the next steps, and address cultural barriers such as fear of mastectomy or discomfort with male health providers.
Long-Term Cancer Burden and Survivorship
While early detection is the immediate goal, the Foundation is also responding to long-term survivorship trends. South Africa has seen a steep rise in disability-adjusted life years (DALYs) from breast cancer, from 196.28 per 100,000 in 1990 to 356.86 in 2021. This reflects not only premature mortality but also chronic post-treatment complications.
In both countries, years lived with disability (YLDs) related to cervical cancer are on the rise. By 2021, YLDs had reached approximately 15 per 100,000 in Peru and South Africa, well above the upper-middle-income country average of 10. These figures point to gaps in follow-up care, survivorship programs, and community-level rehabilitation.
Vaccination and Prevention: Still Underutilized
Cervical cancer is highly preventable, yet screening and vaccination remain underused. Peru’s HPV vaccination program targets girls aged 9 to 13, leaving adult women vulnerable. Screening requires multiple clinical visits—screening, colposcopy, treatment—which can stretch over months or even a year due to infrastructure bottlenecks and staff shortages.
In South Africa, where up to 40% of cervical cancer cases occur in people living with HIV, researchers have flagged the late initiation of screening among women on antiretroviral therapy. One study found that 65% of these women received their first cervical cancer screening more than 48 weeks after starting treatment.
A Model Under Scrutiny
The Movement Health Foundation’s multi-country model will undergo formal evaluation in early 2026, consistent with the CGI implementation roadmap, following full implementation in Lambayeque and Arequipa. By working within national policies and regional timelines, the Foundation seeks to embed its digital tools into public health systems rather than running parallel to them. While many global health initiatives struggle to move beyond pilot programs, this model is designed to evolve based on data, feedback, and local ownership.
The Foundation is not alone in this space. Several other global health initiatives are also advancing digital health solutions in low- and middle-income countries. However, what distinguishes this CGI-backed project is its country-specific architecture: rather than deploying a single platform globally, the initiative is adapted to each country’s clinical workflows, language needs, and political frameworks.