On a sunny day in April 2024, Happiness Malongo smiled as she sat on a bench outside Sekou Toure Regional Referral Hospital in Mwanza, Tanzania. A little over a year ago, the mother of three wasn\u2019t sure she\u2019d even be here \u2013 she\u2019d been diagnosed with stage II breast cancer.<\/p>\n
\u201cWhen I was first diagnosed, I was overwhelmed with fear and shock,\u201d Malongo recalls. \u201cLike many, I thought a cancer diagnosis meant death. But thanks to a supportive and responsive healthcare provider, I found the strength to act quickly.\u201d<\/p>\n
After discovering a persistent lump in her left breast, Malongo sought care at that very hospital. Early detection likely helped save her life. Now a survivor, she hopes her story will illustrate the importance of preventative breast cancer care and inspire other women to seek medical attention without delay.<\/p>\n
Dr. Furaha Munema conducting exam with Ms. Happiness Malongo. Photograph: Jhpiego\/Frank Kimaro<\/p>\n
However, many women in Tanzania and across sub-Saharan Africa face significant challenges<\/a> that can limit or delay access to lifesaving breast cancer care.<\/p>\n Malongo credits much of her recovery to care she received with support from the global health nonprofit, Jhpiego<\/a>, through funding from Action & Impact: A Cancer Care Initiative by The Pfizer Foundation, which aims to help women in sub-Saharan Africa access more timely breast cancer diagnosis and treatment. Through the initiative, The Pfizer Foundation<\/a> is providing<\/a> $15 million to three breast cancer programs in Tanzania, Ghana and Rwanda. In Tanzania, Action & Impact is supporting Jhpiego to scale community-led efforts, developed in partnership with the Tanzania Ministry of Health, in four mainland regions \u2013 Mwanza, Tanga, Morogoro and Mtwara \u2013 as well as both isles of Zanzibar, Pemba and Unguja.<\/p>\n \u201cThe initiative is on a mission to address the inequity of care that exists between higher- and lower-income countries,\u201d says Dr. Mary Rose Giattas, Jhpiego\u2019s Program Director of Women Cancer in Tanzania. \u201cBy promoting early detection, faster diagnosis and timely treatment, this transformational initiative aims to help reduce breast cancer mortality in low-resource settings like Tanzania \u2013 and save more lives.\u201d<\/p>\n Health worker helps raise awareness among community members about the benefits of early detection of breast cancer at Gitimai Hospital in Zanzibar, Tanzania. Photograph: Jhpiego\/Frank Kimaro<\/p>\n Breast cancer is one of the leading causes of cancer-related illness and death<\/a> among women in Tanzania. It\u2019s estimated that nearly half of women<\/a> diagnosed with breast cancer lose their life to the disease \u2013 approximately 90%<\/a> are diagnosed at an advanced stage (stage III or IV), when treatment is less effective, more costly and the outcomes are poorer. Globally, breast cancer is the most common cancer among women<\/a> and the leading cause of cancer-related deaths. While the five-year survival rate<\/a> exceeds 90% in high-income countries, it remains around 40% in sub-Saharan Africa due to barriers preventing and delaying care.<\/p>\n \u201cOne of the biggest challenges with breast cancer is that the disease often goes unnoticed until the late stage,\u201d explains Giattas, who as a teenager lost her own mother to breast cancer. The loss galvanized her to become a doctor in the breast cancer care space. \u201cI don\u2019t want other children to experience what I did when tools are available to support the healthcare system to promote early detection.\u201d<\/p>\n Barriers to care<\/p>\n For Jhpiego and the Tanzanian government, closing this gap is a critical and urgent goal. Women in Tanzania \u2013 especially those in rural areas \u2013 can face significant challenges when it comes to accessing and receiving timely treatment and care. There\u2019s an absence of updated standardized treatment guidelines<\/a>, and many health workers have not received the necessary training to provide them with the skills to effectively screen women for the disease. Funding to expand breast cancer services<\/a> is also lacking, and access to diagnostic tools is limited<\/a>. Furthermore, healthcare providers don\u2019t regularly perform clinical breast exams<\/a>, which are key for early detection. Low community awareness<\/a> of breast health, not to mention social stigma<\/a>, also create obstacles to accessing care.<\/p>\n Health worker helps raise awareness among community members about the benefits of early detection of breast cancer. Photograph: Jhpiego\/Frank Kimaro<\/p>\n To help improve breast cancer outcomes, Jhpiego and its partners are focusing on strengthening the healthcare system and accelerating access to care by supporting women at every stage of their cancer journey \u2013 from raising public awareness and providing comprehensive health worker training to enhancing diagnosis through better imaging, sample collection and lab testing.<\/p>\n \u201cThe program works in partnership with the Ministry of Health in creating strong, innovative and sustainable implementation models integrated into the existing health system and grounded in a woman-centered approach to ensure respectful and responsive services for all women with breast cancer,\u201d Giattas says.<\/p>\n The strategy is anchored in the WHO Global Breast Cancer Initiative (GBCI), which recommends the 60-60-80 targets<\/a> to help improve breast cancer care. That means achieving diagnosis of at least 60% of the invasive cancers in early stages of the disease (stage I and II), completion of diagnostic evaluation in 60 days and completion of cancer treatment for 80% of the cases. Evidence has shown that early treatment leads to better outcomes, fewer complications and lower costs. Every country that has undergone a sustained decline in breast cancer mortality rates of 2% per year<\/a> or more, for at least three consecutive years, has attained this through early detection.<\/p>\n Breast cancer survivors sit together after participating in training on the benefits of early detection. Photograph: Jhpiego\/Frank Kimaro<\/p>\n Dr. Furaha Munema, a surgeon at Sekou Toure Regional Referral Hospital, diagnosed Happiness Malongo\u2019s breast cancer case. Munema went through the Jhpiego program, which she says has been training healthcare professionals to conduct breast ultrasounds and proper breast tissue sampling techniques.<\/p>\n \u201cThe initiative has really empowered health workers to prioritize detection of cancer early and has also extended the awareness of the importance of early detection to the local communities,\u201d Munema says.<\/p>\n Beating breast cancer, togetherHealth workers from district hospitals in Zanzibar, Tanzania participate in training on how to perform Core Needle Biopsies. Photograph: Jhpiego\/Frank Kimaro<\/p>\n Multisector partnerships \u2013 between government, global health nonprofits and philanthropic organizations \u2013 have been key to the success of initiatives like Action & Impact across sub-Saharan Africa. By combining resources, expertise and infrastructure, these collaborations can help expand access to early breast cancer detection, diagnosis and treatment in medically underserved areas. More importantly, they help build stronger, more sustainable health systems that can be adapted in other countries. That\u2019s the ultimate goal.<\/p>\n \u201cBreast cancer does not discriminate \u2013 it affects people across every continent, country and community. Yet, while the disease\u2019s impacts are felt globally, inequitable access to timely care can have a devastating effect, leading to tragic and avoidable loss of life,\u201d says Darren Back, Executive Director of The Pfizer Foundation. \u201cThe Pfizer Foundation is committed to investing in efforts like our Action & Impact initiative that bring together diverse, multisector stakeholders to help ensure advances in breast cancer care \u2013 that are aligned with local and national health priorities \u2013 reach patients when and where they need them.\u201d<\/p>\n Over the next three years, Jhpiego will continue its partnership with the Tanzanian government to scale up breast cancer care nationwide \u2013 and beyond. Through the Action & Impact initiative Jhpiego is also applying a similar model in Ghana. \u201cToo many [people] face late [breast cancer] diagnosis and limited treatment,\u201d said Dr. Pearl Nanka-Bruce, Country Director of Jhpiego Ghana. \u201cTogether, we aim for a future with early detection and accessible care and with support from The Pfizer Foundation, we are expanding breast cancer services: from awareness and early diagnosis to timely, lifesaving treatment.\u201d<\/p>\n Through this collaboration, these global health nonprofit organizations are on a mission to strengthen health systems, build local capacity and drive innovation, shaping a future where women with breast cancer in lower-income countries have the same chances of survival as those in higher-income countries.<\/p>\n According to Giattas, the Action & Impact initiative has begun to help improve early detection in Tanzania by providing community outreach, strengthening health information systems and raising public awareness by dispelling myths and misconceptions.<\/p>\n But most importantly, the initiative has already helped change lives. In February 2024, shortly after being diagnosed with stage II breast cancer, Happiness Malongo began chemotherapy. Today, follow-up tests confirm she\u2019s cancer-free.<\/p>\n Dr. Furaha Munema and Ms. Happiness Malongo sit together outside Sekou Toure Referral Hospital in Mwanza, Tanzania. Photograph: Jhpiego\/Frank Kimaro<\/p>\n \u201cSome people doubted I would survive,\u201d Malongo says. \u201cThey whispered behind my back, convinced I wouldn\u2019t make it. But here I am \u2013 it\u2019s a new year, and I\u2019m alive and well. I\u2019m living proof that breast cancer is beatable.\u201d<\/p>\n The Pfizer Foundation is a charitable organization established by Pfizer Inc. 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