City Cancer Challenge (C/Can) shared a post on LinkedIn:
“In Georgia, breast cancer is more than a number. It’s the most commonly diagnosed cancer among women, accounting for more than one in four new cases.
In her article, ‘From Global Framework to Local Action: Transforming Breast Cancer Care from the Ground Up in Tbilisi’,Dr. Marina Maglakelidze shares how Tbilisi became one of the first cities worldwide to translate the World Health Organization Global Breast Cancer Initiative (GBCI) from framework into practice.
- From adapting breast cancer clinical guidelines and strengthening education,
- To ensuring in-hospital pharmacies secure essential oncology medicines,
- To creating a sense of ownership across policymakers, oncologists, nurses, and patient advocates
This is how global goals become real when translated into local action.
As Dr. Maglakelidze writes: ‘Real progress didn’t come from technology or equipment. It came from people.’
Thanks to the convening role of IFPMA and the support of Amgen, AstraZeneca, Bristol Myers Squibb, and MSD, C/Can has been able to lead this work.
Read Dr. Maglakelidze’s powerful perspective here:
From Global Framework to Local Action: Transforming Breast Cancer Care from the ground up in Tbilisi.
By Dr. Marina Maglakelidze, General Manager, Todua Clinic Digomi
Every statistic in cancer care hides a face, a family, a story. In Georgia, one in four new cancer cases among women is breast cancer – and behind each case is a life we cannot afford to lose. In Georgia, where I live and work, breast cancer is more than a statistic. It affects families, friends, and entire communities. According to Globocan, in 2022, our country reported 13,689 new cancer cases, including 1,730 cases of breast cancer. Among women, breast cancer was the most commonly diagnosed, accounting for more than one in four new cases (26.9%). These numbers are a stark reminder of why tackling breast cancer matters so much.
For a long time, I was familiar with the World Health Organization’s Global Breast Cancer Initiative (GBCI) framework. As a doctor, I understood its promise: evidence-based frameworks, measurable targets, and the potential to reduce mortality worldwide. I had read about it, discussed it with colleagues, and even imagined what it might look like in practice, but it felt distant, almost theoretical.
Then the news came: Tbilisi had been selected as one of the first C/Can cities to implement the GBCI framework. In that moment, I felt a surge of excitement. It was an opportunity to bring global best practices into our hospitals, clinics, and communities, to close gaps in quality and equity, and to show that Tbilisi could lead by example. Suddenly, the vision I had studied and hoped for was within reach, and I could help make it real.
My Involvement in GBCI Activities in Tbilisi
Looking back on my journey with C/Can and the GBCI, one thing stands out: how frameworks can transform into real, tangible change when cities take the lead.
When I began working with C/Can and WHO on GBCI implementation in Tbilisi, I expected a professional challenge. What I didn’t anticipate was how much this experience would reshape my thinking about cancer care and about how systemic change actually occurs within health systems.
My main role was supporting education and adapting breast cancer clinical guidelines. Yet in practice, it meant sitting at the table with policymakers, oncologists, nurses, patient advocates, and international experts, each of us speaking from different experiences. Still, we are all trying to find common ground.
And what struck me most was this: real progress didn’t come from technology or equipment. It came from people. From creating a common language, agreeing on evidence-based standards, and deciding, together, that this wasn’t ‘someone else’s plan.’
It was ours and through C/Can’s city-driven model, Tbilisi became one of the first cities worldwide to translate the WHO GBCI from framework into practice, bridging the gap between global and local
The Bigger Picture
Why does this matter? Because the world can’t afford to ignore breast cancer.
- It’s the most common female cancer in 86% of countries.
- It’s the first or second leading cause of female cancer deaths in 95% of countries.
- Each year, 2.3 million women are diagnosed. By 2040, that number will climb to 3 million cases and 1 million deaths annually, the majority in low- and middle-income countries.
By implementing the GBCI framework and reducing mortality by 2.5% every year, we can save 2.5 million lives in 20 years. Thousands of mothers, sisters, and daughters in cities like Tbilisi will live longer, healthier lives.
High-income countries have already achieved it. The challenge is making it real in places like Tbilisi.
A Different Model of Change
What’s happening in Tbilisi is more than local change – it’s a real signal to other cities worldwide that equity in cancer care can be achieved when global frameworks are localised.
This is why four cities – Tbilisi, Kumasi, Cali, and Phnom Penh – were chosen to pilot the GBCI Framework. The approach is radical in its simplicity: start at the city level. Use cities as living laboratories where global frameworks are translated into locally-owned action plans.
And we are already seeing the results:
- In Tbilisi, in-hospital pharmacies are now securing essential oncology medicines.
- In Kumasi, 36 primary-care facilities have joined a training programme to accelerate referrals.
- In Cali, recommendations from the Breast Cancer Action Plan have been integrated into Colombia’s national cancer plan.
For me, what distinguished the work on the GBCI framework from other initiatives was the significant role of education and clinical guidelines in the discussions. These elements are not merely supplementary; they are essential pillars that drive improvement. These aren’t just technical solutions; they represent a revolutionary shift toward tailored, sustainable cancer care.
We are now witnessing the development of tailored action plans that are relevant, measurable, and sustainable, ultimately benefiting patients by facilitating faster diagnoses and better-coordinated treatment.
Tbilisi’s journey presents a powerful blueprint for other Georgian cities, illustrating how international frameworks can be thoughtfully adapted to create real, lasting change. The possibilities are truly inspiring.
What This Taught Me
Looking back, I see Tbilisi’s Breast Cancer Action Plan not just as a policy tool, but as a blueprint for how change should happen:
- Start with education. Guidelines and training give healthcare teams a shared foundation.
- Build ownership. When solutions reflect local realities, people fight to make them succeed.
- Think small to go big. A referral pathway clarified here, a training module launched there – over time, these create systemic change.
Most importantly: don’t wait. Progress doesn’t come from postponing action until the system is “ready.” It comes from taking the first step, and then the next, with allies who believe change is possible.
A Call to Action
The truth is, breast cancer isn’t just a public health issue – it’s a test of how we value equity, collaboration, and human life. And if Tbilisi’s journey has taught me anything, it’s that global goals only matter when they are translated into local action.
As we look ahead, continued collaboration and investment are essential to expand these lessons beyond Tbilisi – and to ensure that millions more women worldwide can benefit. For leaders in other cities just beginning this journey: don’t underestimate the power of starting small, starting local, and starting now. The path to saving millions of lives worldwide begins with ownership, education, and belief at the city level.
Because when the plan is ours, the change is real.
Thanks to the convening role of IFPMA and the support of Amgen, AstraZeneca, Bristol Myers Squibb, and MSD, C/Can has been able to lead this work.
About Dr. Marina Maglakelidze
Marina Maglakelidze, MD, PAHM, is a graduate of the Tbilisi State University Medical School. She trained in Internal Medicine and Medical Oncology.
She also completed a postgraduate course in Healthcare Management at the University of Georgia.
Dr Maglakelidze has been practising since 2010, the last 8 years at the Todua Center (Tbilisi, Georgia), one of the top hospitals in Georgia, in the position of General Manager.
M.Maglakelidze is the leader of the Arensia Research Site and PI of several I-II faces clinical trials.
She is also a clinical associate professor of medicine at the Tbilisi State Medical University and is vice-president of the association of oncologists of Georgia.
Marina Maglakelidze is board-certified in internal medicine, medical oncology, and medical management.”
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