There is a pressing need for clinical trials to address cancer prevention, diagnosis and treatment in tropical countries with limited resources. While Pharma might be attracted to recruiting patients from tropical countries to trials that address new treatments for common cancers, they are likely to profit from marketing new drugs only in wealthy developed countries and have, in general, refused to make any concessions in drug pricing to allow patients in poor countries to receive them, even in the face of strong evidence that they enhance survival, and regardless of whether some of that evidence came from participation of patients in tropical countries. That is unlikely to change, and governments of such countries are either unable or unwilling to support cancer clinical trials. So how can oncologists in tropical countries engage in clinical research to support the well-being of their patients?

There are no simple answers to the above questions, but some strategies are suggested below.