Reimagining rural cancer care - the Butaro Cancer Center of Excellence (BCCOE) in Rwanda.

Introduction and Problem Statement: Long travel distance, lack of access to clinical trials and reduced availability of interdisciplinary treatments are some of the structural barriers in providing cancer care in rural areas, even in high-income countries. In low- and middle-income countries (LMICs), such challenges are disproportionately exacerbated. It is estimated that 70% of all cancer-related deaths will occur in LMICs by 2040. Thus, rural cancer care in LMICs calls for urgent innovative interventions aligning with the principles of health equity.Model Solution: Launched in 2012, the Butaro Cancer Center of Excellence (BCCOE) is an example of transformative collaboration and innovation. It harnesses the principle of equity by expanding specialized care to remote and rural populations. It delivers cancer-related diagnostic, chemotherapy, palliative and surgical services with the support of national and regional referral hospitals for advanced cancer surgeries and radiotherapy. Complementary social support, such as meals, transportation and living accommodations for families, further optimize patient outcomes by accommodating patients' psychosocial needs while they receive cancer care.Discussion: By 2020, the BCCOE had treated over 11,116 cancer patients from Rwanda, Burundi and the Democratic Republic of Congo. Furthermore, innovative approaches such as the Zipline delivery system - a drone-based drug re-fill community delivery system - were adopted to tide over during the COVID-19 pandemic. As a growing global community of health leaders, it is imperative to adapt these novel designs and augment healthcare delivery for rural populations.