Barriers to Cancer Research in Low- and Middle-Income Countries: Findings from the Arab Region and Beyond

Abstract Background Low- and middle-income countries (LMICs) bear nearly 70% of global cancer mortality yet remain under-represented in oncology research. In the Middle East and North Africa, systemic constraints in training, funding, infrastructure, regulation, and human capital hinder locally led studies. We sought to characterize these barriers through the lived experiences of cancer research professionals in Jordan and neighboring LMICs. Methods We conducted a cross-sectional, web-based survey of clinicians, scientists, and allied professionals with 1 year and more of cancer research experience. Invitations were distributed via institutional email lists, social media, and snowball sampling, targeting all eligible investigators in Jordan and other LMIC settings. The 10- to 12-minute questionnaire, hosted on REDCap, captured demographics, research training, funding and institutional support, infrastructure access, ethical/regulatory processes, data availability, collaboration, human capital, and perceptions of governmental support. Quantitative responses were summarized with descriptive statistics; open-text answers underwent thematic coding. Findings Of 206 respondents (70·7% Jordan; 61% aged < 40 years; 66·3% female), 53·2% had formal research training at university but only 28·8% during clinical residency; 77·9% judged existing training programs inadequate. Funding shortfalls were ubiquitous: one-third “always” struggled to secure grants, and only 7·8% encountered no funding difficulties, with institutional seed funds partially mitigating gaps. Infrastructure was uneven: 38·3% had full laboratory access and 56·0% full journal access. Only 48·7% rated national cancer data as “good” or “excellent,” and 57·0% reported international collaborations despite legal and bureaucratic hurdles. Human capital shortages were reported by 84·5%, with 69·6% observing “brain drain” and 68·2% lacking protected research time. Government support was rated “poor” or “very poor” by 35·6%, and “excellent” by just 9·6%. Thematic analysis highlighted chronic resource scarcity, bureaucratic inertia, and the absence of a coherent national research strategy. Conclusions Oncology research in Jordan and neighboring LMICs is constrained by interlocking deficits in training, financing, infrastructure, regulation, data systems, and workforce support. Reforms should embed experiential research and mentorship in clinical training, diversify funding streams, invest in shared facilities and interoperable data platforms, harmonize ethical-review processes, and strengthen career pathways with protected time and competitive incentives. A coordinated policy commitment is essential to transform regional cancer research from dependency to leadership.