When Professor Richard Sullivan talks about cancer, he doesn’t begin with miracle drugs or new machines. He starts with systems — the people, politics and policies that decide whether any of those advances will actually reach patients.

In the latest episode of the Paul Talks Science podcast, I sat down with Sullivan, Professor of Cancer and Global Health at King’s College London and Director of the Institute of Cancer Policy, for a conversation about what it really takes to build cancer systems that work.

Sullivan began his career as a cancer surgeon before turning to policy and health systems research, a shift that now defines his work. “You can have the drugs, the radiotherapy, even surgical robots,” he told me, “but without strong systems and political governance those technologies do not translate into better outcomes.”

He spoke about the widening gap between innovation and access. Cancer survival has doubled in high-income countries like the UK since the 1970s, yet across much of the world families are still being pushed into poverty by the cost of treatment. “Cancer reflects all the strengths and weaknesses of health systems,” he said.

We also discussed WHO’s new Saving Lives, Spending Less investment case and what it could mean for cancer control. Sullivan welcomed the renewed attention but questioned whether global cost-effectiveness arguments can drive meaningful change on their own. His message was clear: governments need realistic, financed plans that fit their own contexts and can stand the test of time.

I wrote more from our conversation in my recent feature for The Lancet Oncology, which you can read here: Building cancer systems that work.

🎧 Listen to the full conversation on Paul Talks Science wherever you get your podcasts.