Not so long ago, talking about breast cancer was considered taboo in this country. That silence was deadly. Many thousands of women died because they weren't screened, didn't recognize early signs of the disease or were afraid to tell anyone about the lump they could feel in their breast. That's changed dramatically in the United States, but not in much of the developing world where death rates continue to rise and early screening is unheard of or unaffordable.

"There is so much stigma that remains against breast cancer, and that's particularly true in Africa," says Hala Moddelmog, president and CEO of Susan G. Komen for the Cure. "A woman who gets breast cancer in Africa is afraid her husband will leave her and that she will be ostracized by society, and even lose her children if she admits she has breast cancer."

If that assessment shocks you, you're not alone. Too often, Americans' view of women's health issues stops at our borders. Because we've made progress, it's easy to forget that women in other parts of the world are still struggling. American successes against breast cancer and other illnesses that affect women like cervical cancer and pregnancy-related health problems should be models for the rest of the world.

There is still so much to do. Breast cancer is one of the leading causes of death for women in the developing world but there are other threats as well. Last week, during the annual debate at the United Nations in New York, officials of many countries got together to pledge support for international efforts to reduce maternal mortality. Their target is a disturbing statistic: every minute of every day, a woman somewhere in the world dies of causes related to pregnancy or childbirth. These losses have a dramatic effect on children as well; infants who lose their mothers are at greater risk of disease and death themselves. (If you're interested in becoming active in this issue, there are some good links at this United Nations Population Fund Web site.

In addition to these international efforts, American non-profits like Komen for the Cure are also beginning to reach out to women around the world. As one of the country's leading breast cancer advocacy groups and the largest funder of research into the disease after the U.S. government, Komen has been highly effective in drawing attention to the cause. On Oct. 13th, a delegation of doctors and advocates organized by the Komen Foundation will travel to Ghana to help dedicate a medical center that will educate, screen and treat breast cancer. Komen is also sponsoring its first Race for the Cure in Tanzania.

It's a critical mission, according to one of the doctors set to make the trip. "Fifty-five percent of breast cancer deaths occur in developing countries," says Dr. Ben Anderson, chair and director of the Breast Health Global Initiative at the Fred Hutchinson Cancer Center and a professor of surgery at the University of Washington in Seattle. If no changes are made, that percentage could increase in coming years because of demography alone. Right now, western Africa, for example, has a relatively young population with few women in their 40s, 50s or 60s—the ages when cancers start becoming more common. "By 2020, and particularly by 2050, these populations will age and there will be much more of this disease," Anderson says.