Beyond virtual learning: Leveraging project ECHO to sustain and localize national cancer control plan implementation in LMICs.

Project ECHO has emerged as a promising virtual peer-learning model to support National Cancer Control Plan (NCCP) implementation in low- and middle-income countries (LMICs). It aligns with the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020, which underscores national coordination and multisectoral action [2]. In response to the recent evaluation by Eldridge et al., we offer additional insights highlighting the limitations of individual-level training when structural barriers remain unaddressed. Drawing lessons from cervical cancer prevention in Botswana and palliative care capacity-building in India, we argue that ECHO's full potential lies in national-level integration, cross-sector policy coordination, and localized implementation. This correspondence emphasizes a systems-level perspective to sustainably embed ECHO-based knowledge into cancer control programs across LMICs.