The Lancet Oncology Commission on sustainable care for children with cancer1 provides a comprehensive analysis of the global challenges in childhood cancer control. The Commission examines the incidence, survival, availability, and costs of childhood cancer services, models the costs and health and economic benefits of scaling up childhood cancer care, discusses how services can be expanded, and proposes key targets to be achieved by 2030. These aspects are examined and discussed in the context of different countries and regions, particularly high-income countries (HICs) versus low-income and middleincome countries (LMICs).