African Access Initiative: “We Will Count Our Success By Seeing Patients Diagnosed Correctly And Treated With The Right Medicine”

Some 60 percent more Africans die from cancer than malaria, and the number of cancer deaths is expected to increase almost 70% by 2030, according to experts. Breast, cervical, prostate, lymphoma and colorectal constitute the top five cancers diagnosed on the continent. In order to address this emerging cancer crisis, the African Access Initiative (AAI) was launched over a year ago.

Begun in June 2017, AAI’s aim is to provide affordable, sustainable access to cancer therapeutics, enhance healthcare capacity, and foster cancer research in Africa. In order to do so, the initiative is expanding access to cancer medicines and technologies, strengthening healthcare infrastructure, and building clinical oncology and R&D capacity in Africa.

Led by BIO Ventures for Global Health (BGVH) in partnership with the African Organization for Research and Training Cancer (AORTIC), the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), as well as Pfizer and Takeda Pharmaceutical, AAI is working – in its first phase – with the governments of Nigeria, Cameroon, Ivory Coast, Kenya and Rwanda. These five countries have made cancer control a national priority.

In one year, AAI has collected cancer prevalence and drug access data from 35 hospitals, as well as facilitated international training opportunities.

“We have, for example, placed laboratory equipment to empower Nigerian pathologists to improve their diagnostic capabilities,” Jennifer Dent, the president of BVGH told Health Policy Watch in an interview during a visit to Geneva last week. “On top of that, we are currently developing a pricing model, because no model – built on sustainable logical economic basis for low and middle-income countries – exists today.”

Medicine Available in a Safe and Sustainable Way

Jennifer Dent

According to Dent, if the global health community has made important headway in tackling infectious diseases such as malaria in Africa, the continent is seeing an alarming rise in cancer and other non-communicable diseases.

“BVGH was founded to engage private industry in programs and partnerships that would address global health issues,” she said. “Through our other programs and our work with African countries, we realised that cancer was a growing problem and we decided to launch AAI, because we recognized that if we can build true partnerships between African ministries of health and companies, we felt confident that those companies would make their medicine available at much more affordable prices and in a safe and sustainable way.”

Filling the Gaps that have been Identified

“In launching AAI, we signed agreements with the ministries of health that we are working with. We also brought on board 35 hospitals that are treating cancer patients, where we have done our needs assessments,” she continued. “And now looking forward, we are focused on starting to fill some of the gaps that have been identified in those hospitals.”

Dent said African oncologists don’t have the same team dynamics that exist at some of the more advanced cancer treatment hospitals, noting, “They have so much to deal with. They often have to manage diagnostic, surgery, clinical oncology decisions and a palette of cares.”

Among the gaps that have been identified, skills in surgical oncology have been established as a high priority. Radiotherapy constitutes also a significant gap. Not only from the equipment standpoint, which is very expansive, but also from the radiologist’s perspective.

“It is an area where skills development is needed and it is an area where AAI is working to put a lot of capacities,” she said. Fellows from the MSD Fellowship for Global Health are currently volunteering for BVGH in Rwanda, to build diagnostic laboratory capacity at an AAI hospital [sentence corrected].

Access to the drugs is also problematic. “Sometimes it is just having sustainable regular access to those drugs that is the issue,” said Dent. “We are finding that often the hospitals don’t have a regular procurement system – everything is very fragmented.”

African Consortium for Cancer Clinical Trials (AC3T)

BVGH also launched the AC3T program in November 2017, in order to accelerate access to new and established cancer diagnostics, medicines, and treatments for African patients through the conduct of cancer clinical trials. “We want to make medicine available through a pricing agreement, but we also recognised that if we make some medicine accessible for free, that would be beneficial,” Dent said.

What Next?

“We will hold a meeting during the second week of September in Abuja, in partnership with the Minister of Health in Nigeria. We will bring together the CEOS of eight of the leading cancer hospitals and their oncology team with oncologists from the Memorial Sloan Kettering Cancer Center in New York,” she explained. “The goal is to start looking at the Minister of Health’s priorities and what we have identified so far as the hospital’s priorities through our needs assessments, in order to align them.”

Moreover, while already working with Pfizer and Takeda, AAI is talking to other potential partners.

“We do need more companies to come on board and to work with us,” insisted Dent, before concluding: “Ultimately, we will count our success by seeing patients diagnosed correctly and treated with the right medicine, patients that would not have seen that treatment if it was not for AAI.”

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