Closing the Cancer Care Gap in Africa

Cancer in Africa
Africa and other low- and middle-income regions are collectively responsible for 70% of the global cancer burden. Africa faces a 67% mortality-to-incidence ratio from cancer according to recent statistics released by the World Health Organization’s International Agency for Research on Cancer (IARC). Compare this number to the 23% touted by Northern America, and the disparities are clear. Without urgent action, Africa’s cancer burden is expected to double to 2.4 million new cases and 1.6 million deaths annually by 2045.

Africa’s growing cancer crisis is fueled by a lack of high-quality oncology care, particularly in Sub-Saharan Africa (SSA). African countries struggle with access to diagnostic services and treatments. African oncologists see nearly twice the number of patients, travelling to a greater number of sites compared to oncologists in other regions. Research has also shown that individuals of African descent have unique tumor genetics and biologies. African patients are severely underrepresented in clinical trials of novel oncology medicines and technologies, resulting in a “cancer data gap” – lack of scientific evidence regarding the safety and efficacy of many oncology products in African ethnicities.

Driven by Africa, for Africa, BVGH’s African Access Initiative (AAI) takes a holistic, sustainable approach to fighting cancer across the continent. AAI is empowering healthcare professionals to better prevent, detect, diagnose, and treat cancer through tailored training programs; expanding access to oncology medicines and technologies; and addressing the cancer data gap through clinical trials.

Building Cancer Knowledge to Broaden Healthcare Reach
Due to its complexity and ever-evolving nature, healthcare is an industry where continuous learning is not just an advantage but a necessity. By providing a large training docket with responsive topics, BVGH is continuing to build on the aptitudes of healthcare workers in low- and middle-income countries.

With a blend of both targeted in-person trainings and virtual lecture series, BVGH’s courses are guided by the needs of AAI partner countries. Topics have ranged from specifics like gynecologic cancer care to broader topics such as cancer pain management. In response to requests from partner sites, BVGH also organizes specialty in-person courses with industry experts to address a site’s self-identified needs and provide tailored training.

Bolstering Diagnostic Capacity
In SSA, general hospitals are typically not equipped to diagnose cancer. Tertiary hospitals that diagnose cancer frequently suffer from lack of reagents to perform critical tests. Even facilities that do have diagnostic technologies and products can be underutilized, as a lack of knowledge around usage of specialty equipment blocks many pathologists from reaching appropriate diagnoses. Patients often travel for several hours to reach a hospital offering cancer care, only to find that the resources needed to conduct diagnostic tests are not available.

The costs of travel, and time away from work or family, required to access cancer care are generally unaffordable for patients living in lower-income areas. As such, diagnoses are often significantly delayed, allowing the disease to advance beyond the point of possible treatment. For example, 80% of breast cancers are diagnosed at late stages (stages III or IV) in SSA, vs. 15% in high-income countries.

AAI capacity building programs are increasing the number of pathologists across Africa with the skills and expertise to provide high-quality cancer diagnostic services. BVGH’s 2023 virtual pathology courses covered breast cancer, skin cancer, neurological cancer, and ophthalmic cancer. Through its Virtual Pathology Mentorship Platform, BVGH facilitates ongoing knowledge sharing by coordinating and hosting lectures and discussions.

In alignment with African governments and organizations, BVGH also leads campaigns to build screening and diagnostic capacity, and increase access to services, including in remote areas through specialized approaches like mobile cytology clinics.

Breaking Barriers to Access Pivotal Medicines and Technologies
Since launching AAI in 2017, BVGH has coordinated delivery of over 17,000 packs of medicines to partner hospitals. To enable sustainable and demand-driven access, BVGH works closely with AAI hospitals to assist with forecasting drug needs, determining budgets, and negotiating payments. As a direct result of this program, more than 4,000 patients have completed their treatment regimens. BVGH’s drug access program has opened the doors for hospitals to provide more affordable care to patients, including those who were at risk of abandoning treatment due to cost.

BVGH also works directly with hospital personnel to train in cancer treatment technologies, both virtually and in-person. These training programs are customized to either meet specific goals (such as training for an institution’s new machines) or address widespread knowledge gaps with the greatest potential impact for patients and providers alike.

Eliminating the Cancer Data Gap in SSA
Participation of African organizations and scientists in research and clinical trials is critical for validating the safety and efficacy of existing oncology products in African ethnicities, as well as for developing new products tailored to the continent’s diverse populations. BVGH’s African Consortium for Cancer Clinical Trials (AC³T) is fostering clinical trial capabilities and inclusion in Africa through training programs; mentored clinical study opportunities for early-career researchers (funded by Takeda); publication and promotion of African sites’ clinical trial readiness profiles on the AC³T online platform; and facilitation of mutually beneficial clinical trial partnerships between African investigators and global sponsors.

Providing Life Saving Care Through Sustainable Practices
Sustainable, community-driven interventions are needed to reverse the troubling cancer trends in Africa, where cancer has long been regarded as a death sentence. Through AAI, BVGH is working to change this perception and equip healthcare workers with the tools to save lives.