Goals of the VUCCnet in sub-Saharan

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Published: 2 Dec 2013
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Susan Morgan - International Atomic Energy Agency, Austria

There is a drastic shortage of accessible knowledge and quality training programmes in Africa for comprehensive cancer control. In particular, local capacity to train and mentor practitioners within the region is not sufficient to ensure sustainable cancer control. The International Atomic Energy Agency (IAEA), through its Programme of Action for Cancer Therapy (PACT) in cooperation with its international partners in cancer control, launched, in 2010, an initiative to establish a Virtual University for Cancer Control supported by regional cancer training and mentorship networks.

Susan Morgan discusses the goals and objectives of the VUCCnet at the 2013 AORTIC meeting in Durban, South Africa.

Currently there are six founding countries in the Virtual University: Ghana, Uganda, Tanzania and Zambia supported by South Africa and Egypt. These countries, the Ministries of Health and the Ministries of Education are working together sharing resources, existing education and training capacity in ten priority areas in cancer control, working together so that we can strengthen education and training capacity especially in Ghana, Uganda, Tanzania and Zambia so that they themselves ultimately become sub-regional training hubs. So the ten priority education and training areas are clinical oncology, radiation therapy technology, oncology nursing and pathology services and then we have six in-service courses which are a cancer skills package for community health workers, a cervical cancer early detection and prevention course, surgical oncology modules, palliative care modules, pathology technician modules and cancer registration modules. The countries are working together using their experts to develop relevant materials that will then be shared across the network.

The primary objective is in the long term to make these countries self-sustainable in terms of creating their own workforce. So currently in the African continent there’s a trend due to necessity of sending workers out of country and even out of continent sometimes. So you will have a doctor specialising in radiation oncology from Zambia spending four years in South Africa to complete their specialty training because the capacity is not currently there. So it’s about trying to build local capacity and self-sufficiency in health workforce preparation so in the long term people do not have to travel away from home. Using e-learning, as more and more people in Africa get access to the internet, it enables more and more people to access education and training and also they can access it very, very close to home. In healthcare, countries like Australia and the United Kingdom, South Africa, the US that have traditionally undertaken education and training on behalf of lower and middle income countries, they themselves have an aging population and have gross shortages in doctors and nurses. So I think that as we move forward those countries will start to look inwards in solving their own problems in terms of workforce shortages so it’s imperative that we help lower and middle income countries strengthen their own capacity to be self-sufficient.

Are there any future plans to roll this out to other countries in Africa?

Definitely. We are at a very exciting point in the project where we’ve agreed on a governance structure and we are just at the moment of undertaking what we’re calling the founding acts, so we’re signing the constitution, signing the memorandum of understanding. This will link the initial six founding countries together; at that point, any other country who wants to partake or education and training institution relevant in Africa will be able to become a member. Another exciting thing about this project is that it’s almost like it’s a pilot project – we want to capture the lessons learned in almost like a franchise model out of the sub-Saharan Africa experience and hopefully we can replicate this virtual university model in Latin America, South East Asia, just as another example. So Africa is truly leading the way in this initiative globally.

How did the idea for the virtual university come about?

That’s a very good question. I think for a long time people have known that one of the key barriers to improving cancer services across the world in lower and middle income countries is workforce shortage and so people have been looking for innovative ways to enable countries to start training their own workforces but also perhaps to move away from the traditional education and training models such that people can do things quicker as well. So a lot of e-learning is self-directed and people can do it in their own time. So if a student wants to sit down and do 25 hours in a row, they’re able to do it using e-learning as opposed to being locked into standard timeframes with traditional models. So people were looking for solutions that enabled people to access education and training and also to access it close to home to minimise brain drain and also to look at ways that enabled more flexible timeframes and perhaps to get people trained faster. I will say, though, that with health education it’s very, very important that you have hands on clinical practice with the patient so at the VUCCnet which is an e-learning platform, or the VUCC piece is the Virtual University for Cancer Control, that’s the e-learning piece but that must be coupled with face to face and hands on. So the net in VUCCnet is for a regional African clinical training network, it’s not for internet which I think many people think when they hear VUCCnet. So the VUCCnet is about the e-learning platform and creating this network amongst countries but also another step will be how they can share their existing hospitals and resources to make sure that people get the correct clinical practice training as well.

You mentioned that there was some affiliation with IAEA, could you talk a little bit about that?

The IAEA, the International Atomic Energy Agency, has a programme of action for cancer therapy. For many years, probably the last 50-60 years, the International Atomic Energy Agency has been working in low and middle income countries helping them establish or expand radiation medicine services for cancer, so setting up radiotherapy departments. But it became very, very obvious that you can put as many treatment machines, cobalt-60 machines or linear accelerators out into the field, unless those machines are connected in a comprehensive cancer control system, patients will continue to turn up for treatment when it’s too late. So to enable radiotherapy investment to be appropriate and sustainable, for patients to be accessing a cure as opposed to just palliative care, the agency created the programme of action for cancer therapy that enables the agency to articulate with the World Health Organisation, UICC, IARC and many other partners so that we can make sure that our radiation medicine investments are part of a more comprehensive cancer control solution for that country. Because of that and the work that we do in low and middle income countries we were very aware that workforce is a key barrier so we went seeking partners and also donors to support the VUCCnet project. We’re leading the project but we’re working very closely with the World Health Organisation, IARC, UICC, the US National Cancer Institute and many others to help these countries develop up this VUCCnet solution.

Is there anything else you’d like to add or any other points?

No, thank you. I think I’ve talked off your tape.

No, no, that’s perfectly fine. Great, and cut.