Addressing disparities in access to clinicians

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Published: 8 Dec 2015
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Prof Ahmed Elzawawy - President of AORTIC

Prof Elzawawy talks to ecancertv at AORTIC 2015 about the various ways in which cancer care can be improved in Africa.

The fight for better value cancer care is important, he says, but the best long term benefits will be seen from the medical training of many more people.

The huge disparities between the number of clinicians in the developed and developing world are one of the main issues facing Africa, he says.

At the same time, Africa can still be a place for innovation in cancer care and offers, he argues, a wealth of diversity from which to develop research.

He notes the importance of online education and skill sharing.

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It is not paper only, it is a series of works and the recent one is in the Journal of Global Oncology and also before there is some work about the same topic, important topic, as a keynote speech in Harvard in March and previous publications. It is going on as a win-win scientific initiative. It’s an endless, really open way to improve global cancer care based on scientific approaches, not just to give some help, limited help for a while or for small projects, or something like help or aid but looking for win-win initiatives. That is to say, the end result would be a win for the taxpayers in the United States, in Europe, and at the same time improvement of cancer care in developing countries and progress of science and it would be a win for all stakeholders, including producers of drugs and. Otherwise we’ll continue to speak about some type of romantic thing or very limited thing. Because look for the numbers: we have millions of cancer patients in the world so we need really a real achievement and real win-win scenarios based on science.

Also what encourages me really, that there are many published articles. I am not an inventor, I have no patency. It is based on the scientific work of many researchers, done and ongoing and it will be done. It is about how to make treatment better, how to get better value treatment, how to get better value diagnostic measures, how to get better value of our efforts, scientific efforts, to improve cancer care. This will solve, could solve, many problems, even a shortage of essential cancer drugs in the United States. We have a shortage of generics and essential cancer drugs in the United States and in some parts of the world. Not only limited to countries but it should be a search for global solutions, for scientific. There is a book by Lord Grace about this, about how we can invent a way of home and win at home. There are also some references about how to .... of innovation, that is innovation could not be only coming from developed countries but could be also from developing countries. This is win-win but it’s not a matter to provide money, to provide some financial things. This is very short-term results really and this also, or to have some advanced training for some persons who will find no way to apply what they learn in the United States or Europe, and this, of course, brain drain, obligatory brain drain, because this is not only for money but this is also to continue their career. But if they can continue this scientific research in their homelands with the local conditions with what is provided by rich countries is the technology, is the methodology, is revision of data, is statistics, is the publication. So all would win.

I would like that really institutes in the United States and Europe consider these young researchers and scientists and clinicians in developing countries and in Africa like co-researchers and co-workers. So they stay at home and we’ll have more stuff that enriches studies in western countries but at the same time no problem of immigration, of all these things, and no brain drain. And to improve the global cancer care effectively and all could win.

What challenges does Africa face?

We always repeat that we need training, education, yes, but I would like to say something. The last few examples, this is tragic things. We say that from Cameroon there are 500 doctors working in Germany only. The number of doctors who are working from the Republic of Benin in Paris, not all over France but only in Paris, is equal to the whole number of doctors working in Benin. So it is a question of lacking of manpower in Africa.

What potential for research does Africa provide and what insight can the African experience give to global cancer care?

There are rich materials, I say materials but I don’t like this, you can say rich subjects, different ethnicities, rich in different experiments, these growing departments and scientific units in Africa. We can give them a push, help from a scientific point of view, and we could conduct with them really advanced research on cancer care. This will improve global cancer care. There are many examples; I give you examples that really missed an open way for wide research. You measure United States, they examined already it is a difficult part of the work, the technology part of the work, examined 3,000 combinations of all the drugs. Some of them are lacking now in the markets in the United States and there is a great need for those drugs in developing countries and they’re already ready for making this research. It could give indications that we never dreamed about. It could give us more effects than we had before, less side effects and all these tested as experimental. We already did the difficult part of the experiment and surprisingly free in the website of NCI. Nobody it, it is an open way for wide research. You have the workers in Africa, you have the patients, you have the places, you have to support them scientifically and provide them with the methodology, revision of data, statistics, analysis of data. We could do really a very big push forward for the effort of global cancer care based on Africa.

What is important for me as an oncologist and doctor is we’ll see more hundreds, thousands of patients will be treated in the upcoming years and more and more after. Treated and will take reasonable care because if you make this scientific work you are obliged to have good technology and good pathology and everything. This is the support that could be done; in this way you can support.