World Cancer Leaders’ Summit 2015

Improving cancer control in low-middle income countries and creating a global network of expertise

Mrs Ann McMikel - American Cancer Society, Atlanta, USA

In getting better cancer care you have to form all sorts of partnerships. I know you’ve been looking at this, how you get public-private partnerships, what is it that you’ve been doing?

Partnerships are critical to advancing the fight against cancer, particularly in low and middle income countries where the cancer burden is extremely high and where there are ways of addressing it, particularly preventing it, and controlling it that aren’t being dealt with at the moment. So the American Cancer Society works very closely with healthcare workers and particularly physicians around what role we might play in addressing issues of high priority cancers for us, which includes cervical cancer and breast cancer and addressing tobacco control issues.

What are the benefits for American doctors in joining in with the effort in low and middle income countries?

That’s a great, great question. We are all about building the capacity of organisations on the ground in the countries that we work and we work really closely with American doctors to allow them to share their expertise and to share their passion for their work in countries where their particular expertise is not readily abundant.

So you’ve decided to make it a priority of the American Cancer Society to get American doctors to other countries?

Absolutely. The American Cancer Society has more than three million volunteers and many of our volunteers are physicians themselves. They have a keen interest in addressing the disease burden, not just in the States but also in other parts of the world where the disease burden is high and unabated.

Is this purely altruistic or is there a benefit to America?

That’s where partnerships come from. The United States of America is leading in a lot of ways and our healthcare, particularly around cancer management and cancer control, we’re a leader so we can lead by helping to ensure that we’re not looking at the cancer fight just through borders, we’re looking at it wherever it may be.

And a very good ambassadorial role that is too. What sorts of issues have you been able to take on, can you give me some examples in the countries where things have actually been pushed forwards thanks to this effort?

Part of what we look at, our policies, what is it that we can be using our brand and our expertise around and sharing the evidence, sharing the evidence base, around why there should be a priority for countries particularly in the developing world such as Africa. So I’ll just give you an example: what we’re seeing is we need to have stronger cancer plans and cancer policies, particularly around the diseases, the cancers, that are most problematic. So we work with health ministers, we work with the health community, around ensuring that there are stronger cancer policies. An area that we are very proud of is that we’ve been able to work with African First Ladies in particular around championing this disease, bringing our medical might, if you will, to countries where they appreciate it and where we can also help to influence important policies.

One of the pitfalls of exporting expertise, though, is that there’s a risk that it might not be consultative and collaborative because a partnership depends on a partnership of equals. So how do you get your doctors to collaborate and to ask as many questions as they tell stories to?

That’s really, really critical, to go to these places not with any preconceived notions about what you might find but going with a real sincere interest in listening to the problems from those that are on the ground. So we often go on site visits where we’re just listening and then we’re coming up with solutions collaboratively.

And what are some of the problems you encounter, in Africa you mentioned for instance?

In Africa, so we’re seeing diseases like cervical cancer which can be prevented and can be treated and there are tools available to us through the vaccine and through low resource ways of screening for early detection. So those are the diseases that many of our leaders in country are saying, ‘Please help us address this issue.’ So we go in, we work with our counterparts in civil society and with governments to see where there might be some shared solutions around addressing the problem.

What are the ways you get these things implemented?

That’s where we need to be working with the corporate partnerships to see where we might be able to find some public-private partnerships that will allow us…

So government and corporate partners?

Government and corporate, so it’s a multi-sectorial problem that requires a multi-sectorial solution. So we know that we won’t tackle cancer, even in the States, as one sector. So we need to be looking at what is it that we can be partnering with governments and corporates around addressing an issue such as cancer and, in this case, cervical cancer.

Have you got any big success stories so far?

We don’t consider success stories until we’ve succeeded in ending cancer but we do have bright spots and one of the ways in which we are trying to address cancer multi-sectorially is through public-private partnerships that look at a specific country and a specific issue.

E.g.?

I.e. Kenya. Kenya is a wonderful country to support the kind of work that we’re looking at. It has political will at the level of the President and it also has a vibrant civil society community. So through that we are looking at specific projects that support cervical cancer prevention and control and we are very heartened by the fact that the government has really taken this on full swing. So we find that that’s a bright spot. Another bright spot is through an initiative called Pink Ribbon Red Ribbon where we work in partnership with the Bush Institute, UNAIDS, PEPFAR, as well as corporate entities like Merck and Becton Dickinson and ourselves, the American Cancer Society, through a public-private partnership where we’re looking at ways that we can increase awareness and access to breast cancer and cervical cancer prevention and detection services.

So one of the secrets of success is charm and actually implementing these partnerships. Could you sum up what you’d like people to take away from this, what are the key messages?

The key messages are we know that there are some solutions that aren’t being employed and so what we need to be doing is scaling up access to tools and solutions that we know can work in places that we know we can see the burden of cancer being lowered. So if we can just find those, there’s no magic bullet here, but if we can find the right kinds of partnerships that will allow us to really take this fight on in a robust, multi-sectorial manner, then what we can be looking at is a century where we’re seeing more cancers being addressed and more opportunities to finish the fight against cancer. That’s really what we all want to do – put ourselves out of business.

A great idea, what sort of call to action would you make to individual people everywhere?

I would say that cancer is now a global problem that is being recognised on the global agenda through the sustainable development goals. So we do have acknowledgement by world leaders that this a pressing issue. Now it’s about implementation, now it’s about individual countries really taking this on and ensuring that there is action on the ground at the community level. We need a grassroots movement, a global grassroots movement, around fighting cancer and we need to see it as the priority that it is. So the more that we can involve partners on the ground who are really committed to going to their policy-makers, going to their donors and saying, ‘Let’s join hands and let’s see what we can do collectively to address the fight against cancer.’