Personalised research for cancer care in Africa

Bookmark and Share
Published: 10 Apr 2019
Views: 1303
Rating:
Save
Prof Folakemi Odedina - University of Florida, Gainesville, USA

Prof Folakemi Odedina speaks to ecancer at the 2019 American Association for Cancer Research (AACR) meeting about the need for evidence-based medicine that is personalised to improve cancer care in Africa.

Prof Odedina also highlights the fact that the majority of cancer research is conducted in Europe and North America; and raises concerns about the applicability of this research for the African population.

She also mentions the areas where further research needed, which include genomics, epigenetics, implementation, behavioural and clinical science. In order to permit this research, improved infrastructure in Africa is vital, along with investing in its own talented investigators.

 

With respect to conducting research in Africa, I think it’s really one of the things that Africa struggles with and it’s so important to have cancer research in Africa. If you think about it medicine is based on evidence so we really have to have evidence-based medicine that is personalised to cancer care in Africa. We are really caring, controlling and providing treatment for cancer based on research that is done outside Africa; it is based on research that is mostly done in Europe or that is done in North America. If you think about the population that is in North America and that is in Europe they are mainly or primarily Caucasian. So when you think that this is the world of genomics, this is the world of personalised medicine, this is the world of using your DNA to be able to find the best therapy for you and find the best thing that is going to really address your cancer, diagnose your cancer, treat your cancer, then you really have to be able to conduct research to be able to do it. Unfortunately, Africa still struggles with that. I do understand why we struggle with that, I understand that Africa struggles with that because they are fighting infectious diseases. Now it is compounded by non-communicable diseases so it’s like a double whammy and they’re trying to address there and address the care. But you cannot address the care and the treatment without research so it is really important to really focus on research coming out of Africa.

What needs to happen to develop this focus on research coming out of Africa?

I’ve been working with colleagues in Africa since 2005 so I am very familiar with the challenges that are in Africa. One thing that is very clear to me is that if Africa is going to have outstanding science and outstanding research it is going to really be based on the investigators, they cannot rely on the government, they cannot rely on somebody outside. It’s going to be based on the investigators and it is going to be based on the research institutions, on the universities, because the universities are charged with moving science forward. The investigators, your primary mission is to be able to move science forward. So for Africa to be able to do this there really has to be at the individual level of the investigators and at the institutional level. At the individual level the investigators and the scientists have to become mated to hard work and being able to do great science. At the institutional level they really have to change their mode of promotion and tenure to be focussed on research so that you can have your investigators and your faculty really doing great science.

Now, a big challenge of Africa is the infrastructure and the resources and the training of the workforce. We have very brilliant minds in Africa; I came out of Africa and I got my first degree in Africa before I went to go and get my PhD in the US. I really am in awe with the investigators that we have in Africa – they have very brilliant minds, they know what to do. But the problem is there’s no infrastructure to support them, also there is no availability of research training for them to be able to do it. This is one area that I’m really proud of ecancer because now you’re talking about research training and being able to work with investigators in Africa to be able to provide additional training for the workforce, that is great.

What I want to say, if you want to be successful, if you are watching this then you are an investigator somewhere and you’re asking yourself, ‘I am interested in research and I would love to do research. How do I do it?’ Research is not an individual endeavour – you have to really be in the middle of a team, you have to be part of a team. You have to be part of a multidisciplinary research team or interdisciplinary research team. For us, the people that we work with it’s because we practice team science as well as the work within a consortium environment. So we have a consortium that I founded in 2005 that is called CaPTC, Prostate Cancer Transatlantic Consortium. With that consortium, our consortium studies prostate cancer in black men all over the world and we bring investigators together to be able to work together. So in Africa we have over 200 investigators in Africa that we work with, primarily in West Africa. Primarily in West Africa because they are the most connected to the US blacks and so we are trying to have synergy and to be able to understand why do we have a prostate cancer disproportionate burden in blacks all over the world. So I would say if you are an individual person you cannot do this by yourself. This is not the world of competition, it has become the world of collaboration. If you are going to be competing you have already failed. If you are willing to collaborate and work with other teams and tap other resources that other teams have then you are going to be very successful.

I would like to throw an open invitation, if you are in Africa, if you want to join CaPTC, feel free to just Google CaPTC and you will be able to find us. If you are doing other types of cancer please look for consortiums that are African based that you can join. That’s the only way that you can be successful.

What are some examples of where the infrastructure in Africa is lacking?

Simply put, if you look at the different areas of research that has to be done, especially for cancer, you are looking at the areas of genomics, you are looking at the areas of epigenetics, you are looking at the area of implementation science, you are looking at the area of behavioural research and you are looking at the area of clinical science. For you to even be able to do any work in the area of genomics or epigenetics you have to have an outstanding lab that really would be able to take from your tissue procurement all the way for you to be able to bank and biobank those tissues and then for you to be able to do all the analysis and extract the DNA and RNA, which we simply don’t have. Some infrastructure, there’s a little bit of infrastructure, for example one of the universities that we work with in Nigeria is Covenant University. They just got a WHO funding to be able to develop a centre of excellence for prostate cancer and for breast cancer. That’s because that institution decided to invest in infrastructure that includes biobanking, that includes the ability to be able to do DNA extraction and RNA extraction. In addition the institution, Covenant University, invested in its own investigators. One of their investigators is currently in the US doing Fulbright at the lab of Dr John Carpten who is one of the topmost genomic scientists in the world. So the investment that Covenant University put in developing a great lab, in developing its people, is now yielding that grant, a $6 million grant that they now have to be able to do more.

So it’s very important that we know that there are shortcomings, we know that there is infrastructure not there. One of the things that we like to foster within our consortium is adopt a lab so that there would be a way that we can work with you and we can try to get your lab up. In the United States oftentimes we use an instrument, a research instrument, for maybe two, three, four, five years and then we exchange it so those instruments could be sent back to Africa for them to be able to use them. It just takes the right connections. One of our CaPTC investigators actually has just adopted a lab in Nigeria and is sending a lot of instruments to the Federal Medical Centre in Abeokuta. So your partnership with investigators in Europe or the United States actually leads to you to be able to improve your infrastructure. So you may lack but there are opportunities for you to be able to improve it. This is why I said it is so important to be part of a consortium because if you are part of a consortium you are linked to investigators all over the world that offers you the opportunity to come and train in the United States or elsewhere, that offers you the opportunity to have an investigator outside Africa that says, ‘I’m throwing away this instrument, it’s still very useful, you can still use it for this analysis,’ or that has an investigator that can include you in their grant. If they include you in their grant it means that they are going to ask for the all the resources that you need for you to be able to conduct it.

Is there anything else you would like to add?

One of the things, like I said, there are outstanding scientists in Africa. I’m telling you, it’s amazing to me how the scientists in Africa have been able to survive and do all the work that they are doing. So one of the things that my consortium has just started is a Cancer Research Africa podcast and YouTube because we really want to highlight what Africans are doing. We want to highlight the science coming to Africa. So we are going to start actually releasing this in April and our goal, really, is to be able to just say it is great that Africans are collaborating with people outside Africa, that is fantastic, but we want to tell you that there is great research and there is great science coming out of Africa. We want to highlight that great science, we want to showcase those great scientists and what I hope that we do is when African scientists see other African scientists and see their science they can reach out to them and they can collaborate. Ultimately Africa-Africa collaboration is going to be the best because you understand your challenges and you know how to do your work. But within Africa if they can come together and be able to do the research in a way that is culturally sensitive to the African population then science will rise in Africa. That is the whole goal. We want cancer research to rise; we know that Africa is rising and we want to do everything to promote Africa and to promote science in Africa.