African Access Initiative: Improving patient outcomes in Africa

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Published: 15 Apr 2019
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Jennifer Dent - BIO Ventures for Global Health, Seattle, USA

Jennifer Dent speaks to ecancer at the 2019 American Association for Cancer Research (AACR) meeting about the work BIO Ventures for Global Health are carrying out in Africa.

Dent explains the "African Access Initiative" - which is a program focused on building human capacity to improve patient outcomes in the region; by providing better access to drugs, technology and diagnostic tools for patients.

The organisation works with governing bodies to understand the government's priorities in improving the outcomes of patients. However, they also work alongside healthcare providers to improve cancer care in the clinic.

In the future, Dent hopes to see an improvement in patient outcomes in Africa, along with the early and accurate diagnosis of patients and the availability of state-of-the-art treatments.
 

Bio Ventures for Global Health engages private industry, so pharmaceutical biotechnology companies, in programmes and partnerships to impact and improve global health.

What are you doing specifically in Africa?

We’ve launched a programme called the African Access Initiative and it’s focussed on providing access to drugs, diagnostics and technologies as well as building human capacity to improve cancer patient outcomes in Africa. Through this programme, the African Access Initiative, we’ve established partnerships with five Ministries of Health to date; we’re working in Nigeria, Côte d'Ivoire, Kenya, Rwanda and Cameroon and we’ll be launching in Senegal next month. The approach that we’ve taken through AAI, or the African Access Initiative, is to understand what the governments’ priorities are for improving cancer patient outcome and treatment. We work at both the Ministry of Health level, the government level, but also at the hospital level. Once we’ve signed an MOU at the Ministry of Health we then engage at the hospital level and work across departments in a hospital to sign a letter agreement with the heads of the hospital but then to have them actually execute a needs assessment or a questionnaire that follows the current practices in each hospital and how they’re currently diagnosing, managing and treating cancer patients. So this is about a thirty-page questionnaire that assesses right from how many patients present with different types of cancer, what stage they’re presenting with their cancer, and then what the diagnostic capabilities are at the hospital right through to how do they procure the medicines that they use to treat patients and how do they procure them but also is having access to those specific medicines a priority for those hospitals?

What is the fundamental driving force behind the initiative?

The focus of the African Access Initiative is to improve cancer patient outcomes that are focussed on the priorities and needs of our partners in Africa. So for BVGH not to go in with preconceived ideas of how they should prioritise or change their cancer patient management or treatment, to actually look at the priorities and needs of those oncologists and teams in country and then start to build programmes and partnerships that address those gaps. So specifically when we look at access to drugs we’ve moved quite far in Nigeria because Nigeria, being a country with almost 200 million people, quite sophisticated capabilities in diagnosing and treating cancer patients, once we’d completed about eleven of the needs assessments at the hospital level we actually collated and presented that data to the Minister of Health and his team and came away with an agreement to hold a cancer stakeholder meeting with the Minister of Health and to actually develop common treatment practices and guidelines across the federally funded cancer centres of excellence. We came away from that meeting with a list of 26 prioritised drugs and we used the NCCN guidelines to form a baseline of how those drugs would be combined to treat different cancer types. Through that process we’ve now issued an RFP, or request for proposals, to selected pharmaceutical companies that manufacture those drugs and we’re currently in the process of starting to put access agreements in place between the states in Nigeria with these cancer centres and the companies that manufacture these drugs.

What this process really does is for many cancers you need a combination of drugs that are manufactured by different companies, so co-ordinating across those companies to make sure that all of the drugs required to treat, for instance, a breast cancer patient are available at the same time, that they’re all high quality cancer drugs, that they’re transported and arriving at the hospital through a supply chain that is a supply chain that manages the drugs correctly and ultimately that we have the full treatment regimens to treat the patient for the full course of care. One of the challenges that a number of the oncologists in our African countries report is that patients are lost to follow-up, especially if they’re paying out of pocket which so many patients are in Africa. They come in and they have enough money to pay for maybe two courses of treatment but it may be that eight courses or thirteen courses of treatment are required. So we’re also working with the hospital teams to budget by patient so that each patient receives a full course of treatment and can truly have the best chance of having a good outcome and being cured of cancer.

How would you like to see this develop over the next few years?

Our real measure of success in this programme is actually seeing patient outcomes change. So when we start to see patients in these African countries presenting early, getting diagnosed accurately, getting state of the art treatment and a full course of treatment, that’s really going to drive change in African countries because patients will start to hear these stories, these success stories, that people go in with cancer and they come out cured. So ultimately our measure of success in this programme is seeing patients cured, seeing those success stories of patients being cured and really changing the complete paradigm of cancer in Africa as it is today.