Can we fight childhood cancer in Africa the same way we fought HIV?

by Joseph Lubega and Phangisile Mtshali
Thursday, 9 March 2017 15:38 GMT

* Any views expressed in this article are those of the author and not of Thomson Reuters Foundation.

Years ago, as HIV and AIDS raged across Africa, many people thought it would be impossible to effectively treat children with HIV.

Between 1980 and 1999, 14.8 million people died from AIDS in sub-Saharan Africa. More than 20 percent of those who died were children.

Several countries only had palliative programs to prepare these children for death, as there were simply not enough trained professionals and infrastructure to meet to meet the need. Hope was indeed a four letter word.

Yet, through the combined commitment of local governments, global partners, public health workers and volunteers on the ground, we have turned the tide on HIV over the past two decades and lowered the mortality rate to 1.2 percent.

Today in sub-Saharan Africa, pediatric HIV is considered a chronic, survivable disease – not a death sentence.

We are now looking at an entire population of teenagers living into adulthood despite having HIV infection. They have been granted a future and a sense of hope has been restored within communities which for so long, only knew death and loss.

While these systemic changes have created a future for those children living with HIV, these regions are now battling to care for children diagnosed with cancer and blood diseases.

Eeach year, an estimated 11,000 children are diagnosed with cancer, and another 40,000 are diagnosed with serious, life-threatening blood diseases in Botswana, Malawi and Uganda.

Yet, with only five trained pediatric oncologists in those countries combined, we estimate that up to 90 percent of these children with cancer will die.

Why is it that children with cancer or blood diseases in southern and east Africa face these odds?

In many cases, the closest pediatric oncologist is potentially more than 500 miles away, and chances are that a radiotherapy center or trained pharmacist is equally out of reach.

Similar to the earlier days of the HIV and AIDS crisis, parents of children with cancer or blood diseases don’t believe that their child will be cured.

On a global level, the task of saving the lives of these children seems daunting, if not impossible, given the training, specialists and infrastructure needed.

But if we apply the solutions that turned the pediatric HIV and AIDS crisis in these countries into a global health success story, we know that the seemingly impossible becomes achievable.

In that spirit, the Bristol-Myers Squibb Foundation, Texas Children’s Cancer and Hematology Centers and BIPAI, in partnership with the governments of Botswana, Malawi and Uganda are providing $100 million to create an innovative hematology-oncology treatment network.

The comprehensive initiative, called Global HOPE (Hematology-Oncology Pediatric Excellence), will build long-term capacity to treat and quickly improve the outcomes of thousands of children with blood disorders and cancer in southern and east Africa. Additionally, this initiative will support construction, equipping and operating of regional pediatric hematology-oncology clinical facilities.

The significant increase in trained professionals and established infrastructure will drive us to our most important endpoint: that children with cancer and blood diseases live to a productive adulthood, regardless of where they live.

We need families to see that their children are improving with medical care. Our experience tells us that once parents see the possibility of a future for their child, they will be encouraged to return for appointments, despite the distance or time involved.

If the impact is quickly recognized, others will be encouraged to seek treatment for their children as well.

Is the road ahead for treating pediatric cancer and blood disorders in southern and east Africa challenging and complicated in so many ways? Yes. But the most important, fundamental lesson we can take from our HIV experience is that this can be done, and this can be done well.

There is an African proverb that states: ‘To go fast, go alone. To go far, go together.’ We must show these families that hope remains, and that to go far, we must go together.

Joseph Lubega is an assistant professor of pediatrics at Texas Children’s Cancer and Hematology Centers and Baylor College of Medicine, and the Director of the East Africa Pediatric Hematology-Oncology Fellowship Training Program.

Phangisile Mtshali is the director of Bristol-Myers Squibb Foundation’s SECURE THE FUTURE program.