:Global Health Catalyst Cancer Summit @Harvard Medical School
Public-Private Partnerships: Advancing Women’s Cancer Care in sub-Saharan Africa
Doyin Oluwole, MD. MRCP, FRCP, FWACPExecutive Director, Pink Ribbon Red Ribbon
Total: 35.0 million [33.2 million – 37.2 million]
Middle East & North Africa
230 000[160 000 – 330 000]
Sub-Saharan Africa24.7 million
[23.5 million – 26.1 million]
Eastern Europe & Central Asia1.1 million [980 000– 1.3 million]
Asia and the Pacific4.8 million
[4.1 million – 5.5 million]
North America and Western and Central Europe
2.3 million [2.0 million – 3.0 million]
Latin America1.6 million
[1.4 million – 2.1 million]
Caribbean250 000
[230 000 – 280 000]
The Challenge: HIV/AIDSAdults and Children Estimated to be Living with HIV I 2013
The Challenge: Women are now surviving a diagnosis of HIV because of anti-retroviral drugs, but dying of a preventable disease – cervical cancer.
The Opportunity:Antiretroviral Treatment and the Lazarus Effect
The Challenge: Inequity of Cervical Cancer
85% of 528,000 cervical cancer cases per year
occur in the developing world.
It’s not acceptable to save a woman’s life from HIV/AIDS and watch her die
from cervical cancer.
-PRESIDENT GEORGE W. BUSH
Pink Ribbon Red Ribbon
Zambia: 2011| Botswana: 2012|Tanzania: 2013| Ethiopia: 2015| Namibia: 2015
The leading public-private partnership aimed at catalyzing the global community to reduce deaths from cervical and breast cancer in sub-Saharan Africa and Latin America through: raising awareness of these diseases and increasing access to quality services to detect and treat them.
A global catalyst
Launched: 2011Founded by the George W. Bush Institute, the United States Government through the U.S. Emergency Plan for AIDS Relief (PEPFAR), Susan G. Komen, and the Joint United Nations Programme on HIV/AIDS (UNAIDS).
Work in 5 countries
With plans to expand to Latin
America
Namibia
Botswana
ZambiaTanzania
Ethiopia
PrimaryPrevention HPV
vaccine
Secondary Prevention/Screening CBE VIA HPV Cytolog
y
Treat (if abnormal):
Cryotherapy
Refer
Referral
Colposcopy
LEEP Biopsy Labs
Cancer Rx Surgery Chemo Radiatio
n
Palliative Care
Awareness Raising/Community Education
Technical Support
Continuum of Cancer Control and Care
Transitioning programs to national governments with an enabling policy environment and budget to sustain them.
Goalsdeaths from cervical cancer by
25% among women screened and treated in partner countries.Achieve at least
80% coverage of vaccination against HPV.
Screen at least
80% of the appropriate target populations for pre-invasive cervical cancer, and treat those found with lesions.
awareness
reduce stigma
about breast and cervical cancer, and promote the early detection of the disease.
Create and test innovative approaches to sustainability, financing, service-delivery, and laboratory and data systems that can be scaled-up and used globally.
PINK RIBBON RED RIBBON PARTNERS
NEW PARTNERS: • AIRBORNE
LIFELINE FOUNDATION
• INTERNATIONAL ATOMIC ENERGY AGENCY (IAEA)
• VODACOM FOUNDATION
• GENERAL ELECTRIC
Partner Countrie
s
Partners’ Roles---The Continuum of Cancer CarePrimary
PreventionSecondary
Prevention: Screening
Secondary Prevention: Treatment
Referral Diagnosis: Treatment
Palliative Care & Hospice
Data/Registry
HOW WE WORK
How We Work with Countries
A Diagonal Program
PRRR mobilizes resources from governments, foundations, corporate and philanthropic organizations and individuals
Starting from the HIV platform, integrates women’s cancers;
Strengthens countries’ capacities to deliver comprehensive cancer control & address other chronic diseases;
PRRR activities are aligned with country plans & responsive to the national needs & priorities: 3 Tiers of engagement;
Partners fill countries’ prioritized gaps to ensure comprehensive service delivery;
Commitments are publicly made & periodically reported on to promote accountability.
Pink Ribbon Red Ribbon Strategies
EDUCATIONAWARENESS SCREENING
SVACCINATIO
N
ACCESS
TREATMENT SKILLS BUILDING &EQUIPMENT
Results Through Partnerships
Results from Zambia (since 2011), Botswana (since 2012) and Tanzania (since 2013)
Partnerships + Access = Results
HPV Vaccine
42,045Number of
girls who have received all
three doses of HPV
vaccine
Basic Cervical Screenin
g153,670Number of
women screened for
cervical cancer.
Basic Treatme
nt
14,089Number of
women treated with cryotherapy
or LEEP.
Breast Cancer
Screening
5,228Number of
women screened for breast cancer in Tanzania.
Challenges: Cancer Care• 33,991 women are diagnosed
with cervical and breast cancer annually in the five Pink Ribbon Red Ribbon-supported countries;
• This number is under-reported, as many do not seek care in hospitals;
• Unfortunately data on the percentage that receive advanced treatment is unknown;
• A significant percentage of women present with late-stage disease not amenable to treatment.
5,000 new cancer patients each year
2,500 are breast and cervical cancer
patients
Ocean Road Cancer Institute
2,000 come from outside of Dar es
Salaam
500need a place to stay during cancer
treatment
Case Study: Tanzania
The Story of Evelyn
https://www.youtube.com/watch?v=gUbxGwbANgU
• Information and knowledge of the disease• HPV vaccination• Screening, early detection and
treatment services • Funds to pay for health care services• Advanced cancer care close to home—
geographic access • Strong healthcare system
Evelyn died because she lacked access to:
The Way Forward
The Future
Fewer Evelyns!
Prevention: one-dose HPV vaccine Innovative solutions to reach more women more quickly
o HPV DNA testing will reduce number of women needing VIA
o Cryopen: gasless cryotherapyo Mobile services models to augment fixed facilitieso Improved data management & tracking systems: IT
and mobile devices Integration of screening and treatment services with
existing health services such as family planning and post-natal care
Decentralized, functional cancer centers to provide quality care as near to the population as possible: human capital; equipment; maintenance and standards of practice.
CONNECT WITH PINK RIBBON RED RIBBON
Doyin OluwoleExecutive Director
www.pinkribbonredribbon.org@pinkredribb
on