: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

214.751.4318doluwole@bushcenter.org

www.pinkribbonredribbon.org@pinkredribb

on