Speaker
Description
In September of 2013 we began working with a medical physicist at the Ocean Road Cancer Institute in Dar es Salaam, Tanzania. We developed a bi-lateral learning partnership over the course of eight qualitative Skype meetings. From these meetings we have ascertained that there is a gap between the installation of new equipment and treating patients. This gap has often been overlooked by international partners attempting to improve radiation therapy access. Relationships with academic institutions abroad can fill these gaps and lead to sustained care of patients needing radiation.
Today, many scenes in hospital wards of public sector hospitals in Tanzania and other African countries are often reminiscent of the battle to get AIDS treatment under way in the early 2000s. But now, hospital beds once filled mostly with AIDS patients are occupied by those afflicted with cancers, and other non-communicable diseases. In 2012 cancer was responsible for 8.2 million deaths globally. The World Health Organization predicts that by 2030 this number will increase to over 13.1 million deaths. In addition, currently 70% of those deaths are in low and middle income countries (LMICs), like Tanzania, which sadly are unable to deal with the growing cancer pandemic without collaborations. A 2007 Institute of Medicine report recommended collaborations between cancer centers in high-income countries with those in LMIC as the appropriate next step for cancer control in the developing world. A critical area of need in cancer control is in radiation therapy, employed in the treatment of over 50% of cancer patients.
My presentation will highlight our long-term goal to develop a USA/Africa Radiation Oncology Core (ROC), with both practical (PROC) and virtual (IROC) components, dedicated to Research Education/training in Radiation oncology in Africa and providing desperately needed quality assurance tools for patient safety and research collaborations for cancer control. The initial partner collaborating institutions in Africa include Muhimbili University of Health and Allied Sciences (MUHAS) and Ocean Road Cancer Institute (ORCI); from the USA side – University of Pennsylvania (UPENN), MD Anderson and Dana Farber/Harvard Cancer Center; from industry – Varian Medical Systems – the establishment of such an ROC will significantly increase research capacity and ensure radiation/patient safety. Our preliminary collaboration and analysis of publications, workshops in Africa and Harvard highlight a great need for such a Core to build research capacity and address an ongoing silent crises which is undoubtedly causing significant loss of life and disability in Africa. A successful launch of this Core program will provide a hub for Radiation Oncology research/education in east Africa; benefiting students/researchers from neighboring countries like Kenya, Uganda, Burundi, Malawi, Zambia DRC, Rwanda, South Sudan and Central Africa Republic.
While we are just in the beginning stage of this partnership, we believe there is great potential for success between both parties. We hope that MUHAS and/or Ocean Road Cancer Institute will benefit from potential funding and resources by partnering with a High Income Country to develop affordable solutions to clinical problems in Dar es Salaam. Successful establishment of an ROC could have a significant impact in addressing the rapidly rising burden of cancer in Africa, with publications that will shape the emerging field of global radiation oncology. The current literature shows that this global radiation oncology collaboration/partnership can serve as a platform for bi-directional learning where USA/African researchers can exchange ideas and innovations as well as develop the skills necessary to help their countries succeed in the rapidly advancing world of cancer research. Measurable outcomes should include: 1) joint publications on needs assessment for safe radiation medicine research and practice in Tanzania; 2) a new cadre or diverse new generation of cancer researchers who can collaborate effectively in teams with partners from other nations/cultural backgrounds 3) an innovative ROC for quality assurance, treatment planning, and incident learning system in Tanzania, extendable to other LMICs. The ROC could also be adapted for multi-center clinical trial quality assurance, develop technology for African specific needs, serve as a population-based cancer patient registry and potentially connect other arrays such as genetic or pathology information to appropriate research. Based on the information from our study and the creation of a pilot research program, we can develop a strategy for long-term sustainable research and quality radiotherapy care in Tanzania extendable to other LMICs. This project will leverage the strength of an already ongoing collaboration between the partner institutions. These partner institutions are leading cancer research institutions with the institutional environment to support the establishment of the planned ROC that will benefit cancer research and education, crucial for addressing the growing global burden of cancer and related disparities affecting LMIC.
