While about 10,590 children in the United States are diagnosed with cancer each year, more than 80 percent of them survive 5 years or more. But in sub-Saharan Africa, the statistic is vastly different – 90 percent of the 100,000 children diagnosed with cancer annually die from their disease.
At Celgene, we believe that cancer treatment should be available to patients no matter who they are or where they live. That is why Celgene recently supported expanded care capacity in resource-constrained countries through $1 million in grants as part of the Celgene Cancer Care Links™ program.
In recognition of World Cancer Day 2019, Dr. David Poplack, M.D., director of the Global HOPE program at Texas Children’s Hospital’s Cancer and Hematology Centers and Baylor College of Medicine, explains how two grants received by Baylor College of Medicine and Texas Children’s Hospital from the program are being used to improve cancer care in sub-Saharan Africa.
This year marks the launch of the “I Am and I Will” World Cancer Day campaign, which encourages people to make a personal commitment to reduce the impact of cancer. So let’s start there. Can you describe what you’re doing to help fight cancer?
“Our goal at Global HOPE is to improve the survival rate for children with cancer in sub-Saharan Africa by increasing their capacity in this underserved region. To do so, we are establishing centers of excellence in six countries where we train pediatric doctors and nurses to become experts in diagnosing and treating children with cancer and blood diseases.”
What challenges are clinicians facing in sub-Saharan Africa?
“In my frequent travels to the region, there’s a noticeable lack of understanding of cancer. Many children lose their lives without ever being diagnosed. In some regions, they don’t even have a name for cancer.
A major reason so many children go undiagnosed is because of the inadequate health care infrastructure in most of these countries. For example, in most African countries, there are very few pediatric oncologists, the experts in the diagnosis and treatment of childhood cancer. In addition, many of the needed effective cancer therapies are simply not readily available.
We need to better educate the public to raise the awareness of cancer and train pediatricians to become specialists in how to properly diagnose and treat children with cancer. There’s also a tremendous need for adequate resources, like well-equipped medical centers that have the expertise, infrastructure and therapies to treat childhood cancer.”
Why is cancer becoming an important health care priority in sub-Saharan Africa today?
“In recent years, we have developed a better understanding of the burden of non-communicable diseases in low-resource countries. Of the 56.9 million global deaths in 2016, 71 percent were due to non-communicable diseases.
As a result, people have become more aware that cancer is a significant killer in sub-Saharan Africa – a region with some of the most resource-scarce countries. It’s fair to say that we are behind in improving cancer care in these countries. So, support for the Global HOPE program is critical to get closer to where we need to be.”
One of the grants you received focuses on pediatric Kaposi sarcoma in Malawi. What are the challenges that this program seeks to address?
“Kaposi sarcoma is a malignancy that affects both adults and children and is epidemic in sub-Saharan Africa, with especially high incidence in people with HIV. Our project seeks to better understand this disease and to develop an effective treatment.
Specifically, we are developing an approach known as risk-based treatment. For low-risk patients, the goal is to treat them with effective medication that has a lower toxicity. For those with high-risk disease, we must give them a more intensive treatment.”
We cannot achieve a world free from cancer unless we fund innovative approaches to address the problem of the disease in under-resourced countries.
The other grant is focused on pediatric Burkitt lymphoma in sub-Saharan Africa. How does the program propose to address this problem?
“Burkitt lymphoma is associated with Epstein–Barr virus and the endemic type originates in East Africa and the sub-Saharan countries that fall into the so-called ‘malaria belt.’ It presents frequently in children, and is universally fatal if not diagnosed and treated quickly.
A variety of therapies have been used to treat Burkitt lymphoma over the years, and our program is aimed at developing a treatment approach based on disease stage and risk factors. This approach requires making sure we can accurately diagnose the disease, using sophisticated forms of clinical diagnosis, including approaches such as flow cytometry, immunohistochemistry and biopsy.”
How did the Texas Children’s Hospital’s Cancer and Hematology Centers get involved in these global health programs?
“The Texas Children’s Hospital’s Cancer and Hematology Centers has the largest, and one of the most effective, training programs for pediatric oncologists in the United States. So, we have looked at where else in the world we could bring our expertise to impact childhood cancer.
In 1999, Baylor International Pediatric AIDS Initiative and Texas Children’s Hospital, supported by the Bristol-Myers Squibb Foundation’s (BMSF) Secure the Future Program, developed a program and built centers of excellence in African countries to help deal with the problem of pediatric HIV/AIDS. That program, directed by Dr. Mark Kline, is highly successful and treats more than 300,000 children in over a dozen countries. The Global HOPE program for managing childhood cancer developed from additional BMSF funding and leveraged the infrastructure we built for the original.”
What makes the funding that Global HOPE has received from Celgene so unique?
“There are many grant opportunities out there to help improve research for cancers that affect children in the United States, but few speak to the tremendous burden of pediatric cancer in under-resourced countries such as those in sub-Saharan Africa. We cannot achieve a world free from cancer unless we fund innovative approaches to address the problem of the disease in under-resourced countries. With this additional, extraordinary support from Celgene, we will specifically be able to study the biology and improve the care of two cancers that often strike children in sub-Saharan Africa.”
To learn more about Celgene Cancer Care Links™ program, read “Improving Cancer Care in Resource-Constrained Countries.”