Q&A: How the African Access Initiative plans to mitigate Africa's cancer burden

Cancer in Africa is emerging as a mounting health concern on the continent. With it, comes an increased push to provide affordable access to cancer treatments and a concerted effort to expand cancer research, collect patient data and deepen the understanding of the existence of this noncommunicable disease in Africa.

The prevalence of NCDs is rising rapidly and expected to surpass communicable, maternal and nutritional diseases to become the most common causes of death in Africa by 2030.

In response, BIO Ventures for Global Health joined with pharmaceutical companies this week to launch the African Access Initiative — a cancer-focused program that brings together oncology companies with African governments and hospitals to enhance health care capacity, foster cancer research, and increase the availability of life-saving cancer medicines.

BVGH was established by the Biotechnology Innovation Organization, the world’s largest biotech trade organization made up of pharmaceutical and biotechnology-like science companies. Since 2004, their mission has been to engage companies in programs and partnerships that tap into private sector capabilities and assets, including medicines, to support patients and scientists in low- and middle-income countries around the world.

“If you look at cancer on the continent, if we do not act now cancer is going to overwhelm African health care systems,” BVGH President Jennifer Dent, told Devex. “We have an obligation to help support our partners in Africa to develop the infrastructure, the capacity and the access they need to address the growing burden of cancer in Africa.”

Dent spoke with Devex about this group’s plans to couple the latest oncology technologies with business models that produce reasonable treatment options to reduce the number of cancer deaths in Africa. The conversation has been edited for length and clarity.

From where did the idea for the African Access Initiative stem and where are you right now in terms of implementation?

We’ve been thinking about this and recognizing that there’s a real need for access to cancer medicines, as well as technologies to diagnose and monitor patients, and capacity building in training and skills development and knowledge sharing in cancer in sub-Saharan Africa.

We started thinking about this program a few years ago and talking to some of the partners that BVGH knows well in sub-Saharan Africa, looking at the different stakeholders and organizations that were really trying to work in countries in Africa to improve cancer treatment and care. It was obvious that there was a gap and void of real engagement and what we consider to be truly sustainable partnerships in these African countries with some of the leading oncology companies.

Discussions started quite some time ago. Over a year ago the United Nations formed a panel, the U.N. High-Level Panel on Access to Medicines, to look at what are some of the challenges and issues with access to medicines, not just cancer specific, but a global outlook at barriers to access. BVGH participated with early contributions to the high-level conversations about solutions to access to medicines. I was invited to testify to that panel in early February 2016 and during that meeting presented the concept of the Africa Access Initiative and started talking with companies.

All of the countries and hospitals participating in the African Access Initiative have met some important criteria. They are countries that have national cancer strategies, or cancer control plans, or they have plans near completion. Ministries of health have a strong commitment to improving cancer treatment and care. The second criteria was that BVGH had access and communication with the minister of health or the cabinet secretary so that we have endorsement of and support in implementing the Africa Access Initiative. As well, we must have good lines of communication and interest at the hospital level and that means we have engaged the administration of the hospital, we have put letter agreements in place so that we understand what BVGH will deliver and that we will need certain information from the hospitals (priorities in treating cancer patients, the type of patients that they’re seeing) to allow us to be successful.

We have just started to get feedback on our needs assessment questionnaire so once we have identified and selected the hospitals that we will be working with, those hospitals will need to coordinate a response to our needs assessment questionnaire and that captures every cancer medicine that is available and that is approved in the United States and in Europe.

Our program is driven by the priorities of the countries and hospitals not by the portfolios that companies are willing to offer, so it’s kind of the opposite approach. We’re saying to the oncologists and as well communicating to the ministers of health, “What cancers are you prioritizing and what medicines to you have access to now and what to do you need to expand access to?” BVGH will then go back to the companies we work with and match what’s in their portfolio with the priorities of our countries and hospitals.

We’ve done that analysis on both sides. We’ve started the process in our countries and we’ve already done a full analysis on every oncology company and every drug, or medicine, that they have that could potentially be life-saving in our countries and hospitals.

Cancer care can be quite expensive, so in terms of being affordable for the African population, how will AAI make cancer treatments financially viable for those in need?

Our goal with AAI is to develop business models that make cancer medicines affordable for a much broader group of African patients. We will be working with companies to look at these models and obviously companies are going to have to develop new pricing terms to make these medicines available in these African countries.

We have also started to look at and obtain some initial feedback and data on the costs of some of the medicines that the hospitals are delivering to patients now so that we have an understanding of their current budgets and we would be working with our companies to look at business models that take into account the very complex systems in our African countries and the very limited ability of some patients to contribute anything to cancer medicine.

We’ll be bringing partners together looking at business models and we’ll have our African partners at the table as well to be involved in determining how do we craft a model that can significantly expand access in a sustainable way. What we are not doing with AAI is a donation program. We recognize the real importance and positive impact donation programs have in Africa and many other countries, but this program is designed to put in place truly sustainable partnerships with governments, hospitals, and companies.

We want companies to see an opportunity to build these relationships and make their medicine available, but at the same time contribute to helping to build capacity and supporting implementation of research programs so that we have more data, so that our African partners have more data on their patients.

This may seem like a bit of an obvious question, but can you explain the importance of implementing such an initiative and why this is a high priority for BVGH?

Frankly, maybe this should have been done five years ago.

Cancer, I see as one of the biggest problems in Africa and I also think it’s a problem where our companies bring capabilities and life-saving medicines and critical technologies. If we can pull those assets into our African countries with a really sustainable partnership, I think we can develop a new model that can be expanded to multiple countries. I think companies recognize the critical importance and the opportunity to truly make some of their most valuable assets available in Africa.

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