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Monday, 2 October 2017

Merck Foundation Supports Training of 20 Future Oncologists in Africa Oncology Fellowship

Rebecca Ejifoma
In partnership with Ministries of Health across Africa, the Merck Africa Oncology Fellowship Programme is giving back to the society through Merck Foundation’s programmes to build cancer care capacity in Africa, provide Africa with 20 New Oncologists through Merck Africa Oncology Fellowship Programme established in India, Kenya and Egypt.

This is in line with Sustainable Development Goal (SDG) 3 to sustainably invest on building healthcare capacity to improve access to equitable healthcare solutions.
The programme provides one-year and two-year oncology fellowship and a three year master degree in medical oncology at Tata Memorial Centre, India, University of Nairobi Kenya and Alexandria University, Egypt, respectively.

CEO of Merck Foundation, Dr. Rasha Kelej, said: “One of the main objectives of Merck Foundation is to build a strong platform of qualified medical, paediatric and surgical oncologists across the continent through the Merck Africa Oncology Fellowship Programme.”

“Twenty candidates from Uganda, Zambia, Ethiopia, Namibia, Ghana, Sierra Leone, Liberia, Tanzania and Kenya have enrolled in the Merck Africa Oncology Fellowship Program in partnership with African ministries of health, the University of Nairobi, Kenya, Tata Memorial Centre, India and Alexandria University, Egypt in 2016 and 2017. We are very proud of our contribution to lead Africa to a better future through changing the landscape of Cancer care in the continent”, Kelej added.

The Foundation started the second stage of their Africa Oncology Fellowship Programme last year with the aim to increase the limited number of oncologists in Africa.

Speaking still, the Chairman of Executive Board and Chairman of Board of Trustees of Merck Foundation, Prof. Frank Stangenberg- Haverkamp, explained: “Improving cancer care needs a substantial improvement in infrastructure and increase in the number of specialised workforce, which does not exist in many, if not most, Sub-Saharan African countries. Enrolling more candidates from more African countries into our Fellowship Programme is an important step forward towards improving access to cancer care across the continent.”

This June, BIO Ventures for Global Health (BVGH) and the African Organisation for Research and Training in Cancer (AORTIC) released a white paper on the African continent’s emerging cancer crisis.

Haverkamp disclosed that over 20% of African countries have no access to cancer treatments at all, while access is limited and sporadic in other countries. Later-stage diagnosis in African patients contributes to poorer outcomes. “For example, five-year female breast cancer relative survival rates are 46% in Uganda and 12% in The Gambia, compared with around 90% in developed countries, the report cited”.

In partnership with Ministries of Health across Africa, the Merck Africa Oncology Fellowship Programme provides one-year and two-year oncology fellowship programmes and a three year master degree in medical oncology at Tata Memorial Centre, India, University of Nairobi, Kenya and Alexandria University, Egypt, respectively.

Launched in 2016 as part of Merck cancer Access Programme, with the aim to increase the limited number of qualified oncologists in the continent, three medical doctors from Sub-Saharan African countries – Kenya and South Africa – were granted a two-year Africa medical oncology fellowship training at the University of Nairobi.
In addition, Merck Foundation supported another two African doctors from Ghana and Tanzania for the Paediatric and Adult Medical Fellowship programme that is conducted annually at Tata Memorial Centre, India.

“We will continue to enrol more candidates and engage other countries on this program as we firmly believe this is a vital component of improving the quality and accessibility of cancer care in Africa,” added Kelej assured Africa.

Merck Africa Asia Luminary and Solutions for Cancer Access

The inaugural Merck Africa Asia Luminary, holding from October 24 to 25 this year in Cairo, Egypt, will feature a workshop dedicated exclusively to improve access to cancer care through Capacity building through Merck Foundation, It will convene key players from the global, regional and local cancer network, health ministers, First Ladies, with the goal of encouraging dialogue among stakeholders, raise awareness of the issues, explore partnership opportunities to generate ideas for potential solutions to existing challenges.

Merck Foundation Vision and Call for Action
“A world where everyone should lead a healthy and fulfilling life, this is Merck Foundation’s vision. We are working together to achieve the Sustainable Development goals- SDGs. The SDG 3: Ensure healthy lives and promote wellbeing for all at all ages, calls us to sustainably invest on building healthcare capacity to improve access to safe, effective, quality, and affordable healthcare solutions for all by 2030.” Dr. Kelej emphasised.

The African Union has targeted that by 2063, every citizen will have full access to affordable and quality health care services, and integrated and comprehensive health services and infrastructure will be in place, where services are available, accessible, affordable, acceptable and of quality.

Meet the Future African Oncologists who enrolled into Merck Africa Oncology Fellowship Programme (Tata Memorial Center, India):

Dr. Abdulkadir explained “I am a faculty member of Addis Ababa University working at Tikur Anbessa Specialized Hospital department of paediatrics and child health hemato-oncology unit. I am a general paediatrician serving kids suffering with cancer with no additional formal training in paediatric oncology. Merck Africa Fellowship Program will help me to update and upgrade my knowledge and skill in Paediatric oncology. This helps me to give appropriate and improved quality of care to cancer patients and helps me to expand the service.”

This training helps children with cancer to get quality and timely care. It helps to upgrade the current level of care that they are currently getting and improve the outcome with improved survival.

“Ethiopia is a country with approximately 100 million population. Currently the country has three oncologists that serve the stated population. As I am faculty in the university it will help the country to improve training program in by strengthening and expanding Paediatric oncology fellowship program. This will increase the number of paediatric oncologists and improve access for kids with cancer to get timely, improved and appropriate care” he added.

Dr. Natnael said “Merck Africa Oncology Fellowship Program is a Golden path to tackle the growing challenge posed by Cancer in Africa. I was delighted to know about and to be part of the fellowship program on oncology that Merck Foundation is planning to give. By completing this fellowship program, I feel that I will not only further my career, but I will also be an asset for the future expansion of Hawassa Oncology Center”.

“My people are also in great need of specialists like this to address their sufferings. For your surprise, there is no oncologist, even a single one in southern part of Ethiopia with an estimated population of 18 million. For that matter, there are only 3 oncologists in Ethiopia for about 100 million population.” He added

Dr. Natnael explained “Cancer care is not only about the expensive resources it is also about a trained healthcare personnel capable of addressing prevention, early diagnosis, & treatment and able to provide palliative care to cancer patients. So human resource capacity building is a core in tackling the burden posed by cancer. On this regard Merck Africa Oncology Fellowship program already took the lion share in my country and the rest of Africa in general.

Dr. Kabisa introduced himself “I am a general surgeon deeply interested in Surgical Oncology because of my passion to help patents ravaged by cancer especially women with breast cancer. I have been participating in running a breast diagnostic clinic at our only Cancer Diseases Hospital (CDH) for the past 3 (three) years now, with the last one year being run actively by myself. The offered surgical oncology fellowship position at Tata Memorial Hospital through the sponsorship of Merck Foundation will enhance my knowledge and skills in the field of surgical oncology to contribute better in managing patients seeking cancer care at our institution. Our country has been training surgeons for some time now, but no specific surgical oncology training is available yet”.

“This opportunity of training will greatly help in improving the oncological services currently being offered at CDH, contribute to in-house training for other surgeons interested in the field of oncology and participate in local and collaborative research in order to improve service delivery to cancer patients. As such, the country as a whole will benefit from this much-needed skill and knowledge I will gain from this training to be undertaken soon,” he added.

Dr. Kuria emphasised: “As a paediatrician working in a rural

hospital I encounter many oncology patients who are too poor

to get treatment in the cancer centers in big towns like Nairobi.

Merck Africa Oncology fellowship will build my capacity to

manage them at the nearest facility with no need for referral”.

Dr. Paul Kamtwa told us “Merck Africa Oncology Fellowship Program is important for me because it will help me provide comprehensive and multidisciplinary care. The fellowship will help me to receive extensive surgical exposure to gynaecological procedures, chemotherapy and learn the new and advanced techniques of radiotherapy”.

“For the patients, normally those who have the first contact with a gynaecology oncologist have optimal care in staging, surgery, chemo-radiotherapy and follow up and as such better outcomes. Currently this is not the case and the fellowship will bridge that gap. Patients will have a continuity of care since surgery and administering of chemo radiotherapy can be facilitated by same person,” he added.

Dr. Michael Odwory expressed: “The Merck Africa Oncology 

Fellowship Programme will help me advance my understanding of 
various gynaecological cancers and surgical skills. And therefore, 
my poor patients will get help at the point of diagnosis and save 
them (the few who can afford) the trouble of having to travel many kilometres to the capital city, Nairobi for assistance. This will go a long way in improving access to oncology care in our country.” 

Dr. Justin Mulindwa explained “The Merck Africa Oncology Fellowship Program is important to me and my hospital because it affords me a training opportunity that will enhance paediatric oncology patient care, paediatric oncology research and teaching in my country. Currently, I am based at the Cancer Diseases Hospital which is the only center providing paediatric oncology care for patients across a country of an estimated 15 million people with an estimated 45% being in the paediatric age group of up to 15 years old.”

Dr. Kokou explained the Missed Opportunities in Africa “Children affected by cancer have a lot of potentials we are missing as a nation by not keeping most, if not all, of them alive. During my rotation on the paediatric oncology ward of the Korle Bu Teaching Hospital, I had the privilege to “befriend” many children, gifted with special skills, and full of big dreams for their future. Unfortunately, many are not alive today. I still keep the drawings and the stories of most of them in my house and in my heart, wishing my friends were still alive!”

“Currently, the survival rate from childhood cancer in Ghana, like other lower and middle-income countries is even lower than that in the USA in the 1960s. In Ghana, children with cancer die undiagnosed or present very late, due to the low awareness and inadequate diagnostic services in our country. Children with cancer are likely to be managed for other common illness in health facilities or parents seeking help from herbalists and spiritualists for many weeks or months,” he emphasized.

Dr. Kokou added “It is therefore clear that increasing awareness, training more health workers in childhood cancer management; mobilizing funds for early diagnosis and treatment are key to improving childhood cancer outcomes in Ghana.”

“A brighter future through Merck Foundation”, adding that “this is a very special opportunity Merck has offered to help address the numerous challenges in managing childhood cancers in Ghana, especially the inadequate number of trained specialists in paediatric oncology as well as improving diagnosis and care. I am more excited about the future as this training will help unearth undiagnosed cases, while increasing awareness; increase survival through early diagnosis and multidisciplinary management. I will be very active in research activities in the area to fill the knowledge gaps."

Dr. Solomon explained “The fellowship is very important for me, to update myself to practice on 3d treatment planning, CT Simulator, IMRT, IGRT and so on.

"The knowledge I get from this fellowship will help me to give an excellent service to my patients. Since we don’t have RTT training school in my country, the fellowship will help me to train other Radiotherapy Technologists.”

Alexandria University, Egypt: three year Master degree of Clinical Oncology 
Dr. Rashid: “It is estimated that there will be 15 million cases of cancer annually by 2020, 70% of which will occur in developing countries. Ghana as a developing country with a population of about 26 million has only two national cancer centers in the country that offer comprehensive cancer services including radiotherapy.
These centres are located in two tertiary hospitals both in the southern part of the country making it difficult for patients with cancer in the northern part of the country to access these centers due to the distance they have to travel leading to frequent default rates or even complete abandonment of treatment resulting very poor outcomes.

According to him, unfortunately, medical oncologists -who play a central role and coordinating patient care - were rare to find in Ghana with none in the northern part of the country, and therefore an urgent need to train doctors to fill this gap.

Rashid added: “When given the chance to pursue this course and upon my successful competition, it will not only empower me with knowledge and skills to effectively manage patients with cancer but also contribute my expertise in tackling the serious challenges hindering cancer care in Ghana especially in the areas completely deprived of that specialist care in country.

Therefore, he assured Ghana that he would play an advocacy role on prevention and early detection of cases as well as partner colleagues and other health agencies to set up comprehensive cancer treatment centres in the northern part of the country to improve accessibility to caner care hence better outcomes.

"I will, also, contribute to the area of research in oncology, which is in an infantile stage in Ghana. The country will benefit greatly as findings will be utilised to adapt cancer care protocols to our local needs hence bridging the gaps in cancer care in Ghana. Thank you, Merck Foundation,” Rashid had said.