As part of Merck Cancer Access Program- Merck CAP
Merck, University of Nairobi and oncology experts discussing the Merck Africa Medical Oncology Fellowship Program. The meeting was attended by among others Rasha Kelej (4th left), Chief Social Officer, Merck Healthcare and Prof. Isaac Kibwage (3rd right), Principal College of Health Sciences, University of Nairobi
Merck has announced its first “Africa Medical Oncology Fellowship Program” for Sub-Saharan African countries in partnership with University of Nairobi, Kenya. The program will be conducted at the University of Nairobi with the aim to improve access to cancer care in Africa.
“We are committed to improve patient’s access to care all over the world”, said Belén Garijo, Member of the Executive Board of Merck and CEO Healthcare. “In Africa, where the number of oncologists is very limited, this starts by building additional medical capacity. We are proud to kick-off the Merck Africa Oncology Fellowship Program which aims to increase the number of qualified oncologists across the continent.”
“The lack of financial resources is never the only challenge in Africa. The scarcity of trained healthcare personnel capable of tackling prevention, early diagnosis and management of cancer is a bigger challenge, and therefore, we firmly believe that initiatives contributing to build medical capacity such as the Merck Africa Oncology Fellowship Program are very critical for Africa and developing countries”, Garijo added.
As a first step, Merck will sponsor nine medical doctors from Sub-Saharan African countries such as Kenya, Uganda, Tanzania, Ethiopia and South Africa for a period of two years. The program will be extended to other African countries in the following year. Moreover, Merck will support another five African doctors to participate in a pediatric and adult medical fellowship program, which will be held annually at Tata Memorial Hospital, Mumbai, India. This program will start in August 2016.
“The shortage of oncologists threatens cancer care in Africa. Merck is planning to sponsor nine medical doctors from Sub-Saharan African countries such as Kenya, Uganda, Tanzania, Ethiopia and South Africa, for this two-year Africa Oncology Fellowship Program in partnership with University of Nairobi as part of its Merck Cancer Access Program. Moreover Merck will support another five African doctors to join the paediatric and adult medical fellowship program that will be conducted in India. The Fellowship Program will include candidates from other African countries next year,” Rasha Kelej Chief Social Officer of Merck Healthcare explained.
Prof. Isaac Kibwage, Principal of Colleges of Health Sciences, University of Nairobi emphasized: “We believe that the only way to effectively prevent, detect and treat the rising number of cancer cases in Africa is through establishing public private partnership-PPP models between health ministries, academia, and industry in implementing successful programs such as this partnership with Merck to provide the Africa Oncology Fellowship. This fellowship program will not only target Kenyan doctors but doctors from all over Africa as well with the aim of improving the quality and accessibility of cancer care in the continent.”
Medical students from African Universities during a “Merck Cancer Control Program”
According to World Health Organization (WHO), by 2020 there are expected to be 16 million new cases of cancer every year, 70% of which will be in developing countries where governments are least prepared to address the growing cancer burden and where survival rates are often less than half those of more developed countries.
“Cancer is expected to have a huge economic and social burden on Africa. This will represent a huge challenge since Africa has its share of communicable and neglected tropical diseases (NTDs) and its healthcare system is built to only tackle them. Therefore, University of Nairobi is happy to partner with Merck to provide Africa Oncology Fellowship Program for medical doctors across Africa starting with Kenya. Merck Cancer Access Program will add tangible value in improving quality of cancer care,” Prof. Kibwage added.
“I was delighted to hear that Merck has offered this opportunity to our hospital. The school has been in need of expanding its oncology set-up being the only oncology centre in the country with only four oncologists serving a population of above 100 million. Looking at the scarce set-up, the Ministry of Health has offered us expansion with a four storey building for patient chemotherapy. Though this is a good opportunity, we have had difficulties because of the shortage of manpower we have, so this fellowship program will be of a great help to our hospital and university and to the country in managing oncology patients,” Dr Daniel Seifu, Dean of School of Medicine, Addis Ababa University said.
Challenges of improving the access to cancer care in Africa
“Engagement in cancer care needs a substantial improvement in infrastructure and increase in the number of specialized workforce, which does not exist in many, if not most, Sub-Saharan African countries. For example, in Kenya there are only 13 oncologists, most of them based in Nairobi for population of 47 million which means one oncologist per 3.6 million people, while in United Kingdom there are around 13 oncologists per 1 million people. Moreover in Ethiopia there are only four oncologists, all based in Addis Ababa for a population of around 100 million. Therefore this fellowship program is very critical for improving access to cancer care in Africa as oncologists are very few here and sadly they only tend to work in the capital cities,” Kelej added.
“With the assistance of Merck, the fight against cancer has jumpstarted in Africa,” said Prof. Nicholas Anthony Othieno Abinya, Consultant Oncologist, University of Nairobi.
Merck to empower women in healthcare and research
Women are underrepresented in research and healthcare and especially in the field of oncology. Most of the candidates for Merck Africa Medical Oncology Fellowship Program are women. The program will create fellowship opportunities for African doctors with the aim to increase the number of oncologists in general, but women special oncology fellowship opportunities will be dedicated for women doctors.
First candidates from Ghana and Tanzania selected for Merck Oncology Fellowship Program in India
The first two candidates to attend the Merck Africa Oncology Fellowship Program at Tata Memorial Center in India have been selected from Tanzania and Ghana.
Nihad Salifu from Ghana College of Physicians and Surgeons will attend the Fellowship to train in Paediatric Oncology and Christina Malichewe from Muhimbili University of Health and Allied Sciences, Tanzania is interested in learning more about the treatment of gastro intestinal malignancies.
Dr. Christina V. Malichewe, Muhimbili University of Health and Allied Sciences (MUHAS) Dar es Salaam, Tanzania
“Cancer is a growing concern in Tanzania. Limited facilities and few healthcare providers against the high rising number of patients diagnosed at advanced stages pose a great challenge to a developing country like Tanzania. Unfortunately there are only two medical oncologists in a country of approximately 50 million people. One studied in Italy and another in China. We need more specialized oncologists in this field. Thank you Merck for starting this program!! However, it is only through unique opportunities such as the Merck Africa Fellowship Program we can make needed change in our societies so as to improve patient access to cancer care,” Christina Malichewe said.
“I am thankful and proud to be among the young doctors from Tanzania to attend the Merck Africa Medical Oncology Program which I believe after completion will further help in imparting knowledge to others and increasing the access to cancer care in the larger Tanzanian population,” Christina added.
Christina is interested in learning more on the treatment of gastro intestinal malignancies. “I know a lot is changing on the management and in our country there is little interest on this area in terms of screening, management and research among the oncologists compared to cervical, breast and Kaposis sarcoma cancers”.
Dr. Nihad Salifu, Senior Residency trainee in General Pediatrics at Ghana College of Physicians and Surgeons
“Ghana has a population of about 26 million with a cancer rate of 109 per 100,000 people and yet there is no single trained medical oncologist in the whole country. The duty of medical oncologist is handled by other specialties such as radiation oncologist, general surgeons, genitourinary surgeons, and hematologists among others. This makes the care of patients very difficult because these doctors are not formally trained in medical oncology,” says Nihad Salifu, a Senior Resident trainee in general pediatrics at the Ghana College of Physicians and Surgeons.
“In addition, there are only three paediatric oncologists in the whole country and our cancer cure rate is very low in children- it is about 20% when cure rates are approaching 80% in many developed parts of the world,” adds Salifu.
Salifu, who is one of the first candidates of the Merck Africa Oncology Fellowship Program says: “This huge human resource deficit in childhood cancer care is the main motivating factor for my applying to be considered for this training. I will benefit from this great opportunity being given to our country by Merck. The Merck Fellowship Program will definitely add to the few paediatric oncologists in Ghana; ease the workload and improve quality of patient care; add to the number of voices advocating for these patients and to the number of trainers of health workers delivering services including awareness creation; and also strengthen the team effort in the area of research and improving the paediatric cancer registry.”
First candidates from South Africa, Kenya and Uganda for Merck Medical Oncology Fellowship Program at University of Nairobi
Dr. Bonginkosi Shadrack Shoba, working with fledgling hematology service at Medunsa in South Africa. Born in rural Kwa Zulu-Natal in South Africa to illiterate parents.
Dr Shoba shares the challenges of cancer care in South Africa and why he believes that the “Merck Africa Medical Oncology Fellowship Program” is the solution to improve cancer care in his country and in Africa at large.
“I am extremely excited and indeed very grateful for the wonderful opportunity extended not to me personally but to Africa as a whole by Merck. Personally I watch on a daily basis black, poor, rural, young folk dying merciless, avoidable deaths from even easily treatable Hodgkin’s lymphoma,” Dr Shoba emphasized.
Dr Shoba further explained: “For a very long time the world believed that cancer was a disease of Europe and North America. These countries consequently boast comprehensive cancer centres, many of them. What everyone had forgotten about cancer the world over was that cancer is indeed driven by chronic inflammation therefore transformation and proliferation and the biggest cause of inflammation is infection. It is only in the past five years that the world has woken up to the fact that cancer is in fact a disease of Africa, India and Brazil, the so called third world.
“Two thirds of the total burden of cancer is shouldered by the third world. With the greatest burden HIV/AIDS positioned in Sub-Saharan Africa, it goes without saying that perhaps this is where the biggest concentration of oncologists should be. Alas, for example South Africa has no more than a mere handful of oncologists, all of them in Johannesburg, Cape Town or Durban. There are no dedicated oncology centres even in those big cities. There is currently one public stem cell centre in Cape Town that caters for three patients at a time,” adds Shoba.
“Sad but true, a diagnosis of any form of cancer including early stage Hodgkins lymphoma in South Africa carries a swift, cruel death sentence, particularly so if you happen to reside in a rural area, where 80% of South Africa’s population resides. Throughout my early medical school training I have endeavored to position myself where the battle is thickest. I have delivered on this promise. I have spent all my life working as an MO and specialist in the smallest, poorest hospitals in KwaZulu,” Shoba says.
“Over the past five years I have worked at Ngwelezana Hospital where I started single-handedly a service where I treated Kaposi sarcoma and lymphoproliferative neoplasms with great success with the most limited resources. I have a publication from this experience.
Currently, I am working with fledgling hematology service at Medunsa where we see poor people from Limpopo, the North-West, parts of KwaZulu-Natal and Mpumalanga. I have never seen so much suffering with Burkitts, acute leukemias ever,” emphasizes Shoba.
“I am also very keen on investigating the epidemiology and molecular biology of common cancers in South Africa. I have previously worked on protocols, methodology and ethics towards research in the molecular pathogenesis of Burkitts and also Kaposi sarcoma. All these efforts have been frustrated by lack of funding. It is my dream to work towards creating comprehensive cancer services in South Africa and the frontline states. It is also my intention to intensify training of nurses and junior doctors towards early detection and treatment of cancer at primary and secondary levels. I believe I am capable of demystifying chemotherapy, reducing the paralyzing fear of cancer amongst patients and caregivers and making oncology accessible to many,” Shoba explains.
Dr. Teddy Namulems Diiro, Uganda Cancer Institute
Dr Teddy Namulems Diiro from Uganda is one of the other candidates for the Merck Africa Medical Oncology Fellowship Program to be held at the University of Nairobi, Kenya. She talks about the human resource capacity challenges Uganda faces in the provision of cancer care and how her attendance of the Fellowship Program will make a significant contribution.
“With the global incidence of cancer increasing every year, and the fact that most of these new cases are diagnosed in developing countries like Uganda, the need for qualified oncologists has never been greater across the African continent,” says Diiro.
“To manage this ever increasing burden of cancer, the Uganda government is doing a lot to improve the infrastructure at the Uganda Cancer Insitute (UCI) and around the whole country. These includes the new radiotherapy facility under construction at the UCI and setting up regional cancer care centers to mention but a few. All these efforts to improve infrastructure would be in vain if no efforts are made to increase the number of health care personnel in the field of oncology to actually utilize these facilities and take care of the patients,” explains Diiro.
Diiro emphasizes: The Merck Africa Oncology Fellowship Program has come at a time when it is most needed and is a ray of hope for most African countries, who are stranded with a huge burden of cancer patients with a limited number of qualified oncologists to handle them. I am very positive that by the end of this two year fellowship, I will be better equipped to manage cancer patients through prevention, early diagnosis and treatment. After the Fellowship, I plan to continue with my position at UCI, where my experiences from the Fellowship will prove invaluable both in research and care of cancer patients.”
Dr. Angela McLigeyo, Kenyatta National Hospital, Kenya
Dr. Angela McLigeyo, a medical doctor in Kenya has worked as a medical officer and consultant physician for the past 12 years and shares about the challenges oncology patients face in the country and how the Fellowship Program will impact cancer care.
“Five years ago, after a personal experience with cancer, I realized that oncology patients in Kenya have a tough time accessing healthcare because there are no programs to support the expensive treatment and there are practically no public health programs for improving health systems for cancer management. The outcomes therefore for patients with cancer in my country are very dismal,” McLigeyo says.
McLigeyo explains: “My decision to study oncology was made then. One of the goals in this decision has been to improve the quality of oncology care in Kenya. This is especially in the setting of the growing cancer burden in Kenya and the high mortality rates that accompany it. In addition, majority of cancer patients in Kenya have to travel out of the country to seek treatment due to high local treatment costs, shortage of specialists and weak health systems.”
“The decision to study oncology meant taking initiative for self-learning as well as collaborating with like–minded oncologists. To this end, I joined the hemato and medical oncology unit at the Kenyatta National Hospital as a volunteer from early 2014, and I have been working with the team there since then,” adds McLigeyo.
McLigeyo emphasizes: “The Merck Africa Oncology Fellowship Program” in partnership with University of Nairobi is timely for the African continent. It aptly suits our need for increasing the number of trained oncologists in the continent, both through developing knowledge and skills as well as increasing research and leadership skills. I look forward to the two year learning period after which I hope to train others under the same program in addition to offering quality oncology services in my country, Kenya.”
Dr. Mohammed Ezzi, Kenyatta National Hospital, Kenya
“I have wanted to become an oncologist ever since I was a teenager, after I lost my father to cheek cancer. To make matters worse, I was told that if he would have sought medical attention earlier, he would still be alive,” Ezzi explains. “At that time, cancer was a disease that was not talked about openly. I was told he had cancer, but I had no idea what it was. In my naivety I assumed it was a minor illness that would go away. That was 20 years ago,” he adds.
“The new millennium has brought with it knowledge and technology. The good side is that people are now able to know what cancer is, how it can be tackled and are seeking medical attention. Everywhere, every now and then there is an event that is creating awareness on cancer. The government is also trying to tackle this menace by making cancer a national disaster, setting up regional cancer centers, and buying equipment worth billions of shillings for its early diagnosis. However, the human resource capacity required in managing cancer is lagging behind. We need the personnel- the oncologists to complement the efforts by government and other organizations, so that we can effectively tackle this menace,” Ezzi explains.
The “Merck Africa Oncology Fellowship Program” in partnership with University of Nairobi, therefore is a beacon of hope for Africa. It is the light at the end of the tunnel at a time when we have a very limited number of oncologists,” Ezzi adds. “I applied for this fellowship, because we will be trained by professionals who have a wealth of ideas on what ails cancer in Africa and what the local solutions are. I am positive that at the end of the two year fellowship, I will be better equipped to manage cancer patients in prevention and early diagnosis, followed by treatment. Merck’s Oncology Fellowship Program will set a precedence for producing quality oncologists, such that one day, someone’s father will still be alive even after being diagnosed with cancer,” Ezzi says with confidence.
Stay tuned to know about the rest of the candidates and to follow how Merck plays an important role in improving access to cancer care and bringing hope to Africa…
Watch the videos below on the experience of women cancer survivors and how their lives have been empowered through “Merck More than a Patient”.
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