This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American
Little noticed amid more glamorous world events was a historic meeting that took place in Nairobi about a month ago. Search for details of it online and you’d be hard pressed to find evidence of the conference.
Yet, this low-key meeting—convened by a coalition of 30 cancer experts from 11 countries in sub-Saharan Africa, and by the American Cancer Society and National Comprehensive Cancer Network—took a significant step towards transforming treatment of a rising cancer epidemic in poorer countries. It deserves the attention, support and cooperation of the public, private and not for profit sectors.
For the first time, cancer treatment guidelines were created specifically for patients in lower-resourced countries in sub-Saharan Africa—the forgotten cancer sufferers. At the same time, technology is now helping poorer countries predict their unique chemotherapy needs and place larger, more discounted medicine orders with pharmaceutical manufacturers.
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The potential result? An assault on cancer in the developing world in much the same way that malaria and HIV, once thought intractable, were successfully addressed. This is a brash prediction, given that cancer treatments are more varied than those for HIV and malaria. However, we believe it is now within reach.
Until now, the few oncologists in poorer countries, who each potentially serve millions of patients, have been forced to tinker desperately with chemotherapy regimens that had been developed for the more ample resources of Western societies. They’ve needed to do so because cancer medicines are prohibitively expensive, often unavailable, and of dubious quality in sub-Saharan Africa. National ministries of health there can’t systematically predict caseloads, and don’t meet the minimum quantities necessary to place affordable medicine orders. Entrepreneurial, niche suppliers exist, but their small inventories are expensive. Prices vary wildly, even between neighboring countries.
Cancer is merciless enough without these added hurdles. The outrage would be palpable if these barriers existed in the developed world. While we’re focusing on developing new medicines, others across an ocean are struggling just to get access to existing, proven therapies.
Until recently, many people in sub-Saharan Africa might not have lived long enough to contract cancer. But with rising life expectancies, and more pervasive treatments for more acute and contagious illnesses like HIV and malaria, cancer is becoming a crisis. The World Health Organization estimates that more than 500,000 people in sub-Saharan Africa died of cancer in 2015, more than those who died of malaria. They also project that by 2030, close to 1 million people in the region will die annually of cancer. For every four people who die of HIV/AIDS, there will be three who die of cancer. Even though the most common cancers in sub-Saharan Africa are treatable, fewer than 10 percent receive any treatment—even simple pain relief.
In a heady age of exciting cancer breakthroughs, these stark realities are a humbling reminder that we still have a lot of work to do. Without the reshaping of pharmaceutical markets, the new treatment guidelines are impotent.
To that end, IBM worked with the American Cancer Society and the National Comprehensive Cancer Network to produce "ChemoQuant," free software to help ministries of health more accurately forecast their chemotherapy needs. It will now help planners predict their drug needs based on expected cancer cases. The technology is the result of a new, pro bono IBM health incubator effort called IBM Health Corps, which draws upon the company’s commercial experience in applying its know-how, including Watson artificial intelligence, to oncology.
Uganda and Ethiopia’s ministries of health will begin using the software next month, with several other African countries to follow this year. Armed with better data and bigger medicine orders, the Clinton Health Access Initiative hopes to negotiate more affordable medicine deals with trusted pharmaceutical manufacturers.
These developments couldn’t have come at a more pivotal period. This month’s meeting in Nairobi, where cancer treatment protocols for resource-constrained countries were codified for the first time, convened without the hoopla we’ve come to expect in the war on cancer. Nonetheless, combined with new technology and better market structuring, our cancer moonshot may have just gotten the boost needed to go global and truly aim for the stars.
Sally Cowal is the senior vice president of Global Cancer Control at the American Cancer Society and a former U.S. Ambassador. Jen Crozier is IBM's vice president of Corporate Citizenship.
