Improving Patient Care

Last October at the ASCP Annual Meeting in Long Beach, Calif., ASCP announced a groundbreaking global initiative: Partners for Cancer Diagnosis and Treatment in Africa. This effort will provide patients in underserved areas of Sub-Saharan Africa with access to rapid anatomic pathology cancer diagnostics and appropriate care and treatment. The goal is to use digital slide technology and a cloud-based system to allow ASCP member pathologists to make histologic-based diagnoses of Sub-Saharan African patients, issue a report within 48 hours, and allow local providers to care for and treat the patients. Non-communicable diseases (NCDs) have become the leading cause of death in Sub-Saharan Africa. Increases in life expectancy, changes in diet and lifestyle, and a lower burden of communicable diseases promise to increase this cancer burden.1 Data from the groundbreaking Global Burden of Diseases project of the Institute for Health Metrics and Evaluation shows that NCD death and disability increased 33 percent between 2000 and 2013, more than 200 percent faster than the decline of infectious diseases in the region.2 Approximately 650,000 people in Africa develop cancer annually, an about 510,000 cancer deaths occur. More than one-third of these cancer deaths are easily preventable and/or treatable, if detected early. There are fewer than one pathologist per one million people in Africa, compared with 60 pathologists per one million people in the United States. The vast majority of individuals do not have access to diagnosis to allow for appropriate care and treatment. The success of HIV/AIDS treatment has resulted in a marked increase in NCD (cancer) deaths, which now needs to be addressed. In addition to the humanitarian reasons to address diagnosis and treatment of NCDs, there is a significant economic cost associated with this increased burden of cancer. Deaths from preventable cancers mean catastrophic health expenditures, less income in the household, and potential impoverishment. Globally, the World Economic Forum projects that this NCD epidemic will inflict $21.3 trillion in losses in developing countries over the next two decades.3 By addressing this epidemic, Sub-Saharan African countries would be wealthier and thus less dependent on U.S. aid, more stable, and better able to act as trade and strategic partners. ASCP is leading a $26.5 million program of infrastructure, funding, and in-kind resources to provide diagnosis, care and treatment, measurement and evaluation, and workforce building to meet the needs of low- and middle-income countries in support of the goals of the World Health Organization's Global Action Plan for the Prevention and Control of Noncommunicable Diseases. This coalition includes governmental organizations such as the White House Office of Science and Technology Policy, Centers for Disease Control and Prevention, National Institutes of Health, National Security Council, and National Cancer Institute; non-governmental organizations such as Partners in Health, American Cancer Society, Institute for Health Metrics and Evaluation, Clinton Global Initiative, American Society for Microbiology, Association of Public Health Laboratories, African Strategies for Advancing Pathology, and Africa Society for Laboratory Medicine; and industry partners including Secura Finetek, Roche Diagnostics, Pfizer, and Omnyx LLC/GE Healthcare. The coalition will engage with African partners and governments to implement a diagnostic and treatment solution. This unique coalition is being spearheaded by ASCP. It will provide American pathologists with the rare opportunity to make a significant impact on global health with a minor time commitment and without the burden of traveling to another country (the hope is that people can do it from home, office or via mobile device). This will be a short- to medium-term solution. A longer, sustainable solution, to create an in-country workforce, is also a part of this project. If you are interested in becoming part of a solution to the tremendous crisis of diagnostic pathology services in Sub-Saharan Africa, go to the ASCP website at http://www.ascp.org/Global-Impact/home.html# and sign up to help. Please join us in this outstanding effort.