Clinton Global Initiative (CGI)

Non-communicable diseases (NCDs)-chronic diseases such as cancer, cardiovascular disease, respiratory disease and diabetes-are the leading cause of death in Sub-Saharan Africa, with cancer at the forefront. Increases in life expectancy, changes in diet and lifestyle and a reduced incidence of communicable diseases will increase the prevalence of cancer in the future.Clinton Global Initiative

Cancers diagnosed in Africa are associated with a higher mortality compared with other regions of the world. Approximately 715,000 new cancer cases and 542,000 cancer deaths occurred in 2008 in Africa. By 2030, those figures are expected to nearly double due to the aging and growth of the population. The potential could be even higher because of behaviors and lifestyles associated with increasing economic development in some countries.1 In 2013, NCDs killed 8 million people before their 16th birthday.2

Curbing Unhealthy Behaviors
Nearly two-thirds of NCDs are associated with tobacco use, unhealthy eating, physical inactivity and harmful use of alcohol. A key to curbing the epidemic is to curb unhealthy behaviors of the youth. 20% of youth are at high risk of obesity, with another 10-19% at medium risk; 70% are at high risk of physical inactivity; 40% use alcohol: and 16% or more use tobacco.3

75% of NCDs occur in middle-to-lower income countries.4 300 thousand women die each year from cervical cancer, mostly in low and middle income countries.5 NCDs are dramatically increasing in Sub-Saharan Africa, affecting younger populations and creating worse health and economic outcomes than those in developed countries such as the United States. Currently, more than one-third of Africans, or 360 million, are between the ages of 10-24. By 2050, when they are middle age, the risk for NCDs will be at its highest for that population.5

Lack of resources-limited availability of screening, laboratories and pathologists-are a key reason for this trend.

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The economic costs associated with cancer, both immediate healthcare costs and loss of productivity, are threatening continued development and prosperity. Deaths from preventable cancers mean catastrophic health expenditures, less income in the household and potential impoverishment. Globally, the World Economic Forum projects that the NCD epidemic will inflict $21.3 trillion in losses in developing countries over the next two decades.6

Call to Action
ASCP, as a global pathology and medical laboratory community, can do something about it. The people of Sub-Saharan Africa cannot wait for the situation to improve. ASCP has been working directly with the White House Office of Science and Technology Policy and the Clinton Global Initiative to develop a solution.

In response to the White House “call to action,” ASCP will lead a cross-sector coalition of industry, non-profit and professional societies to improve pathology services in 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 Non-communicable Diseases.

ASCP will lead this initiative-known as Partners for Cancer Diagnosis and Treatment in Africa: a Clinton Global Initiative Commitment to Action-which includes a prestigious roster of partners: Partners in Health, the National Institutes of Health, the Centers for Disease Control and Prevention, USAID, the Institute for Health Measurement and Evaluation and the Union International Cancer Control-as well as industry partners, including Pfizer, Roche Diagnostics, Omnyx LLC/GE Healthcare and Sakura Finetek.

On Oct. 26, 2015, the White House Office of Science and Technology Policy, the National Cancer Institute and the National Security Council met with ASCP senior leadership and members of this coalition to confirm a $26.5 million commitment of infrastructure, funding and in-kind resources to improve pathology services. ASCP is well-positioned to take on this new initiative through its established relationships with government Ministries of Health as part of its involvement in the President’s Emergency Plan for AIDS Reduction (PEPFAR) over the past decade.

Leveraging Cloud Technology
By leveraging innovative, leap frog technology and the skills and experience of ASCP members, clinicians in Sub-Saharan Africa will gain access to quality real-time cancer diagnostics, allowing them to detect cancers and subsequently treat patients more quickly. ASCP and partners will develop and administer an economical, scalable, secure and reliable cloud-based infrastructure and telemedicine platform to register specimens, record findings and disseminate diagnostic results to local clinicians whom can implement patient management. Through this commitment, local clinicians in Sub-Saharan Africa will be able to provide a level of diagnostic care currently scarce or unavailable locally.

The approach will provide quality diagnostics through three main steps. First, automatic histopathology systems in high population centers will be established, in which clinicians can send biopsy specimens to be processed and scanned by locally trained lab technicians. Then, by leveraging cloud technology, ASCP pathologists in the United States can view each processed sample, diagnose the patient and upload their findings. Finally, local clinicians will be able to access the results within 24-72 hours, communicate them where needed and implement patient management.

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