Two major pharmaceutical companies have announced plans to slash prices on 16 essential cancer medicines in order to make them more accessible in Africa.
In collaboration with the American Cancer Society (ACS) and the Clinton Health Access Initiative (CHAI), Pfizer Inc and Cipla Inc will set competitive prices on certain oncologic therapeutics in Ethiopia, Nigeria, Kenya, Uganda, Rwanda, and Tanzania. Almost half (44%) of all cancer cases diagnosed in sub-Saharan Africa each year occur in these six countries.
“For more than a hundred years, the American Cancer Society and our volunteers have led the fight for a world without cancer, and we’re committed to making sure that the progress we’ve made in the United States is not limited to our borders,” stated Gary M. Reedy, CEO of the American Cancer Society, in a statement.
“Every person with cancer deserves access to treatment, no matter where they live,” he said. “Collaborating with companies like Pfizer and Cipla is a critical next step toward leveling the playing field for people with cancer and saving lives in this part of the world.”
Other participants in the collaboration include the National Comprehensive Cancer Network and the African Cancer Coalition, a network of 32 oncologists in 11 African countries.
The agreement with Pfizer pertains the following medicines: carboplatin, cisplatin, docetaxel, doxorubicin, epirubicin, fluorouracil, gemcitabine, leucovorin, methotrexate, oxaliplatin, and paclitaxel
The agreement with Cipla includes cutting the price of anastrazole, bleomycin, capecitabine, carboplatin, cisplatin, cytarabine, oxaliplatin, and vinblastine.
A Collaborative Effort
Founded in 2002, the CHAI is an initiative of the Clinton Foundation (founded by former President Bill Clinton) but is a separate, nonprofit organization that works to increase the availability of antiretroviral treatment to people with HIV/AIDS living in developing nations. Although the CHAI focuses on HIV/AIDS and has not been involved with the cancer community, the organization has extensive experience in negotiating low prices for drugs, finding funding for them, and dealing with red tape, corruption, and other challenges to the delivery of medicines.
“The state of cancer treatment in Africa today is very reminiscent of the challenges faced when working to increase access to lifesaving antiretroviral therapy for HIV/AIDS over a decade ago,” said CHAI CEO Ira Magaziner in a statement. “While cancer treatments and the tools for early diagnosis are readily available in developed countries, market forces and other barriers have limited access in Africa.
“As was done for the HIV/AIDS crisis before it, this public-private collaboration will help revolutionize cancer treatment in sub-Saharan Africa and has the potential to save thousands of lives each year,” he explained.
The drug agreements with Pfizer and Cipla were negotiated by the CHAI, which received funding and technical assistance from the ACS, according to the New York Times. The project began 2 years ago, when the ACS gave the CHAI a grant to study the market and to approach drug manufacturers. The two organizations plan to continue working together and are pursuing additional markets to increase access to cancer care.
The ACS and the CHAI are also working with IBM Health Corps to develop and deploy a chemotherapy forecasting software called ChemoQuant. The goal is to assist countries in quantifying their need for cancer drugs and help them plan their budgets and procurement. Currently, Uganda is using the software, and five additional countries are expected to begin using it by the end of the year.
Adapting Guidelines
The cancer burden is rapidly growing in sub-Saharan Africa, and mortality remains high, primarily because diagnoses are being made at late stages, and there is a lack of treatment, notes the ACS. In 2012, there were an estimated 626,000 new cases and 447,000 deaths due to cancer. The mortality rate is expected to almost double by 2030, owing to aging populations.
Many of the tumor types that are most commonly seen in Africa are also the ones that are the most treatable, including malignancies of the breast, cervix, and prostate. But survival is dramatically different in Africa in comparison to the United States. In Uganda, for example, 46% of breast cancer patients survive 5 years, compared with 90% in the United States.
Despite these statistics, global funding for cancer prevention and treatment in lower-income countries is less than 2% of global health spending, and remains much lower than for other diseases.
The ACS points out that although improving access to essential chemotherapeutic agents is a critical step to improving cancer treatment, many more issues need to be addressed. These include improving access to treatment and finding solutions to shortages of healthcare workers.
There is a severe shortage of oncologists. To assist them with treatment decisions, the National Comprehensive Cancer Network is dividing its guidelines into four tiers, which will make them more useful and applicable for facilities with different resources, the New York Times reports.
IBM is also helping to adapt the guidelines by putting them into the Watson supercomputing program. This will help generate the best treatment regimens on the basis of hospitals’ capabilities.
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