Leveraging a matrix of stakeholders to facilitate access to chemotherapy for women’s cancers in the Democratic Republic of the Congo

Abstract

Background: Cancer incidence is increasing worldwide. Over the next 20 years, the growing proportion of cases in low-and middle-income countries (LMICs) will account for an estimated 70% of all cancers diagnosed. The vast majority of cancer patients in LMICs will require chemotherapy, due to the advanced stage of their disease at the time of initial presentation. Unfortunately, the availability of cancer drugs in these environments is sparse, resulting in premature death and years of life lost. In an effort to lay a foundation for women's cancer control in the Democratic Republic of the Congo (DRC), we implemented a programme which combined workforce development, infrastructure creation and cancer drug access. This manuscript reports on our experience with the latter. Methods: A private sector healthcare facility was selected as the programme implementation site. Workforce capacity was developed through a south-south partnership with an African national cancer centre. Cancer drugs were procured through a global cancer medicine access initiative.Results: A new chemotherapy infusion unit was successfully established at the Biamba Marie Mutombo Hospital in Kinshasa, DRC. A team of Congolese healthcare providers was trained at the Cancer Disease Hospital in Zambia to safely and effectively administer chemotherapy for breast and cervical cancer. Over 100 breast and cervical cancer patients have been treated with 337 courses of chemotherapy, without any serious adverse events. Research

Establishing women’s cancer care services in a fragile, conflict and violence affected ecosystem in Africa

“…Oversight and quality assurance were provided through a combination of onsite visits and teleconferencing with a senior chemotherapy nurse and clinical oncologist from the Zambian cancer centre. This experience is described in detail in the chemotherapy manuscript in this series [16]. Since forming a partnership with BVGH, over 100 breast and cervical patients have been safely treated with chemotherapy, having received a total of 377 cycles of cytotoxic agents.…”

“…This model of purchasing chemotherapy drugs at a reduced cost is one of the only options for accessing essential cancer medicines, irrespective of whether they exist on national formularies. For more details, refer to the chemotherapy manuscript in this series [16].…”

“…This report gives an overview of our approach to programme implementation in which workforce training was integrated with service delivery and clinical infrastructure development [9,13]. Other manuscripts in this series provide a detailed and rigorous evaluation of the clinical outcomes of our activities [15][16][17].…”

Establishing women’s cancer care services in a fragile, conflict and violence affected ecosystem in Africa

“…Oversight and quality assurance were provided through a combination of onsite visits and teleconferencing with a senior chemotherapy nurse and clinical oncologist from the Zambian cancer centre. This experience is described in detail in the chemotherapy manuscript in this series [16]. Since forming a partnership with BVGH, over 100 breast and cervical patients have been safely treated with chemotherapy, having received a total of 377 cycles of cytotoxic agents.…”

“…This report gives an overview of our approach to programme implementation in which workforce training was integrated with service delivery and clinical infrastructure development [9,13]. Other manuscripts in this series provide a detailed and rigorous evaluation of the clinical outcomes of our activities [15][16][17].…”