Behind every patient: Strengthening health systems to improve breast cancer care in Africa

Breast cancer is a serious condition that impacts millions across Africa, and is the most common and most deadly type of cancer affecting the continent. This year, for Breast Cancer Awareness Month, we are shining a light on the way health systems can be strengthened to help patients access screenings, diagnostics, treatment and care.

Strong, resilient health systems help patients access the care they need at every step of their health journey. But, we know that just as every individual’s health journey is different, so is every country’s health system. A one-size-fits-all approach to breast cancer care will not work to improve the health of every patient in every country in Africa. That’s why for Roche, it’s important that we work from the bottom-up to identify areas where we can catalyse exponential change. At the core of finding and scaling the right solution is listening to, understanding and working with patients and stakeholders in Africa to ensure each solution addresses their reality and brings meaningful, lasting change to patients.

With women making up more than fifty percent of the African population, addressing women’s health and cancers must be a priority. Early detection is a proven way to improve outcomes for breast cancer patients, but barriers to screening and treatment can vary from awareness issues to cultural roadblocks. Many women in low-and-middle-income countries (LMICs) face barriers at the very beginning of their cancer journey, namely lack of clarity on where to go for screening or treatment, lack of awareness about risk factors, cost concerns, and the stigma and fear they would face if diagnosed with breast cancer.

Expanding access to breast cancer care improves women’s lives and makes it easier for them to receive treatment, not only for breast cancer, but for other cancers like cervical cancer. To drive lasting health outcomes for women, we believe stakeholders and strategies must holistically address the determinants of health through women centred care. At the end of the day, a focus on women’s health is also a focus on population health that uplifts everyone.

With regional and global partners across the healthcare ecosystem that include patient advocacy groups, NGOs, government, and hospital systems, we have the ability to strengthen health systems so that women can get screened early and get the treatment they need. We have seen the benefits of this collaborative approach through partnerships across the continent:

• Building Capabilities for Early Diagnosis in Egypt: In early 2020, Roche signed a cooperation protocol with the National Women’s Health Project committing to build capabilities for early diagnosis of breast cancer within the public sector, and ensure greater access to treatments for early breast cancer patients in Egypt. This was in alignment with a women’s health initiative set forth by the President of Egypt, General Abdel Fattah El Sisi, aiming to enhance the wellbeing of Egyptian women and achieve equity amongst patients regardless of affordability - with special attention to the early detection & treatment of breast cancer. Together with the Government of Egypt, we focused on three key areas: diagnostics tools and capabilities upgrade, standard of care improvement, and supporting the digital transformation to optimise the overall patient journey. This resulted in more than 8 million Egyptian women getting screened for breast cancer - and enrollment of 140 patients in personalised healthcare, so far!

• Improving Access to Standard of Care Treatment for Women in Kenya: With many breast cancer patients in Kenya lacking access to standard of care treatment, Roche undertook an ambitious project to make one of its treatments available for all eligible HER2+ patients and improve the overall healthcare system, to more effectively treat breast cancer nationwide. The Roche team engaged health care providers and ultimately brought to light a major gap that was shared with the Ministry of Health—a lack of treatment protocol and cancer data and a very fragmented government drug supply system. Today, the government supply agent is more informed on cancer management and procuring standard of care for the public sector. Policy work to expand breast cancer treatment access yielded positive results that included the development of patient referral pathways, enhanced diagnosis, capacity building, and ultimately, increased the impact we could have on patients.

• Better Understanding the Patient Journey in Ghana, Kenya & Nigeria: To better understand the Breast Cancer Patient Journey, Roche conducted research to evaluate diagnostic and treatment availability and practices, timing and financial requirements for patients. The findings provided evidence needed for policymakers and stakeholders to consider when shaping policies to improve patient access and outcomes.

At the end of the day, strong patient outcomes are enabled by strong health systems. We are committed to working with partners to support policies across Africa that prioritise women’s cancers, build local capacity in hospitals, and bring innovative treatments and diagnostics to Africa.