Closing the gap on inequities for women with breast cancer

Two female leaders, spearheading change for women’s health, share their thoughts on why this topic deserves special attention. They explore how, by boldly believing that positive change is possible, we can form partnerships that make life-changing improvements for women throughout the globe.

An interview with Stephanie Sassman, Portfolio Leader, Women’s Health, Genentech, and Jacqueline Wambua, General Manager, East Africa, Roche

On the Topic of Women’s Health and Female-Centric Care…

Stephanie: Women’s health is easy to get passionate about. It is known that improving women’s health has a ripple effect across communities and the globe, yet women’s unique health needs have historically been overlooked, under-researched and little understood. A woman’s experience of life is different to a man’s, her biology, the way her body is impacted by treatment, and the different stages in her life journey when she might receive a cancer diagnosis, all need to drive the care she receives. 

In my role I am privileged to be able to work across Roche to consider women’s health holistically, and how we can be more integrated about those stops along the patient pathway.

Jacqueline: I echo this. Here in East Africa, which is a patriarchal society, women are one of the pillars for economic development. However, if you look at the lives of women, it's the same thing here and across the world. Women are the connectors of the family and community, the gatekeepers of family health, but can be forgotten from a healthcare perspective. There is always a spouse, elderly parents or children who come first. There are also socio-cultural issues that mean women do not seek healthcare. 

We must identify and address these hurdles. Women make most healthcare decisions for their families and as the nurturers of future generations, they must be put at the centre. 

Stephanie: Exactly, for me, women and health are inseparable. Women are the ‘chief medical officers’ of their families, and that’s why we should make them the centre of our efforts.

The Changing Narrative of Breast Cancer

Jacqueline: We need to change the narrative of breast cancer to one of hope. A core barrier for us in Africa is the stigma surrounding cancer. It is presumed a death sentence, but enabling early diagnosis and early treatment can change this.

Stephanie: Absolutely and yes there's an urgency to treat and address the cancer, but there should also be considerations of her future life built into that discussion, whether that be her fertility or menopause for example, and how they fi t with treatment. Personalised care means tailoring it to the individual's unique needs and seeing the full picture.

Women mustn't just survive breast cancer, but thrive. Access to treatment is key here; we can't let women be lost in the system.

Jacqueline: It's interesting you talk about access. I still believe that where you are born or live should not be a determinant of whether you live or die of cancer. In Africa, we are losing too many women every day and to your point Stephanie, a lot of these women are in the reproductive stages of life, which is catastrophic for their families left behind and society at large.

Empowering Grassroots Change 

Stephanie: One of the things Roche has always tried to do is work with local communities and health systems to drive change from the root up. Jacqueline is going to talk about the Enabling and Motivating Partnerships Owned by Women who Engage and Reclaim their Lives (EMPOWER) programme, many elements of which were inspired by work carried out by our team in Colombia who have screened over a million women for breast cancer. Jacqueline took this concept and brilliantly translated it to Kenya. 

Jacqueline: Thank you Stephanie and it was a privilege to visit Colombia and bring back those learnings. In creating EMPOWER we decided that if women were not part of the discussion or did not have a seat at the table, then we would have to set up our own table. 

We said, ‘let’s go to the community, understand local stigma, barriers, and entry points.’ At its core, EMPOWER is a partnership between public, private and not-for-profit organisations – the people who have the power to mobilise. Our ambassadors include the First Lady network advocating for their own communities. We started with breast and cervical cancer screenings for women and were surprised that men would attend. This provided a good opportunity to educate them, offer prostate screenings, family planning advice and provide information on human papillomavirus (HPV) vaccination for their daughters. We made each visit really count to create a cascade effect that extended to the whole family and the wider community through word of mouth. To the earlier point, maybe it goes beyond woman-centric care to family-centric care.

Another aspect I am particularly proud of is that we brought in women from the community with disabilities and trained them in screening and health education, to provide opportunities for them. 

Stephanie: It’s elegant and this holistic approach needs to happen wherever a woman is - whether Basel, New York, or Kenya. If this can be done in rural Kenya during a pandemic, this can be done anywhere.

Thoughts on Breast Cancer Awareness Month (BCAM)

Stephanie: I wish every month was like BCAM! It not only generates mass awareness but can really act to trigger discussions with policymakers. 

Jacqueline: For me, it’s about changing the narrative to one of hope; let’s talk about prevention, survivorship and living with dignity. Six years ago, I was talking to healthcare professionals about standard-of-care breast cancer treatments that even I, had I been diagnosed, would not have access to. But today many of these treatments are reimbursed, so when I reflect on BCAM I have a lot of pride that we are changing the narrative for breast cancer in Africa. 

Stephanie: We do still have a way to go to bring this change forward for women globally. There are undeniably gaps and facts about women’s experiences in healthcare that need to be addressed – and that starts with all of us. I’m proud that we at Roche are making this our responsibility and priority. By launchingwe’ve committed to driving real change through partnering, funding and action to make a difference for women everywhere. 

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