Tackling the gaps in healthcare through Project ECHO

Six billion people all over the world are suffering and are at risk of dying every day from diseases we already know how to treat because they lack access to the right medical knowledge, at the right time, at the right place. For example, despite being a country of over 17,000 islands and 270 million inhabitants, Indonesia only has around 140 medical oncologists and 200 surgical

To help broaden access to best practice cancer treatment in lower and middle income countries (LMICs), Project ECHO offers a collaborative video telementoring model for medical education and care management that connects national centres of excellence to remote and underserved areas. By training and mentoring healthcare personnel in underserved or rural communities it enables them to diagnose and treat patients faster and more effectively providing better care to more people, right where they live.

Since its launch in 2003, Project ECHO has grown to serve people around the world, with over 724 hub partners (serving 70 disease areas) in 59 countries and learners in 192 countries (see example fromRoche aims to act as a catalyst for the development of additional ECHO programs which will help change health ecosystems in these countries.

In October 2020, Roche began a three-year partnership with the Project ECHO and is supporting ECHO pilots in seven countries across the globe to build the capacity and capability for better health outcomes (India, Indonesia, Ivory Coast, Malaysia, Pakistan, Philippines, Canada).

We not only provide local knowledge and support for the pilot schemes, but also bring our global expertise as an industry leader in digital technologies and cancer care. By providing support for initial infrastructure, we are helping to expand medical capabilities beyond key centres, to reach more patients. The initial focus is on women’s cancer diseases intending to expand to cover other cancers in the future. In 2021 Roche launched ECHO programs in the Philippines and Indonesia that will focus on breast cancer.

In addition, we have just signed a memorandum of understanding with the Ministry of Health in the Ivory Coast, and plan to launch our cervical cancer program in the country by the middle of 2022. Projects in other LMIC countries are under negotiation and development; our goal is to launch in two countries per year.

The initial success of our recently established ECHO programs in Indonesia and the Philippines is already having a significant impact. Both the local government of Guagua, Pampanga in the Philippines and the Dharmais National Cancer Hospital in Jakarta, Indonesia decided to focus on health strategies for the management of breast cancer within the ECHO program.

For example, in Indonesia, Dharmais National Cancer Hospital, with support from the Ministry of Health, has included the ECHO telementoring program as a key requirement to help accelerate the formation of a national breast cancer centre network. The model has also been adopted by a patient organisation who initiated an early detection of breast cancer project in Tangerang municipality, in Banten province. Local stakeholders together with their National Cancer Control Center have established a scale-up plan where they aim to establish a telementoring network of 10 hubs and 110 participating sites by 2024.

In the Philippines, the local government issued a municipal law to ensure continuity and sustainability of the project through the allocation of funding and resources for early breast screening and detection.

Through Roche’s global partnership with Project ECHO, we can also explore leveraging virtual networks to strengthen cancer screening programs in a similar manner to our activities in other countries. For example, in Tanzania we have an opportunity to leverage over dozens of ECHO sites across a region of Tanzania to virtually connect facilities and referral hospitals. Also, our extensive presence from our involvement with HIV programs together with 15 Roche testing systems in 11 regional hospitals for HPV tests enables us to collaborate and optimise existing footprint to achieve global targets in HIV and cervical cancer.