Dr. Aziza Shad, Medical Director, The Aslan Project The Building of a Sustainable Pediatric Cancer Health System in Ethiopia Dr. Aziza Shad, Medical Director, The Aslan Project September 23, 2017 9th Annual Ethio-American Health Care & Medical Education Conference

Why Invest in Pediatric Cancer? MOST CHILDHOOD CANCERS IN LICs ARE CURABLE… Survival rates > 80% for children with cancer in high-resource countries Why Invest in Pediatric Cancer? …AT LOW COST TO THE SYSTEM… Using simple protocols and generic drugs <$1,000 …AND SAVE SIGNIFICANT PRODUCTIVE YEARS. An average of 71 productive years, benefiting families, communities, nations and the world

Building Blocks of A Pediatric Cancer Infrastructure: The Aslan Project Approach

Building Blocks of Pediatric Cancer Infrastructure Early and Accurate Diagnoses Effective Service Delivery Access to Essential Medicines, Resources & Health Information Systems Pediatric Oncology Units (Centers of Excellence) Stewardship Philanthropy & Advocacy

Early & Accurate Diagnoses Community Awareness Timely Referral Accurate Diagnoses Pathologists trained in oncology-related testing/diagnoses Availability of necessary technologies and equipment Reagents Microscopes/IPath Flow cytometry Early & Accurate Diagnoses

Effective Service Delivery Human Resource Development Palliative Care Parent and Family Support

Human Resource Development Sufficient capacity in all specialty areas that support pediatric cancer care Pediatric hematology/oncologists Pathologists Pediatric surgeons Radiation oncologists Transfusion medicine specialists Pediatric oncology nurses Oncology pharmacies Psychologists and social workers Data managers Training programs pursuant to internationally-accredited curricula

Palliative Care From date of diagnosis to end of treatment Access to adequate pain medication Compassionate communications

Parent & Family Support Access to housing and transportation (free if needed) Nutritional supplementation Psychosocial supports – e.g., coffee ceremonies, counseling, art therapy Education/skill building

Access to and Affordability of Essential Infrastructures Resources Medicines Supplies, Equipment & Medical Devices Health Information Systems, Research & Reporting

Essential Resources Blood products/Blood bank Stable power source (incl. solar) Water IT bandwidth to ensure electronic function and communication

Essential Medicines Placement of all essential chemotherapy drugs, antibiotics, morphine, and other medications on National Essential Medicine List (NEML) National government supply chain management Stable and reliable pharmacy inventories Provision of drugs/treatment regardless of ability to pay

Supplies, Equipment & Devices Government supply of: Personal protective equipment to ensure safety of nurses and pharmacists Biologic safety cabinets (hoods) for safe mixing of chemotherapy Prosthetics and other devices

Health Information Systems, Research & Reporting Hospital-based data collection and management system Link to national cancer registry Monitoring & evaluation processes Research & reporting

Stewardship, Philanthropy & Advocacy Financial support must come from international, national, and local sources – both public and private Local leader (pref. trained pediatric oncologist) needed to direct medical care and interact with institutional and national stakeholders Need for grassroots organization – e.g., private foundation – dedicated to raising awareness and funds and advocating on behalf of childhood cancer Stewardship, Philanthropy & Advocacy

https://vimeo.com/185266201 Aslan video

Early Outcomes and Impact Through ongoing advocacy with FMOH, most essential drugs now available More than 100 children treated Highly favorable early outcomes for LMIC Pioneered treatment for AML & use of ATRA Fellowship training program has offered exposure to world-class faculty from the United States, Canada, India, and Pakistan with intensive trainings abroad in US & India Ongoing training/mentorship in pathology – pathology residency training program to commence in 2018 Elevated standards of care in nursing, pharmacy Donation of biological safety cabinet Early Outcomes and Impact

Lessons Learned from Aslan’s Six Years in Ethiopia To build a Comprehensive Pediatric Cancer Program, many partners are needed Partnership at the National, Local and Civil Society Level National: Federal Government Ethiopian Pediatric Society Local: Jimma University Tikur Ambessa Hospital Civil Society: TAPCCO Mathiwos Wondu-Ye Ethiopian Cancer Society Advocacy Lessons Learned from Aslan’s Six Years in Ethiopia

Lessons Learned from Aslan’s Six Years in Ethiopia Partnership with the Ethiopian community in the USA Aslan is a US based non-profit organization Funding comes from private donations and some grants Not being Ethiopian, we are at a disadvantage Have some great Ethiopian ‘Friends of Aslan’ We would love to engage with others here to see how we can work together to ensure that every child with cancer in Ethiopia has access to care in the years to come. Advocacy Lessons Learned from Aslan’s Six Years in Ethiopia

Thank you for including The Aslan Project in this important conference Join us on Oct. 14th in Washington, DC for our annual gala! For more information, contact emily.vaughn@aslanproject.org