1. UNVEILLING OF ISAAC FOLORUNSO ADEWOLE FOUNDATION (IFAF)
Professor Oladapo A. Ladipo, OON

2. COMPLIMENTS
The Organisers
The Celebrant
Isaac Folorunso Adewole, FAS

3. Why is this Foundation imperative?
In Nigeria, we have made modest improvement in improvement of the health of our women but access has not been universal.
Majority of women suffer untold hardships as well as myriads of health and social challenges, which either cause ill health or premature death.
Our reproductive health indicators, which are poor, remain a significant indicator of our state of national development.

4. Global mortality per annum of Cervical Cancer
Northern America
> 12,000 new cases
> 4,000 deaths
Europe
> 54,000 new cases
> 25,000 deaths
Worldwide, every 2 minutes a woman dies of cervical cancer1
The highest burden of disease (up to 80%) occurs in less developed regions2 where there is a lack of effective screening programmes
This demonstrates a clear medical need for new cervical cancer interventions
Asia
> 312,000 new cases
> 159,000 deaths
Latin America
> 67,000 new cases
> 31,000 deaths
Global mortality per annum
There are > 80,000 new cases of cervical cancer in Africa per year.
Africa and Central and South America are regions with the highest incidences of cervical cancer, with substantial variations seen regionally. North Africa and the Middle East are regions of low to intermediate risk, according to GLOBOCAN data.
GLOBOCAN is a compendium of data taken from cancer and mortality registries and pathology departments from all over the world. Strict methodology is applied across all regions. In countries where official statistics are affected by poor diagnostic capabilities and registration, GLOBOCAN generates estimated data based on those of neighbouring countries. The data shown here are the best estimates available, although they may not truly reflect the incidences seen by specialists in some countries and should be seen as the lower limit.
Reference Ferlay J, et al. GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide. IARC CancerBase No.10; Lyon, France, 2010
Africa
> 80,000 new cases
> 53,000 deaths
Cervical cancer mortality rates worldwide
1. Ferlay J, et al. GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide. IARC CancerBase No.10; Lyon, France, 2010;
2. Kitchener HC, et al. Vaccine 2006; 24(Suppl 3):S63–S70.

5. Cervical Cancer needs Attention!
Cervical cancer is the second commonest cause of cancer deaths in among Nigeria women.
About 70% of the 14,000 women who develop cervical cancer every year die from the disease.
These unacceptable fatalities are due to
Ignorance about the cause,
Poor health seeking behaviour
Lack of access to and use of effective preventive services
Weak treatment facilities and poverty.

6. Progression of cervical disease
Months
Years
Time
Normal
epithelium
Progression of cervical disease
The process of cervical carcinogenesis is illustrated schematically here. After the cervix is infected with HPV, infection may cause mild Pap abnormalities and/or mild CIN, which usually clear spontaneously.
Koilocytosis is a distinctive histological feature of HPV infection and is the appearance of halo or koilocytotic cells in the differentiated layers of the squamous epithelium. The koilocytes are squamous epithelial cells that contain an acentric, hyperchromatic nucleus that is displaced by a large perinuclear vacuole.1
It has become clear that persistence of high-risk HPV is a key factor in the progression to precancerous lesions or high-grade dysplasia (CIN2/3) which has a greater likelihood of progression to invasion and cancer.2,3
As shown, abnormal infected cells and CIN1 can also be termed low-grade squamous intraepithelial lesions (LSIL), while CIN2 and CIN3 can also be termed high-grade squamous intraepithelial lesions (HSIL).3
The progressive development of cellular changes from HPV infection to cervical cancer generally takes 10–20 years, although, in very few cases, it may only take 1–2 years.2
CIN1 changes can arise within 3 months of infection, CIN2 within 6 months and CIN3 within 1–2 years.
References
1. Krawczyk E, et al. Am J Pathol 2008; 173:682–688.
2. Burd EM. Clin Microbiol Rev 2003; 16:1–17.
3. Solomon D, et al. JAMA 2002; 287:2114–2119.
HPV infection
koilocytosis
CIN1
CIN2
CIN3
Invasive
carcinoma
Low-grade squamous intraepithelial lesion (ASCUS/LSIL)
High-grade squamous intraepithelial lesion (HSIL)
Regression
* With increasing probability of viral DNA integration. CIN = cervical intraepithelial neoplasia; ASCUS = atypical squamous cells of undetermined significance.
Burd EM. Clin Microbiol Rev 2003; 16:1–17;
Solomon D, et al. JAMA 2002; 287:2114–2119.

7. Continuum of Care for Cervical Cancer Control
15 years
30 years
45 years
Screening and
treatment
Vaccination
Cancer
treatment
Source: WHO 2006

8. IFAF is non-profit philanthropic organisation
The need to improve on the health of our women that is often neglected remains the driver of the passion of Isaac Folorunsho Adewole who decided to establish a non-profit philanthropic initiative, Isaac Folorunsho Adewole Foundation (IFAF).

9. The IFAF Concept
The Isaac Folorunsho Adewole Foundation (IFAF) was conceived to offer high quality humane and selfless services in area of
Advocacy
Development of accessible cervical cancer prevention programmes
Capacity building for young and committed medical faculty/other allied professionals
Networking and linkages as well as partnering with other interest groups to promote health of women at national and international level.

10. IFAF aims to translates despair to hope!

11. Strategic intervention of IFAF to prevent CC
Behavioural Change Communication
Operational Research to generate better policy
Community based prevention programmes – (Human papilloma virus vaccine demonstration project; Community Screening Model, and Treatment of pre-cancer stages)
Linkage, treatment and control of invasive cervical cancer cases
Technical support on Cervical Cancer
Policy formulation
Capacity building for frontline workers
Resource mobilization and networking
Programme monitoring and evaluation

12. Membership of Trustees
Prof O.A. Ladipo OON - Chairman
Prof I.F. Adewole FAS
Justice Pat Mahmoud
Mrs Ngozi Iwere
Dr Adeola Adewole
Dr Adebayo Jimoh
Prof Funmi Togonu-Bickersteth
Director- Dr Adeola Adewole

13. How can IFAF be reached and supported?
Web address

14. The Unveiling Moment
To the Glory of Almighty, It is my pleasure to unveil the Isaac Adewole Folorunso Foundation focusing on Women Health with specific attention on Cervical Cancer Prevention and management programmes
It is my hope and fervent prayers that IFAF shall prosper in her dealings with humanity.
Let us all support this initiative with our resources!

15. Thank you for Listening