Fellowship boosts Pediatric Hematology-Oncology specialists in East Africa

By Esther Nakkazi

The East African Pediatric Hematology and Oncology Fellowship Training Program at Makerere University College of Health Sciences has graduated its first class of graduates building on the critical mass of pediatric hematology-oncology specialists to independently provide effective, evidence-based pediatric cancer and hematology care in the African setting.

The four physicians who graduated are all pediatricians physicians; Ruth Namazzi, MB ChB, MMed, Barnabas Atwiine, MB ChB, MMed., Fadhil Geriga, MB ChB, MMed. and Dr. Philip Kasirye, MB ChB, MMed. 

“By training physicians through the fellowship program, we are increasing the number of pediatric hematology-oncology specialists who will be practicing in East Africa. This will improve the overall survival for children with cancer and blood diseases in the region," said Dr. David G. Poplack, Director of Global Hematology-Oncology Pediatric Excellence or HOPE and Associate Director of Texas Children’s Cancer and Hematology Centers.

The East Africa Pediatric Hematology and Oncology Fellowship Training Program is part of the comprehensive Global HOPE initiative, which launched in February 2017, a two-year fellowship program. 

“This first class of graduates of the fellowship program represents an exponential increase in the number of pediatric oncologists in East Africa and by extension a huge increase in the number of children diagnosed with cancer who may now receive high-quality treatment and the chance of recovery,” said John Damonti, President of the Bristol-Myers Squibb Foundation. 

“We are proud to support the creation of a sustainable, highly qualified team of oncology and hematology healthcare providers in southern and east Africa, to help change the health outcomes for children,” said Damonti.

In sub-Saharan Africa, about 90% of pediatric patients with cancer die while 80 percent of children with cancer survive in the USA. The most common types of childhood cancers in Africa are blood cancers, including leukemia and lymphoma.

Although most childhood cancers are treatable up until this point, the main reason for the staggering death rate across Africa has been due to an inadequate healthcare infrastructure and a significant lack of expert physicians and other healthcare workers trained to treat children with cancer and blood disorders. 

With the ambitious efforts of Global HOPE to build medical capacity to diagnose and treat pediatric blood disorders and cancer in Africa, the impact is already evident in the higher numbers of children receiving care in Uganda, Botswana and Malawi.

The East Africa Pediatric Hematology and Oncology Fellowship Training Program is the result of cooperation and commitment between some of the most eminent institutions in Africa and on the world-stage in cancer care, medical education, health policy, and pediatric hematology and oncology.

Its a partnership between the Ministry of Health of the Republic of Uganda, Makerere University College of Health Sciences, East African Community, Uganda Cancer Institute, Baylor College of Medicine Children’s Foundation- Uganda, Mulago National Referral Hospital, the Bristol-Myers Squibb Foundation and the Texas Children’s Cancer and Hematology Centers and Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children’s Hospital (BIPAI). 

Atwiine, during his Fellowship, led to the development of a new combination chemotherapy approach to treating children with Burkitt lymphoma in Africa; and championed the widespread use of hydroxyurea to control sickle cell disease in children. He will return to Mbarara to head the children’s cancer service and to initiate a pediatric hematology service.

Geriga conducted research that demonstrated the high incidence of muscle cancers of the face that were previously often misdiagnosed as lymph node cancers. He will spearhead the development of a world-class muscle and kidney cancer care and research program at The East Africa Center of Excellence in Oncology at Uganda Cancer Institute, under the mentorship of world experts from Texas Children’s Hospital.

Kasirye, during his Fellowship, oversaw gigantic improvements in the care of children with Sickle Cell Disease at Mulago and formulation of nationwide guidelines of care for which he received an award of excellence from the Ministry of Health. He was requested to lead the Pediatric Cancer and Blood Diseases program of excellence at Kamuzu Central Hospital in Lilongwe, Malawi before returning to Mulago Hospital.

Namazzi led the upgrading of leukemia and kidney cancer treatment protocols that resulted in major improvements in the survival of children with these cancers. She also served as the Chief Fellow for the last two years. She will focus on research in cancerous and non-cancerous blood diseases and will co-direct the East Africa Pediatric Hematology and Oncology Fellowship.

At the graduation ceremony, Dr. Poplack was awarded an Honorary Doctor of Science, DSc. (Honoris Causa) from Makerere University for his academic contribution in the field of science. Under his leadership for the last 25 years, Texas Children’s Cancer and Hematology Centers established itself as an internationally-recognized leader in the treatment and research of pediatric cancer and blood disorders. 

With a desire to expand care to areas of the world with limited resources, Poplack and his team have worked over the last decade to provide care to children in sub-Saharan Africa. With the inception of Global HOPE, access to care will only continue to increase with this training of pediatric hematology-oncology physicians through the fellowship program.

The Global HOPE was developed to create an innovative pediatric hematology-oncology treatment network in southern and East Africa and will build long-term capacity to treat and dramatically improve the prognosis of thousands of children with cancer and blood disorders.

The initiative will train an estimated 4,800 health care professionals from Botswana, Uganda, Malawi and other African countries, including doctors and nurses specializing in pediatric hematology-oncology and social workers. 

The program estimates that over 5,000 children will receive care in the first five years. Modeled on the work of the Bristol-Myers Squibb Foundation, BIPAI and the Governments of Botswana, Uganda, and Malawi, which created the largest pediatric HIV treatment network in the world, leveraging existing experience, infrastructure, and public/private partnerships created through the initiative. 

Since 2003, the Bristol-Myers Squibb Foundation and BIPAI have trained 52,000 healthcare professionals and currently provide care for nearly 300,000 children with HIV and their families in sub-Saharan Africa, lowering the mortality rate for these children to 1.2 percent. 

The Bristol-Myers Squibb Foundation is committing $50 million over five years to fund the training of healthcare providers as well as clinical infrastructure and operations. BIPAI will raise an additional $50 million for the initiative.

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