Bringing Vision and Leadership to Confront the Cancer Epidemic in Africa

Jun 21, 2010

July 2010 Issue: Clement A. Adebamowo, MD, ScD, of the Institute of Human Virology in Abuja, Nigeria, and the Institute of Human Virology in Baltimore, Maryland, is the first person from a World Bank–defined lower-middle-income country to serve as ASCO’s International Affairs Committee (IAC) Chair. Before Dr. Adebamowo accepted this leadership role, he was recognized as a 2003 recipient of The ASCO Cancer Foundation® International Development and Education Award (IDEA). In the interview that follows, Dr. Adebamowo discusses his work in Nigeria, his leadership role in ASCO, and the IAC’s continued efforts to promote the exchange of scientific information throughout the world.

AC: How have you applied what you learned during your IDEA experience to your institution in Nigeria?
Dr. Adebamowo: The most important thing that I learned through my IDEA experience is the value of a nurturing professional community. In many developing countries, cancer care is provided by individuals without specialized training in oncology. We need to create a community of cancer care professionals that will provide networking, mentoring, training, and research resources that are more readily accessible. This motivated the creation of the Society of Oncology and Cancer Research of Nigeria (socron.net) to provide such a platform. So far the results have been better than expected.

AC: How has your IDEA experience affected your career?
Dr. Adebamowo:
The IDEA experience represented an inflection point in my career. I was able to change from a predominantly clinical oncology practitioner to someone who devoted more time to cancer research, advocacy, and policy issues—taking a broader public health perspective and seeking more broadly impactful interventions. The clinical paradigm is the predominant approach to cancer in developing countries, yet—given the resources, educational, and managerial constraints in these countries—training and research on measures with meaningful impact at public-health levels need to be given more prominence.

AC: Why is the IDEA program important for other early career oncologists in developing countries?
Dr. Adebamowo: Early career oncologists in many developing countries, particularly those in lower-middle- and low-income countries, suffer from a lack of adequate training, research, and networking opportunities. The evidence shows that programs like IDEA have contributed significantly to the development of a new generation of oncology leaders. Of course, everyone, including ASCO, recognizes this is not sufficient, and it needs to continue to be expanded. One idea, which would have even greater measurable impact in a shorter period of time, is to give awards to the entire cancer care team in specific institutions, which will enable them to jointly attend the ASCO meeting and visit oncology programs afterwards. Of course, such a program would be complex, but has the advantage of encouraging a more multidisciplinary approach to cancer care while recognizing the necessary interdependence of specialists and other care providers in ensuring improved cure rates and quality of life for patients.

AC: What experiences made you realize you wanted to serve in a leadership role within ASCO?
Dr. Adebamowo: My involvement in ASCO leadership was midwifed by people who recognized the need to not just nurture careers, but to also build leadership. I think they were motivated by the increasing internationalization of ASCO, realization of the growing incidence of cancer in developing countries, and the need to nurture the intellectual and human response to it.

AC: What areas will you focus on during your 2010-2011 term as IAC Chair?
Dr. Adebamowo: I am keen on the issue of creating communities of cancer care professionals and developing the leadership that needs to go with it. I would like to see an ASCO International Leadership Development and Mentoring program (I can even venture to name it in the spirit of the times—“iLEAD”) similar to the program currently open only to U.S. oncologists. The “iLEAD” program would be modified to take account of the peculiarities of the international environment and the specific needs of the low- and middle-income-level countries. My second area of focus is in AIDS-associated malignancies. This is very much “a disaster, foretold.” Africa has been particularly hard hit by the HIV epidemic, and the response of the world has been extraordinary. Yet much needs to be done because a substantial number of people with HIV remain untreated. The oncologic implication of this is that there is a twin problem of increased incidence of AIDS-defining malignancies and of non-AIDS–defining malignancies. This is one of those rare instances in human history where an epidemic of cancer can be fairly accurately predicted. I am therefore concerned about the need to develop appropriate prevention strategies; affordable, effective treatment programs that use best practices learned from the HIV/AIDS intervention programs; oncology resources; and stronger health systems to respond to this challenge.

AC: How will your perspective as the first person from a lower-middle-income country to serve as ASCO’s IAC Chair help you bring innovation to the IAC?
Dr. Adebamowo: As someone who studied and practices largely in the developing world, my perspective is informed by my daily experiences of the huge trauma that cancer causes. Compared to infectious diseases, the incidence-rate numbers look small, but this obscures the chronic nature of the disease, the long duration of treatment, and the impact that this has in communitarian environments where there is usually as much sharing of joys as of sorrows. This background has shaped my journey so far, and I see it continuing to influence the choices I make and the issues that I will champion as ASCO’s IAC Chair.

AC: What other roles or projects would you like to explore with ASCO in the future?
Dr. Adebamowo: I would like to be in a position to promote the mission of ASCO in other countries—to clone ASCO, so to speak—because the need for the services that ASCO offers exists and is probably greater in other countries. With the passage of time, these needs are amplified and become greater still. I would like to be able to move colleagues in other parts of the world toward creating communities of oncology professionals that nurture the next generation, while providing the best quality of cancer care for the patients of today.


Read Dr. Adebamowo’s editorial, “AIDS-associated Malignancies in Developing Countries: An Epidemic.”

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