BY VICTOR ADAR
Ask any doctor about what it takes to predict illness, foretell risk of cancer or lack of it, and he or she will quickly tell you that it takes a single drop of blood to identify hundreds and thousands of normal and abnormal genes. Isn’t it interesting that experts are saving people from adverse impact of diseases?
According to Prof. Mansoor Saleh, the founding chair, department of oncology, and founding director of Aga Khan University Hospital, Nairobi Cancer Center, if cancer is detected early, there are better chances of survival. He says that setting up proper cancer wards is a move in the right direction. He has opened a new oncology ward and is spearheading cancer trials at the hospital.
“My focus is to elevate patient care and clinical research,” he says. “Access, diagnosis and treatment are the three things that determine care. But we are losing in one, which is access. Patients don’t get to us in time partly because they are not aware, or because the system does not allow them to access clinical care close to them. In addition, we don’t have insurance. National Hospital Insurance Fund is there but may not cover everybody. So access is a problem.”
There is a wrong notion out there that cancer has no cure, and for many years, people who are diagnosed with the disease generally see death at the corner. Step to take is to seek best medical care from either government (public facilities) or private sector.
“We keep good clinical care but we are missing research, and education. So my job is to bring in research, to bring in training, which is education, and public best clinical care for a patient. If you get upgrade to business class no problem,” he says.
Professor Saleh went through the Aga Khan School system, pursued medical education at the University of Heidelberg in Germany and conducted doctoral research at the Max Planck Institute for Medical Research in Heidelberg. He received his clinical and translational research training in haematology and oncology at the University of Alabama at Birmingham Comprehensive Cancer Center where he was not only a professor of medicine and pathology but also director of the First-in-Human early Drug Development Program.
He believes in “targeted therapy of cancer”, which is his area of research, clinical trials and treatment, and is quite sure that war on the disease can only be won if, and only if, patients are willing to visit doctors early enough, and diagnosis performed in good time.
With more than 35 years experience mainly working in the United States, he says that in the era of gene sequencing, everybody, from the haves to the have not should not be worried. To him, cancer is the second most common cause of death both in developing world as well as in the low to middle-income countries.
“We have guidelines but I don’t think those guidelines are being implemented. We certainly fail to prevent cancer as much as we do in America. I think we have it all in theory. We do research for HIV, malaria, TB but not for cancer. You need to differentiate between one cancer to the other. And once you do that you have to use the right drugs,” he says.
Statistics from World Health organization show that breast cancer, for example, is the most frequent cancer among women, impacting 2.1 million every year. Breast cancer also causes a big number of cancer related deaths mainly among women. In 2018, it is estimated that 627,000 women died from breast cancer – this is approximately 15% of all cancer deaths among women. In an effort to turn around the situation, experts say, sending patients abroad should not top the list.
Saleh in lauding treating patients locally says that if it doesn’t work and there are challenges, something can still be done. For example, the cost of care is expensive because drug development is expensive in itself, there is delivery of drugs, and those who do it must have a certain margin. As always the case, drugs can be made affordable by having other generic drugs or by buying drugs that are similar in terms of activities when originals turn to be a tad expensive.
“Our job at AKU is that everybody gets the best of care. If you want to upgrade to business class no problem. In the past many decades, pharmaceuticals have overlooked East Africa. They go to South Africa, Middle East… We have to show them that we exist and I think we can do it. We have trained workforce and patients are willing to come to us. I’m happy that we can do what we can do because that is what is required of all of us,” he says.
To those, especially the young people who would like to do what he does, his advice is that passion and hard work are why you will make it. At the same time, as you work towards becoming who you want to be, the solution is to know the professional training that is needed. It is also important to think differently (change status quo) and do things differently.
“We are all born with a certain talent and you don’t have to be a doctor. You could be anything you want with the talent you have… you have to have a general desire to do whatever. You could be a farmer, you could be a vegetable seller, you could even be somebody who sweeps the street… Take pride in what you do and do it the best way you can. Two, nothing comes free. You have to work hard. You must educate yourself, and education does not mean one degree and you stop. It is lifetime thing and once you have that it is important that that knowledge you have gained is not for personal gain but anyone can gain from it. And there are always opportunities but it has to start with individual desire”.