1. :
Global Health Catalyst Cancer Summit @Harvard Medical School
Public-Private Partnerships: Advancing Women’s Cancer Care in sub-Saharan Africa
Doyin Oluwole, MD. MRCP, FRCP, FWACP
Executive Director, Pink Ribbon Red Ribbon

2. Total: 35.0 million [33.2 million – 37.2 million]
Middle East & North Africa
230 000
[160 000 – 330 000]
Sub-Saharan Africa
24.7 million
[23.5 million – 26.1 million]
Eastern Europe &
Central Asia
1.1 million
[980 000– 1.3 million]
Asia and the Pacific
4.8 million
[4.1 million – 5.5 million]
North America and Western and Central Europe
2.3 million
[2.0 million – 3.0 million]
Latin America
1.6 million
[1.4 million – 2.1 million]
Caribbean
250 000
[230 000 – 280 000]
The Challenge: HIV/AIDS
Adults and Children Estimated to be Living with HIV I 2013

3. The Challenge:
Women are now surviving a diagnosis
of HIV because of anti-retroviral drugs,
but dying of a preventable disease –
cervical cancer.
The Opportunity:
Antiretroviral Treatment and the Lazarus Effect

4. The Challenge: Inequity of Cervical Cancer
85% of 528,000 cervical cancer cases per year
occur in the developing world.

5. It’s not acceptable to
save a woman’s life from
HIV/AIDS and watch her
die from cervical cancer.
-PRESIDENT GEORGE W. BUSH

6. Pink Ribbon Red Ribbon
Zambia: 2011| Botswana: 2012|Tanzania: 2013| Ethiopia: 2015| Namibia: 2015
The leading public-private
partnership aimed at
catalyzing the global
community to reduce
deaths from cervical and
breast cancer in sub-
Saharan Africa and Latin
America through: raising
awareness of these
diseases and increasing
access to quality services
to detect and treat them.
A global catalyst Launched: 2011
Founded by the George
W. Bush Institute, the
United States
Government through
the U.S. Emergency
Plan for AIDS Relief
(PEPFAR), Susan G.
Komen, and the Joint
United Nations
Programme on
HIV/AIDS (UNAIDS).
Work in 5 countries
With plans to expand to
Latin America
Namibia Botswana
Zambia
Tanzania
Ethiopia

7. Primary
Prevention
 HPV
vaccine
Secondary
Prevention/S
creening
 CBE
 VIA
 HPV
 Cytology
Treat (if
abnormal):
 Cryotherapy
 Refer
Referral
 Colposcopy
 LEEP
 Biopsy
 Labs
Cancer Rx
 Surgery
 Chemo
 Radiation
Palliative
Care
Awareness Raising/Community Education
Continuum of Cancer Control and Care

8. Transitioning programs to national governments with an enabling policy environment and
budget to sustain them.
Goals
deaths from
cervical cancer by
25% among
women screened
and treated in
partner
countries.
Achieve at least
80%
coverage of
vaccination against
HPV.
Screen at least
80%
of the appropriate
target populations for
pre-invasive cervical
cancer, and treat
those found with
lesions.
awareness
reduce stigma
about breast and cervical
cancer, and promote the early
detection of the disease.
Create and test innovative approaches to sustainability,
financing, service-delivery, and laboratory and data systems that
can be scaled-up and used globally.

9. PINK RIBBON RED RIBBON
PARTNERS
NEW PARTNERS:
• AIRBORNE LIFELINE
FOUNDATION
• INTERNATIONAL ATOMIC
ENERGY AGENCY (IAEA)
• VODACOM FOUNDATION
• GENERAL ELECTRIC
Partner
Countries

10. Partners’ Roles---The Continuum of Cancer Care
Primary
Prevention
Secondary
Prevention:
Screening
Secondary
Prevention:
Treatment
Referral
Diagnosis:
Treatment
Palliative Care
& Hospice
Data/Registry

11. HOW WE WORK
How We Work with Countries

12. A Diagonal Program
PRRR mobilizes resources from governments, foundations, corporate and philanthropic
organizations and individuals
 Starting from the HIV platform, integrates women’s cancers;
 Strengthens countries’ capacities to deliver comprehensive
cancer control & address other chronic diseases;
 PRRR activities are aligned with country plans & responsive
to the national needs & priorities: 3 Tiers of engagement;
 Partners fill countries’ prioritized gaps to ensure
comprehensive service delivery;
 Commitments are publicly made & periodically reported on
to promote accountability.

13. Pink Ribbon Red Ribbon Strategies
EDUCATION
AWARENESS
SCREENINGSVACCINATION
ACCESS
TREATMENT SKILLS BUILDING
&
EQUIPMENT

14. Results Through Partnerships

15. Results from Zambia (since 2011), Botswana (since 2012) and Tanzania (since 2013)
Partnerships + Access = Results
HPV Vaccine
42,045
Number of girls
who have received
all three
doses of HPV
vaccine
Basic
Cervical
Screening
153,670
Number of
women screened
for cervical
cancer.
Basic
Treatment
14,089
Number of
women treated
with cryotherapy
or LEEP.
Breast
Cancer
Screening
5,228
Number of
women screened
for breast cancer
in Tanzania.

16. Challenges: Cancer Care
• 33,991 women are diagnosed with
cervical and breast cancer annually in the
five Pink Ribbon Red Ribbon-supported
countries;
• This number is under-reported, as many
do not seek care in hospitals;
• Unfortunately data on the percentage
that receive advanced treatment is
unknown;
• A significant percentage of women
present with late-stage disease not
amenable to treatment.

17. 5,000
new cancer patients each year
2,500
are breast and cervical cancer patients
Ocean Road Cancer Institute
2,000
come from outside of Dar es Salaam
500
need a place to stay during cancer treatment
CaseStudy:Tanzania

18. The Story of Evelyn
https://www.youtube.com/watch?v=gUbxGwbANgU

19. • Information and knowledge of the disease
• HPV vaccination
• Screening, early detection and treatment services
• Funds to pay for health care services
• Advanced cancer care close to home—
geographic access
• Strong healthcare system
Evelyn died because she lacked access to:

20. The Way Forward

21. The Future
Fewer Evelyns!
 Prevention: one-dose HPV vaccine
 Innovative solutions to reach more women more quickly
o HPV DNA testing will reduce number of women needing VIA
o Cryopen: gasless cryotherapy
o Mobile services models to augment fixed facilities
o Improved data management & tracking systems: IT and mobile
devices
 Integration of screening and treatment services with existing health
services such as family planning and post-natal care
 Decentralized, functional cancer centers to provide quality care as near
to the population as possible: human capital; equipment; maintenance
and standards of practice.

22. CONNECT WITH PINK RIBBON RED RIBBON
Doyin Oluwole
Executive Director
214.751.4318
doluwole@bushcenter.org
www.pinkribbonredribbon.org
@pinkredribbon