First Lady headlines global cancer meeting…chronicles Zimbabwe’s fight against childhood cancer

Tendai Rupapa in New York, USA

ZIMBABWE health ambassador — First Lady Dr Auxillia Mnangagwa — was invited to be among the panelists at a high-level meeting commemorating the fifth anniversary of the launch of the Global Initiative for Childhood Cancer.

The event — which was held on the sidelines of the 78th Session of the United Nations General Assembly — ran under the theme “CureAll implementation advancing toward Universal Health Coverage realisation and bridging the survival gap in childhood cancer”.

Dr Mnangagwa joined other high profile panelists including President of the Slovak Republic Her Excellency Zuzana Caputová, director-general of the World Health Organisation Dr Tedros Adhanom Ghebreyesus, global health experts and health advocacy champions at a round table discussion centred on enhancing survival for children with cancer.

The high-level event was hosted by the Slovak Republic, St Jude Children’s Research Hospital (WHO Collaborating Centre), World Health Organisation, and the International Society of Paediatric Oncology (SIOP). 

The meeting sought to strengthen children, adolescents, and young adults’ health, considering its complexity and diversity, by effectively addressing current challenges and activating a global network and effort to bridge the gaps.

It also discussed the role of non-State actors, including engagement strategies to amplify the voice of the affected population, in line with WHO’s campaign and framework, and by partnering with states in strengthening social and health systems to deliver essential services for all children, including their families, and covering the most vulnerable.

Goals included the need to activate stakeholders around the shared target of improving survival for children with cancer.

In her remarks on advocacy — Dr Mnangagwa acknowledged that the global burden of cancer was increasing worldwide and about half-a-million children under 19 years were estimated to develop cancer each year. 

“According to our own National Cancer Registry — in 2018, a total of 293 paediatric cancers were registered accounting for 3,7 percent of all cancers diagnosed in Zimbabwe. The five most common cancers diagnosed were leukaemia, Wilms tumours, retinoblastoma, lymphoma, and rhabdomyosarcoma. If cancers are diagnosed early and appropriate treatment is given, 80 percent of childhood cancers can be cured. However, like most low to middle income countries, cure rates are much lower,” she said.

Many factors — Dr Mnangagwa said — contribute to these lower cure rates, including late presentation, poor diagnostic tools, shortages of chemotherapy drugs, poor quality medicines, poor access to radiotherapy services, cultural and spiritual beliefs and high cost of the treatments. 

According to World Health Organisation, she said, there were four pillars to cancer control-prevention, early detection, diagnosis and palliative care.

“In children these pillars are ensured and consented by the caregivers who are usually the mothers in most developing countries. It is my view that cancer control for childhood cancers can only be effective if awareness of cancers in general in these caregivers is high. A mother who is aware of the risks, signs and symptoms and benefit of early diagnoses and treatments of breast cancer and cervical cancers, the commonest cancers amongst women, will also be more likely to be interested in childhood cancers, thus, knowing the signs and symptoms of cancer in her child. She will also more likely look for medical treatment timeously, consent for testing and treatment and adhere to follow programmes for her child.

“This is why through my Angel of Hope Foundation — where I am the patron — we have been driving cancer awareness programmes amongst women in Zimbabwe. The programme has reached more than 70 000 women to date and more will be reached as we move on with the programme. 

“Our hope is that these women will be able to help fight the myths about cancer— increase early diagnosis of childhood cancers — and reduce the late presentation and treatment dropouts amongst the children who may be diagnosed of cancers in their own family and communities. Parental care is needed to monitor and supervise the children,” she said.

In addition — the First Lady said her foundation, working with the Ministry of Health and Child Care — have carried out the Human Papilloma Virus (HPV) vaccination for young girls aged between 10 and 14 in an effort to curb cancer.

The Government of Zimbabwe through both the Ministry of Health and Child Care, the Ministry of Higher and Tertiary Education, she added, have for years been trying to increase the human resource needed for cancer control. 

There are a number of training programmes available that include oncology nursing, paediatric oncology, hemato-oncology medical physics, therapy radiography and radiation oncology. 

“We are, however, very grateful that they still have well-meaning partners like St Jude Hospital who still have a heart to develop childhood cancer control programmes in developing countries, to complement our efforts, for that we are so much grateful.

“The department of paediatrics at one of our universities is working closely with St Jude Hospital and a non-governmental organisation — Kidzcan — in improving the outcomes of cancer treatments for children. Efforts are also being made to decentralise those services for greater access to care for all communities in Zimbabwe. Respected guest, ladies and gentlemen, we are now in 2023, in the second half of the Agenda 2030, which was set in 2015 at the UN General Assembly with the 17 Sustainable Development Goals to be achieved.

“I am happy that today, we are here to evaluate one of these and a section of SDG Number 3, SDG 3.8 — whose target aims to achieve universal health coverage, including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all pertaining to childhood cancer care. 

“In conclusion — the gap between childhood cancer survival in the developed and developing countries has to be bridged and closed. I am sure that this global initiative for childhood cancer is going to be the answer to closing this gap and I am hopeful that we will achieve this before 2030,” she said.

Dr Mnangagwa said her foundation, will continue advocating and bringing awareness programmes to the public so that they become aware of cancer.

“Also in December this year — we are going to have the International Conference on AIDS and STIs in Africa (ICASA) — and I have invited other First Ladies to come and be trained in NCD’s (non-communicable diseases) to help advocate and bring awareness in communities,” she said.

President Zuzana Caputová, highlighted the successes realised since the coalition of states launched the global initiative on childhood cancer and yellow fever, among other ailments.

“By 2030, the survival rate of children diagnosed with tumours must reach minimum 60 percent in all countries and I am happy Slovakia is part of this urgent call — especially now when more children are increasingly being diagnosed with cancer. Our joint efforts can make a difference,” she said.

Zimbabwean cancer survivor — Wadzanai Mayiseni — shared her journey and the advocacy work she was doing to assist others.

She first acknowledged the presence of Dr Mnangagwa before delving into her story.

“I wish to acknowledge the First Lady of my country Zimbabwe, Dr Auxillia Mnangagwa. 

“I am a bone cancer survivor and I stand before you on behalf of children and young adults battling cancer worldwide. On October 15, 2011, my mother grabbed my right hand as we walked towards the hospital. I was 12 when I fell during a physical education exercise at school and an x-ray scan revealed a mass in my bone pointing to cancer.

“I watched as a raucous joy usually shared at my family’s dinner table gradually dissipated and was replaced by anxious inquisition loaded with confusion, fear and apprehension. My paternal grandfather had suffered the same diagnosis and died — so we all wondered if the same would be my story. 

“Thankfully, I am alive and well today though my leg was amputated. This past May, I graduated with honours from Columbia University with a Bachelor’s Degree in Neuroscience and Behaviour. Over the past decade — I have dedicated my time to saving children and women battling cancer in Zimbabwe. I have also organised online socials to educate and share resources with young people in Zimbabwe because in this fight against cancer, we need all hands on deck,” she said.

WHO Director-General, Dr Ghebreyesus thanked Amai Mnangagwa for her commitment towards the fight against cancer.

He said it was his wish for child cancer patients to access quality treatment so that they realise their dreams and contribute to the development of their home countries.

“First Lady Dr Mnangagwa — thank you so much for your commitment — your presence here shows the commitment you have. Please accept my respect and appreciation. I am very proud,” he said.

He added: “Every year an estimated 400 000 children are diagnosed with cancer in low and middle-income countries. Unfortunately— high-quality treatment is often unaffordable and unavailable and for this reason survival for children in these countries is less than 30 percent compared to 90 percent of children in high-income countries. 

“Five years ago — with our partners from St Jude — we made a commitment to tackle this great health inequity. Today, we celebrate the progress achieved by the countries in implementing the global initiative for childhood cancer even as we look forward to expanding the programme, thank you all for your commitment to giving children with cancer the greatest medicine, and that is hope,” he said.

Speaking at the same occasion — Argentina health minister Dr Carla Vizzotti said she was glad to commemorate five years of the launch of the WHO Global Initiative for Childhood Cancer.

In Argentina, she said, cancer was the second cause of death in children. 

“The concept of childhood cancer care requires a particular set of tools for each pathology: human resources training, healthcare facilities, and appropriate equipment in health care centres. The Argentine Childhood Cancer Registry has been registering patients under 19 years old with new cancer diagnoses since 2000. According to this registry, over 30 000 cases have been registered from 2000 to 2021.

“The overall survival rate of children under three years old suffering from hematologic and oncologic diseases has improved recently — from 64 percent to 72 percent — with variations based on cancer types and healthcare centres.

“Multi-sectoral engagement in cancer-related issues is key,” she said.

Dr James Downing, president and chief executive officer of St Jude Children’s Research Hospital, said while countries needed to be proud of what they had accomplished, there was much more they needed to do.

“Seventy countries is incredible; but I challenge everyone in this room and every country in the United Nations to commit to joining the global initiative on childhood cancer. This should be a priority for them. This is the future for every country… the children. Together the individuals in this room, the representative of countries that are not here today, the World Health Organisation and many other organisations that have stepped up and joined this movement, we can change the outlook for children everywhere and not only children with cancer. Our efforts will affect all of health care for children so that one day they won’t die from diseases that are curable. I applaud the work that we have done over the last five years. We should all be very proud of it. We have much more to do and we must bring every country in the world into this and we must address this as a global problem, one that will change the outlook for children everywhere,” he said.