In 2005 AstraZeneca began a pilot project in Ethiopia, designed to build local capability in managing breast cancer – the second most common cancer among young women in that country.

We are partnering with Axios, an organisation experienced in working with the private sector to advance healthcare in developing countries, with a focus on integrating local resources and priorities in chronic disease management and drug delivery.

AstraZeneca has a strong track record in cancer medicines, including the development in the 1970s of Nolvadex (tamoxifen), which has had the single biggest impact in breast cancer. Since then, we have continued to advance treatment with, in particular, Arimidex, which was introduced in the 1990s and which is now overtaking tamoxifen as the gold standard.  In the developed world, cancer detection and treatment is well resourced. In the developing world, where the incidence of cancer is on the increase, it is predicted that 20 million more people will be diagnosed by 2010, and 70% will live in countries that between them will have less than 5% of the resources for cancer control.

Improving these statistics is not just about donating drugs – it’s about strengthening local capabilities and infrastructures to provide a sustainable framework for the prevention, detection and effective treatment of disease.

At the outset of our Ethiopia Breast Cancer Project, the country had only one cancer specialist for the entire population; there was no mammography; no easy access to chemotherapy or hormonal agents; no cancer screening and no national treatment protocols. Our programme focused on strengthening diagnosis and treatment capabilities at Tikur Anbessa University Hospital in Addis Ababa, where the country’s only cancer specialist was based. In the last three years, with our help, the hospital has become a centre of reference for breast cancer treatment across Ethiopia. Activities have included developing treatment guidelines, strengthening the referral system, setting up an institutional-based cancer registry, raising awareness of the facilities amongst healthcare professionals and providing training for other physicians in Ethiopia. AstraZeneca’s breast cancer medicines, Nolvadex and Arimidex, are also being donated.

The impact of the programme has been much broader than we anticipated for what was originally intended as a small, targeted pilot. By focusing on the creation of treatment protocols and standardised reporting guidelines; by collaborating with the Ministry of Health and other health institutions on the guideline development and national distribution, and by working with the Ethiopian Cancer Association to help strengthen awareness- and fund-raising capabilities, the benefits have been far wider reaching than just the Tikur Anbessa Hospital. We believe that, this pilot is delivering a sustainable model that can be successfully replicated in other countries and other disease areas.

Some examples of the progress the Ethiopia project has enabled:

January 2005

Patients referred late or not at all No data on breast cancer patients No treatment guidelines No standardised pathology testing No pain management guidelines and morphine not available No mammography No hormone receptor testing in Ethiopia Existing ultrasound broken No baseline data for patient throughput No access to anastrazole Frequent out-of-stocks of consumables, reagents and drugs

November 2007

Monthly reports on number of patients diagnosed + follow-up Treatment guidelines developed and distributed to all 5 teaching hospitals Standardised pathology reporting form in place Pain management guidelines developed; morphine available under restricted access Hormone receptor testing introduced and available 43 tests to date New mammography equipment installed 13 staff trained 136 patient tests Jan – Nov 07 Ultrasound machine installed 2 staff trained 106 patient tests March to November 2007 From 2006, time between diagnosis and surgery decreased from 2-3 months to 1-2 months in 2007 Nolvadex available free of charge from March 2006 415 patients benefited so far Arimidex available for first time in Ethiopia July 2007 and provided free of charge 18 patients benefited so far Training and reporting tools provided to help manage pharmacy and radiology services – leading to improved services and supplies management.

The content of this page was externally assured by Bureau Veritas, February 2008