Global Access and Equity in Cancer Care: Pat Garcia Gonzalez v1 | United Against Cancer

Zainab Shinkafi-Bagudu: So good afternoon, good morning, hello everyone, it’s nice to be here again on another OncoDaily interview, United Against Cancer. My name is Zainab Shinkafi-Bagudu, I’m a pediatrician, I run a non-profit in Nigeria called the Medicaid Cancer Foundation and I’m a board member of the Union for International Cancer Control. Today we’re going to be having a chat with one of the loveliest people I’ve ever met, her name is Pat and she’s going to tell us a little bit about herself in a minute.

Pat Garcia is the CEO of the Max Foundation. Max Foundation is one of the foundations that have been working very hard in terms of accelerating health equity and equity in terms of justice and fairness to all. We’re not talking about equality when we talk about cancer control but we’re talking about equity so that there is a just and fair access to treatments, to the valuable treatment that is coming up in cancer.

Max Foundation is dedicated to the memory of young Max and after that a lot of innovative progress came in the area of leukemia, in particular chronic myeloid leukemia, which I’m sure Pat is going to mention in her interview today. Thank you very much for joining us for this interview, Pat. I’d like you to start by giving us a brief introduction about yourself and the work that you do at the Max Foundation.

Pat Garcia-Gonzalez: Thank you so much. Thank you for having me. It’s a pleasure to be here and thank you for talking about Max because he is the inspiration for the organization.

As you know, Max was my stepson and he passed away many years ago from chronic myeloid leukemia. He was only 17 years old. I understand what families go through all over the world and we established the Max Foundation to alleviate the suffering of other families so they didn’t have to go through what we went through.

You know that when we established the Max Foundation from day one until today for all these years, every day I receive emails from people from all over the world that have a very similar situation. They or their loved one has been diagnosed with cancer. They are told that there is a medicine, but the medicine is not in their country.

And they are trying to ask us, please, can we help them access this medicine? So for the past 25 years, we have dedicated to figuring out how we can help these patients. And we are fortunate that we have been able to accomplish a lot.

We have helped more than 100,000 families access innovative cancer treatment for the past 26 years. Many of these families we helped for many years because some of these treatments today for cancer, you have to take for many, many years, sometimes for decades. So, you know, we stay with the patient and their family for as long as they need the treatment.

And, you know, we, as happy and proud that I am of what we have accomplished, as you know so well, there is so much more, there is so much more need. So, you know, we need to continue to work together to increase access to treatment for cancer in low and middle income countries.

Zainab Shinkafi-Bagudu: Yeah, thank you. That’s very true. And we do know about the excellent work and the impacts in particular that the Max Foundation has made in low middle income countries by providing access to chronic myeloid leukemia medication, but especially imatinib.

So, with about 20 years of experience that has been dedicated to improving the lives of cancer survivors, what have been your most significant challenges? And should I say also in the same breath, maybe you can tell us the achievements. We’ve seen the impact that you’ve made, the number of lives that have been touched, the doses that you deliver on a daily basis at the foundation.

But what kind of challenges do you face? It’s a global access program. We work with various access programs in Nigeria, in the foundation, the UICC recently launched ATOM as a program, but you are doing it on a more global level.

So tell us a little bit about the challenges that you have faced in delivering this amazing work that you’ve done.

Pat Garcia-Gonzalez: Yeah, thank you so much. I think, honestly, the biggest challenge we have had to overcome is to overcome perceptions. We have to break through a lot of assumptions.

For example, first, as you know so well, first, many years ago, people said cancer is not a problem in Africa. Cancer is not a problem in low and middle income countries. So we are not going to prioritize.

And it has taken us a long time to show not only that cancer is a problem, but that there’s a cancer epidemic in these countries. So once we show that, and finally, we convince people, okay, cancer is a problem, then they raise the bar and they said, okay, we understand it’s a problem, but it’s not possible to treat cancer. It’s not possible because there is no infrastructure.

And so in the past 20 years, we have demonstrated, I think one of the most important thing the Max Foundation has done is demonstrated that indeed you can treat cancer safely and you can improve the lives. You know that in chronic myeloid leukemia and in a few other cancers, we have data that shows we have eliminated the survival disparity between the Western world and the low income world. There is, because we have actually provided access to the drugs, we have provided access to the diagnostics, and we have provided patient support.

So we showed the world, it’s not that it’s not possible, it is indeed possible. So now you know, they raise the bar higher. And now they said, okay, it’s not sustainable.

Okay, it’s possible. Okay, there’s a need. Okay, there is possible, but it’s not sustainable.

This is the latest, right? It still has to be sustainable. And then I asked myself, first of all, if we have done it for 20 years, how is that not sustainable?

And second, sustainable for whom? For whom? Because we need to implement programs that are sustainable for patients, that are sustainable for physicians, that are sustainable for institutions.

So this is the current fight that we have. And I think you and I can agree that we need to overcome this perception. The challenges, the logistical challenges are a lot, of course.

The regulatory environment, as you can, as you know, is so complicated. So dealing with international regulation of shipment of medicines, storage of medicines, controlling the supply chains, we’ve had, we have very good systems for forecasting and planning. And then we face the challenge of the diagnostics, which is such a big barrier.

Because of course, because there has never been treatment, there was no need to diagnose. I’m sure you know so much better than I do. Nobody wants to diagnose a patient, so that you have nothing to do.

Yeah. So we have been working a lot on that, to bring diagnostics and increase a infrastructure, strengthen infrastructure. And I think that at the end of the day, we all need to understand that access to cancer treatment should be seen as a long-term investment in these communities.

You know, we need to, if COVID taught us anything, is that we are on this world together. We need each other. And we cannot leave half the world behind.

It is not good, even from an economic perspective, it is not good for us to leave the half the world behind. We just need to understand that. And if I can share, you know, I see this every day, how important it is for that one patient who is a person, who has a family, to be able to access treatment and survive their cancer.

You know, I have, for example, the example of a dear friend in El Salvador named Jessica, who was diagnosed with leukemia when she was 16. Some time ago, she sent me an email. She told me she is a lawyer.

She’s a lawyer now. She’s 25 years. She’s a lawyer.

Or my friend Rose, who lives, Rose is a widow. She’s a mother of six. She’s a farmer.

And she lives in a remote island of Papua New Guinea. Her life is important. She’s the core of that family and that community.

So we think that it has a lot of value for the world to save her life if we can. Or my dear friend in Ethiopia, who was diagnosed with leukemia when he was a medical student. And now not only he is a hematologist, but he has now been a teacher and he has brought in nine new resident hematologists to Ethiopia, which of course is so important.

So we just have to think about this differently. And we have to make sure that the world understands that.