Dr. Zainab Shinkafi-Bagudu: Advocating for Equity in Cancer Care – UICC Presidential Candidacy

In this episode of OncoDaily, Dr. Zainab Shinkafi-Bagudu, chairperson of the Medicaid Cancer Foundation and a distinguished global health advocate, shares her insights as a candidate for the presidency of the Union for International Cancer Control (UICC). She highlights the urgent need for equity in cancer care, particularly in low- and middle-income countries, and presents her vision for the UICC presidency, emphasizing advocacy, community engagement, and capacity building. With the election approaching on October 8, Join us for this compelling discussion hosted by Dr. Gevorg Tamamyan as she articulates her commitment to advancing global cancer care from an African leadership perspective.

Dr. Zainab Shinkafi-Bagudu is a global cancer advocate, a pediatrician, a UICC Board Member,  Founder of the Medicaid Cancer Foundation, and the Chairperson of First Ladies Against Cancer (FLAC). Dr. Bagudu is working with the state ministries of health, education, and women affairs to implement programs to sustainably improve menstrual hygiene, girl-child education, economic empowerment of women, and put an end to gender-based violence. Zainab Shinkafi-Bagudu is a member of the Editorial Board of OncoDaily.

Gevorg Tamamyan is the Editor-in-chief of OncoDaily, President-Elect of SIOP Asia Continental Branch and Pediatric Oncology East and Mediterranean (POEM) Group, and the CEO of the Immune Oncology Research Institute (IMMONC). He is the Chairman and Professor of the department of Haematology and Pediatric Oncology at Yerevan State Medical University.

He is a Co-Founder and Board Member of the Armenian Association of Hematology and Oncology, City of Smile Charitable Foundation, Co-Founder and Chairman of the Board of the Institute of Cancer and Crisis, the Former President of the Harvard Club of Armenia.

00:51 Motivation for presidency
03:38 Challenges of Limited Resources
06:11 Transforming Leadership Perspectives
09:07 Presidential Agenda
15:23 Dr. Zainab’s Message

Gevorg Tamamyan: Hello everyone, welcome back to OncoDaily. Today it’s a great privilege and honor for me to interview Dr. Zainab Shinkafi-Bagudu, the chairperson of and the president of the Medicaid Foundation, charitable foundation in Nigeria, global health advocate, a great friend of mine and who is currently running also for the UICC presidency and it’s a great pleasure for me to host you.

Zainab Shinkafi-Bagudu: Thank you very much. Thank you, it’s a pleasure to be here. Thank you OncoDaily and the entire team for the work that you are doing, it’s amazing, well done.

Gevorg Tamamyan: Thank you very much. Dr. Zainab, why you want to become the president of the UICC? It’s a very old organization, very powerful, why you want to become the president?

Zainab Shinkafi-Bagudu: Well, you’ve started me off on the right footing. It’s an organization that is 90 years old, it’s an organization that is the umbrella body for over 1,500 organizations that are working in the cancer space, which as you introduced is what I do. I run a cancer foundation mostly operating in the northern parts of Nigeria and from that I became a board member of the UICC for three terms.

I’ve been elected by the members making a total of six years on the board and it’s given me a global leverage to be able to improve the outcomes for cancer control through advocacy, through talking to government, through working on different committees within the UICC and even outside. So by being the president of the board, the board maintains an oversight function on the programs, initiatives and governance and decisions of the UICC. So by being the president of such a large organization that oversees all these bodies, I hope that we can improve outcomes.

I hope through my presidency if I am successful to be able to use my advocacy to engage governments, to work with the community workers, improve capacity building, close the care gap generally. There’s a huge gap between the high and the low and middle income countries of the world and if we’re talking about global health equity then we must focus a little bit more on the younger populations like Africa where I come from and help them by training, by providing more opportunities, by looking within to see how they can partner within themselves and outside to improve cancer outcomes.

So in a nutshell that’s why I want to be the UICC and I think I’ve put in a lot of work through my advocacy, engaging members, going about different countries, understanding the issues that they face.

I have a background as a pediatrician and that helps me to understand the science behind cancer control and all the new innovations that I see. It’s amazing and I’d love to see more equity across the world when it comes to cancer.

Gevorg Tamamyan: Thank you very much. You’re a pediatrician, you’re coming from a country with very limited resources where sometimes even the basic things are lacking. How is it to be a pediatrician or how is it to be a doctor in a place I mean where you know you can deliver more but you have limited resources?

Zainab Shinkafi-Bagudu: Well I think first of all when resource limited or a country setting you’re a doctor first before you’re a specialist which means that you can see a woman, you can see a man, you can see children. Yes it’s very difficult, it can be frustrating.

It’s one of the reasons why I went into diagnostics because we could provide more facilities that will help diagnosis.
You find that the doctors have very good clinical skills but they don’t have the equipment, the backup, the technology that will help them to go that final mile and make the decisions. It is frustrating but it’s also rewarding because when you do the simple things and get it right, sometimes even by just educating the mothers, by letting them know that oh your child has a fever this is the way you should do it. It’s very rewarding.

There’s a lot more that can be done. As you rightly mentioned the resources are limited. Payments for health is mostly out of pocket for ailments like malaria, pneumonia and not to talk about cancer.
Health insurance coverage is not as wide as it should be. We’re slowly beginning to see a coverage in the formal sector, the formerly employed people but in the informal sector it is really very poor and people have to pay out of pocket for their health care. This affects children greatly because obviously they have no income and so that’s a big problem for us in Nigeria.

We look towards government, we look towards private partnerships, we look a lot towards civil society organizations that have innovative ways of raising funds to support the care for children, whether it’s nutrition, providing the nutrients path, whether we’re talking about cancer or you’re talking about pneumonias and HIV, civil societies have a great role to play. Civil societies and international donor agencies are doing a lot of good work in LMICs including Nigeria.

Gevorg Tamamyan: As far as I know there was within 90 years of UICC there was not a single president from Africa, right? So you want to change the paradigm?

Zainab Shinkafi-Bagudu: Yes, I would like to change that narrative. I think that as a young population Africa is the largest but it’s the youngest in terms of development and it also has a very high burden, the highest burden of most issues when we look at development and when you look at health and cancer, Africa bears the largest burden. So having worked in that space and understanding the needs of people of the system and of the health care workers, the delivery issues that they face, I think that it is right and it’s time for us to have leadership from a low middle income country, from Africa in particular.

There have been other presidents from LMICs but none from Africa in 90 years. I also think that it’s important in the spirit of global equity that we often speak about in cancer control, regardless of where you come from, your religion, we should have equal access. It’s equally important in leadership.

We’ve had a leader of the board just two years ago from the same country, the same institution and so we should spread it around the rest of the world. Let’s bring it to Africa this time and then also I don’t see myself as the candidate for DEI diversity, equity and inclusion. I see myself as a capable candidate because I have proven myself.

I have worked for six years with the UICC. I have engaged with the committees, the other board members, the current president, the incoming president are all very respected people. Even my colleagues that we’re running together, they’re all very respected people with their own skills and so I think that it’s right that we have somebody in the leadership position to represent the African continent.

Gevorg Tamamyan: Very nice, I agree with you and you have my vote and I’m sure you will be a great president so I wish you good luck. As you mentioned, our colleague who is running with you also is a very well-known and respected colleague and a great person but this time as I mentioned, certainly I hope you will be the winner and next time myself at least I will support his candidacy but this time I think it’s time for Africa to run the UICC presidency. You are a proven leader, you have done a lot in the cancer field.
What else you are going to do when you are a president of the UICC?

Zainab Shinkafi-Bagudu: Well, I spoke about the promises and things that I think are relevant and one of them is working with patients and the community health workers. Yes, the UICC works with patients and through the inputs of people like us that are on the board, it has steadily increased and the call, WHO recently had issued a referendum at the last world assembly meeting saying that there should be more social participation, that is engagement of patients.

We were at the World Cancer Congress recently, there was a whole day of patient engagement, a co-creation workshop that was dedicated to patient advocates, lived experience survivors, so that they can really say the issues that they face when engaging care, either diagnosis or treatment with the health workers, so that is the focus that I want to bring.

I want to also champion the cause for childhood cancer. Childhood cancer patients are just like marginalized populations, it’s not a word that I like to use but that is the fact. Generally, you find that you’re always the smallest person on the wall in the hospital, you get the smallest budgets and so on, and we’re used to that fight and championing the cause.

You know, you find the big surgeons, they come and they give every child five mils of paracetamol regardless of the weight of the child, so this is a constant battle and getting people to understand that the child is not a small person, the child is an individual that needs to be looked at as an entity and looking at each system and helping them separately. So, I’m very pleased that WHO has a global childhood cancer initiative that is working to close the gap. In cancer, you have a very wide, the widest and starkest disparity along with cervical cancer when you look at childhood cancer.

In high-income countries, survival rates easily exceeds 80-90%, but for us, we’re struggling with 20-25%, late diagnosis, lack of access to diagnosis, lack of treatment, these are all the things that we face. And then healthcare workers, the question you asked me was what do I want to focus on. So, patient advocates, childhood cancer, healthcare workers, there’s a whole lot that healthcare workers can deliver to increase cancer control.

On top of the list of things that I would like to see the UICC doing more of is capacity building. UICC runs a lot of online courses, but UICC has the capacity to run simple physical courses, how to take a pap smear, how to take an HPV sample, how to use thermal ablators, how to look at a blood smear of a child. And there are healthcare workers, community-based, living directly in contact with the population that we can help to do this.

We mentioned all the partner organizations that belong to the UICC. We can leverage on this great strength to increase capacity. We’re seeing a lot of flight of healthcare workers from places like Africa to income countries.
Understandably, greener pastures, better welfare, better living conditions, better pay remuneration. So, what can we do to keep them? We have to start growing the ones that are under and keeping them there means that we have to give them better skills that they can use to do their work.

Interfacing with government is something that I’m quite used to doing. I interface with government a lot. I work as a senior advisor to the coordinating minister of health in Nigeria on cancer and women’s health.
And so, apart from this, there are many other instances that I have been able to interface with government. Government has a particular way of working that as medical people, we don’t always understand. We talk a lot about funding.

We just want government to fund. How do we make that happen? Who do we advocate to?
We write about it. We do fantastic reports, but who does the budget? Who are the people that are in charge of appropriation in a country?

The legislators. How often do we see legislators in our conferences? How often do we see the bankers, the private sector that are able to put down funding that is important?

So, these are the points that I think that we need to look at more. Of great importance right now in the world is a focus and a need to focus on patients that are living in areas with humanitarian needs and areas of conflict. And we have to look at them also as an entity and a marginalized population because the needs that are there, regardless of, it’s not about the political argument or debate in whichever country we’re talking about, but there’s a need to focus on these patients because they are getting absolutely zero care in many places.

Even the one center that you have in some of these countries have been bombed, whether it’s Ukraine, Gaza, Sudan. It’s really terrible and it’s a humanitarian crisis. And I’m so glad that we have a lot of capable colleagues, Princess Dina, Richard Sullivan, Nazik Ahmed.
These are all people that have close links with the UICC and are also working very hard to bring that focus. So, as a precedent, I would work with them to try to elevate the conditions that patients living with cancer are facing in those areas.

Gevorg Tamamyan: Thank you very much, really. I mean, I totally agree with you and these are the problems certainly need to be taken care of. And what else you would like to address?
I think the voting is on October 8th, right?

Zainab Shinkafi-Bagudu: Absolutely. Well, thank you for the opportunity to say this. Like I have said, I have put in a lot of time and I have proven my credibility and I have proven my commitments to the cause of cancer.
I do absolutely nothing else aside from improving the lot of cancer patients and trying to see how we can make things better for everybody. And so I would like to be president-elect of the UICC and I would like the members to vote for me en masse on the 8th of October. The timing is different.

You might not know who is going to vote in your institutions. UICC is a funny organization. We have very big academic institutions and then we have small organizations like Medicaid Cancer Foundation that employs 10 people.
But, you know, it’s one person that will get the vote. The voting is now online. It’s virtual.

The general assembly, the voting happens during the general assembly on the 8th of October and the lines open. If I get this wrong, please correct me. I think it’s at 3.30 Central European Time, AM, 3.30 AM, and it closes at 5.30 PM Central European Summer Time. So it’s important to note those times and also important to find out who votes in your institution. There are two names on the slate arranged alphabetically. So on the 8th of October, after you receive the link, mine is the second name alphabetically.
Click on Zainab Shinkafi Bakudu and vote for me as the President-Elect of UICC.