United Against Cancer v1: Runcie C.W. Chidebe and Zainab Shinkafi-Bagudu on Bridging Care Gaps

In this episode of United Against Cancer, Runcie C.W. Chidebe, Executive Director of Project Pink Blue, joins host Zainab Shinkafi-Bagudu to discuss global disparities in cancer treatment and the impact of patient-driven initiatives. Chidebe highlights how Project Pink Blue’s approach, including the Upgrade the Oncology program is bridging gaps in local cancer care by bringing international expertise to Nigeria.

The conversation delves into the progress and challenges of cancer awareness, the vital role of civil society organizations, and the importance of integrating these efforts with national policies. Chidebe also reflects on the evolution of Project Pink Blue’s World Cancer Day initiatives and calls for continued global support and collaboration in the fight against cancer.

Dr. Zainab Shinkafi-Bagudu is a global cancer advocate, a pediatrician, a UICC Board Member, UICC President-Elect 2024-2026, 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.

Runcie C.W. Chidebe serves as the Executive Director of Project PINK BLUE and holds a position as an External Academic Board Member for the Birmingham and Lewisham African and Caribbean Health Inequalities Review. With a background in psychology, research, and social entrepreneurship, Runcie is deeply committed to cancer control advocacy and global health consultancy.

He is dedicated to supporting underprivileged cancer patients, organizing free screenings for breast and cervical cancer in rural areas, fundraising for those in need, advocating for policy changes with governments, and providing specialized training for healthcare professionals in oncology and cancer awareness, including in local dialects. 

00:00 Introduction
07:42 Inequities in cancer care
11:45 about strategic partnerships
20:38 Screenings, integration, policies

Zainab Shinkafi-Bagudu: Hello everyone, good day, good afternoon, good morning, good evening. My name is Zainab Shinkafi Bagudu. I am the founder CEO of Medicaid Cancer Foundation, a non-profit in Nigeria, a board member of the Union for International Cancer Control, and I work with various government agencies and also serve as a senior advisor to the Coordinating Minister of Health of Nigeria.

You’re welcome to this week’s edition of United Against Cancer, our series of conversations with various cancer advocates, researchers, and very influential people and stakeholders in the cancer ecosystem. Today, we have a very special guest and I will tell you why he’s special later. He has a very extensive bio, so I’m going to just read a little bit of it and he’s a patient advocate, a psychologist, a global health consultant, and the executive director of Project Pink Flu, a cancer non-profit operating in Nigeria.

He supports people battling cancer and established the first patient navigation in Nigeria in 2015, founded the Abuja Breast Cancer Support Group in 2017, and he’s also the founder of the Network of People Impacted by Cancer in Nigeria, which coincidentally you will hear my connection with as well very soon. He’s won various prizes both nationally and globally, including the 2020 Global Ties U.S. Award for Social Innovation and Change, the International Gynecologic Cancer Society Distinguished Advocacy Award, and the 2023 Rising Star Made with Patients Award by the Patients Engagements Open Forum. He’s also won, I’m looking for a particular one, the prize from the UICC.

Anyway, we’ll come to it later. My guest today, as some of you would have guessed, because he’s a very well-known face in the cancer space, is Mr. Runcie Chidebe, and like I said, he’s the Executive Director of Project Pink Flu. Runcie, you’re welcome, it’s a pleasure to have you, and I hope you’re doing well.

Runcie C.W. Chidebe: Thank you so much, thank you so much. I really, really feel so honoured to have this very exciting conversation with you, thank you so much.

Zainab Shinkafi-Bagudu: You’re welcome. Now, I promised to tell you why Runcie is special, and I will do it in the beginning before we get to the end. Today, Runcie is a face that a lot of people in Nigeria, in Africa, and globally associate with cancer advocacy, and he builds this by himself over the last, should I say, 15 years.

And I met Runcie as a young graduate, he had just come out of university, and in Nigeria we have what we call the NYSC, that’s a national youth service programme where all youths are mandated to spend a year doing compulsory service to the nation. And at the time, Runcie decided he wanted to do his community projects in cervical and breast cancer awareness, and that was the birth of Project Pink Blue.

He had a community awareness programme, looked around town and thought, who are the people that can support me and are doing cancer programmes, found Medicaid, and he came to us, and the rest is history.
I have watched him grow with a lot of pride and joy in so many ways over the years, and I’ve seen him build the organisation that today we all know as Project Pink Blue, as well as other credible organisations. So Runcie, it’s a pleasure for me to be here talking to you in this position today. I am so proud of you, as always, I don’t shy away from saying this, and I’m pleased that we have the opportunity to do it today.

So in your very extensive bio, is there any points that I have left out? He sits on so many boards, the World Ovarian Cancer Coalition, the Global Steering Committee for Novartis, on the UICC World Cancer Day Advisory Group, and also an external board member of the Birmingham, Lewisham, African and Caribbean Health Inequities Review in the UK. He’s published a great load of articles and publications, peer-reviewed journals, 40 Under 40 Cancer Advocacy, Distinguished Advocacy, so many.
Well done, Runcie.

Runcie C.W. Chidebe: One thing you missed in my bio is that you missed to name me as one of the people you’ve mentored.

Zainab Shinkafi-Bagudu: That’s true. Well, I described this. I’ve watched him grow, helped him where I could help him, mentored him, giving him advice.

I remember one particular day when he came to the office to see me, and he said, you know, I have problems getting patients to share their experience, you know, and we talked about various options, and I know that he went through with it, and he was going through that frustration of getting patients in our environment to destigmatize their disease and speak about this in a way that would be helpful to others. And today in Abuja, when you talk about patient groups, you have to go to Project Pink Blue.

In Nigeria, in fact, you have to engage with Project Pink Blue. When I get asked, oh, let’s do this, let’s do that support group, and so on, I say, okay, we can do this, but let’s call the people from Project Pink Blue. So well done, Runcie, you’ve created a niche for yourself, and it’s been very helpful.

So let’s start. So we know a lot about the work that you’re doing, the extensive advocacy work that you do, supporting patients, both within and outside Nigeria, raising funds, and the work that you do in publications as well, and bringing to attention, focus the inequities that exist. What do you believe, how do you think we can make progress with the inequities?

Maybe just let us know some of the inequities that you see in cancer as an advocate, nationally and internationally, and how can we try to employ some of these best practices?

Runcie C.W. Chidebe: I mean, I would really start by saying that a cancer patient in Lagos, Nigeria, and a cancer patient in Accra, and a cancer patient in probably in Dallas, Texas, or, you know, in Kuala Lumpur, is the same cancer patient. What really, really differ, or what separates this cancer patient, it’s really what they have access to, the kind of medication they have access to, the kind of healthcare workforce that were able to take care of them, and the kind of healthcare system that they were able to utilize. So the crucial issue, as we speak today, is that the global inequity is so wide.

For instance, a continent like Africa that has over one billion people, today, we just have only 109 oncology clinical trials in the entire continent. If you compare this to the clinical trials that are happening in other parts of the world, you will be shocked. And when patients are not included in clinical trials, unfortunately, we don’t even know if those medications are going to work better on them, because they were not used to really understand the efficacy of these medications.

The other challenge is, is there are so many technologies that are coming up every single day in helping to provide the best radiation care, providing the best diagnoses that are tailored. Most of these are also not available. So I really think that there are multiple ways that we can begin to rethink what we mean by global health.

And anytime people talk about global health, when I go for conferences, I get really mad because global health, it’s still not truly global health. People just talk about it as a way for them to get maybe funding or as a strategy for them to show that they are committed to the world. So when we talk about global health, talk about global cancer control, I am still unsure if anything like that truly, truly, truly, truly has really reached to the level that people talk about it.

Yeah. So these are all the big issues. These are all the big top policy, high level issues that global leaders need to interrogate.
And some of the ways I believe we can start it is first of all, redefining that, redefining that and ensuring that people who are underrepresented, people who are marginalized, are able to find support.

Zainab Shinkafi-Bagudu: Hmm. Hmm. And thank you for that, Runcie.
So a lot of points you raised there in terms of clinical trials, in terms of drugs, in terms of access to issues like radiation, and not just limited to Africa, but across LMICs in particular, and the need to really holistically own the issue for all of us and address it as a funding issue that needs to be really looked at. In your experience, how would you say the best partnerships are formed? Project Pink Blue is a very well-known organization with various partners, some of whom we know, both locally and internationally, and we have been able to do a lot through these partnerships.

So what kind of partnerships are we looking for when we want to be intentional about closing the care gap?

Runcie C.W. Chidebe: Yeah, thank you so much. So I think that the kind of partnership that really make a lot of impact is those kind of partnership that actually were defined by the patients themselves. So one of the biggest challenge we have today is in most cancer engagement, people don’t even think about patients.

You see very big meetings, you see very big events, very big deals, and very big partnerships that are being discussed on cancer survivorship, cancer diagnosis, cancer treatment, cancer funding. You will not find a cancer patient in the room, and you’ll be asking, how would you want to form a partnership to save the life of patient, and then the patient are not there to provide their own patient experience? So we need to begin to always think about what exactly do we want to talk?

What exactly do we want to change? Who are the best people that can bring the best input? And at Project Pink Blue, we have been working really hard to see how we can integrate that cancer patient and ensure that the cancer patient are at the forefront of every decision we make.

And that has been very useful in some of the partnership we formed, like the upgrade oncology. Ma, as you are aware today, oncology workforce is the biggest problem we have in Nigeria, and I mean in most African country. There are so many African countries today that have just only one oncologist, and some of them have over 10,000 and 20,000 cancer patient incidents every single year, and they have just only one oncologist or two.

Some even don’t have. Nigeria only have less than 80 oncologists for 120,000 cancer patients. So we asked ourselves one big question.

We asked ourselves, what are the biggest issues that we as an organization need to face to help to address the poor treatment outcome? So we asked the patients. Technically, what many organizations would do is to donate to hospitals, to donate to them, and to reach out to the hospitals and know what machines they could give to the hospital.

But when we asked patients, what do you guys think are the biggest problem? They told us that the biggest problem they have is that their doctors are amazing. However, their doctors don’t have enough time for them.
So did you see? But me as a non-patient and other people as a non-patient were thinking the doctors were horrible, like the doctors are bad. But the patients are telling you because they are the one experiencing this.

They are the one that can give the best feedback. They say they have the best doctors in Nigeria, but the doctors are not giving them enough time. And we investigated deeper.

We realized that clinical workload is the biggest problem the doctors are facing. Most Nigerian doctors are so patriotic that they don’t want to leave Nigeria because of their patients. But the doctors also have the same problem that the patient had, that the doctors want to spend more time with their patient.
And when they do that, they have more satisfaction with themselves. Amazing. Fascinating for us.

And then we interrogated further and asked the patient, what do you think we can do better to improve the kind of treatment outcome that you get from these doctors? They were like, they think some doctors need to be trained, for them to be trained to understand the newer things that their patient has seen from Dr. Gugu. They talk to their doctor about, they see it from their face, observe from their face that the doctors are not aware of it.

So did you see how the patient engagement, the patient insight has helped us as an organization to understand the best kind of project, the best kind of partnership we could find. And that was how we reached out to the U.S. government. And we said, hey, U.S. government, you know, you guys have been taking me around across the world.

You take me to the U.S., you want me to travel around the U.S. This is the time I want the U.S. people to come to Nigeria, to also travel around Nigeria, to also experience what we’re doing. And that’s how we created Upgrade Oncology in 2018. And through that partnership, we’ve actually brought in almost, I think, about six to seven U.S. experts, professors in oncology, pharmacy, professors in medical oncology, nurses, both pathologists.

We’re also hoping to dive into surgery. So I believe those kinds of partnerships are usually useful to the people when it is down, you know, bottom up, rather than some people sitting in New York with AC fitted buildings and cross their leg with night suits and decide that they have a plan for Africa and they have a plan for sub-Saharan Africa. And they bring this plan down.
It’s not usually sustainable. It doesn’t make the kind of difference that, you know, those people in those bottom really want.

Zainab Shinkafi-Bagudu: Amazing. A lot of very interesting points there, particularly the outcome or the findings that we often think that, yes, medical people, they think on a medical line and then the patients are more to things to do with emotions and support and so on. But to find that even the medical people actually require more time with their patients so that they can have better outcomes is truly interesting.

And of course, the work that you’re doing with the Upgrade Oncology Program, amazing work, being able to bring in health care professionals at a very high level into the country so that they can impact their knowledge. And this skills transfer is really very important and a way that we can even start to train and help the people that are staying back in LMICs to improve their skills without necessarily leaving the shores of whichever country they are. If we do more of this, then it might solve some of the reasons that we so often hear for the professional flights that we’re currently going through with the health workforce.

Thank you so much, Runcie. Now let’s come home a little bit to the civil society space. And I know that every year, one of the programs that you carry out at Project Pink Blue, you offer free screenings, particularly around the World Cancer Day in February.
And you solicit for partnerships around and offer free screenings for cancer, for free cancer screenings. And also you raise funds to treat cancer patients. Famously, every year, Runcie on his birthday, he doesn’t want any present from us.
He asks us to pick one patient and we have to donate to that patient instead of buying him gifts. A very selfless and laudable way of celebrating your birthday, Runcie. Now from all these screenings at the Medicaid Foundation, we do similar.

Have you noticed a change in the trend over the years or the willingness, should I say, the participation of the communities? When you head into a community, how do they receive you? And how would you say the screening has helped us to move the needle in cancer control?

Then the second part of that question would be, as civil society, we’re often working in silos doing a lot of laudable work. How can we include our work within the national policy and government system to make it more impactful? You are a member of the National Cancer Control Committee and so many other committees that go on in Nigeria that have to do with policy and creating programs for cancer.

So how can we help make that better? It’s a very long question, but give us your own two cents.

Runcie C.W. Chidebe: Yeah. So the first thing I would really say is that Nigeria has really moved from the years upon which people are really so scared of cancer to that level that people are now seeking to understand cancer more. That is what I am seeing.
I know several years ago, so many people were really aware of cancer. However, most of them do not have accurate awareness of cancer, but that is changing gradually.

And I can say that social media has been the power of change in cancer control in Nigeria.
And I think that is also being replicated in other parts of the world, because now people can just open their phone on Twitter, on all the other platforms, and they are able to get some information on cancer. That is really phenomenal. But I think what we need to do as a country right now is to build on that, to ensure that people are having the accurate and consistently accurate information on cancer.

Because the challenge is that as we all are going out there to provide cancer information as civil society, there are some people who are interested in making money that are providing other information, that are promoting vaccine hesitancies, that are really changing the minds of people to think that if you take HPV vaccine, this will happen to you, this will happen to you, and all those kinds of conspiracy theories. And I also think another thing we need to continue to do is to use multimedia platforms.
Like what you’re doing, what you are doing with the OncoDaily. I think this is really valuable, because we are getting to that level where people no longer read. People these days just want to listen to multimedia, audiovisual materials.

So I believe this is so, so important, because years into years, people just tune in this video and they are watching it, they are doing something else, but they are listening to what you are saying. And we have also applied this in our research. The research we did on cancer health workforce, the research we did on cancer patient navigation, we also went ahead to transform this research into simple press release on newspapers, because not everyone has access to journals.

That is one thing I would say, Nigeria has made remarkable progress in cancer control. And I would really give that to the government. I would give that credit to the CSO and to the government.
And I will tell you why, because people will be shocked that I’m giving a credit to the government. Because they know I’m always saying no government, it’s not being a no. But I will say why.

Why I think so is because this is the first time in several years that we’re seeing ministers of health, and we’re seeing president’s wife, wife of a president, are taking more drastic action in cancer control. They’ve been more proactive. They’ve been more proactive.
We’re seeing cancer on headline news, unlike before. So this is commendable. All we as CSO need to do now is to hold them accountable.

We did it, because in March of 2020 was the first time the vice president, Yemi Osibanjo, announced in the first time that CHP vaccine will be added into national routine vaccination. And since 2020, we eventually had it in 2023. But we were all tweeting, you know, including you.
Including you.

Zainab Shinkafi-Bagudu: Including you. That was a beautiful tag team. When we go six months, then I say, Runcie, let’s bring up that tweet.
And so we dig up the video of the vice president promising us HPV. And then, you know, run with it again. And we still don’t have HPV.
But thank God we have it today. The end justifies the means.

Runcie C.W. Chidebe: And I’m sure they know it was from a good And so the reality is that we need to continue to engage the government. We need to tell the government when they’re doing well and tell them when they’re not doing well. And I keep saying it.

I don’t hate any government. I love every government. I only just, you know, I only love my patient more than I love government and any other person.
It’s so unfortunate. Why do I love my patient more is that every single day of my life, I get text messages, I get emails of patients that are battling with one disease or the other. There is no human being with a conscience that will be in this situation and the state that I am.

I would not love to support cancer patients and fight for cancer patients. So, you know, bouncing to the second question you asked, how can we as CSOs work more with government? I think the question, it’s such an empowerful question because so many CSOs are battling with understanding how best to do this.

And this is what I will say from my own experience, which might not be the best experience. Try and tell yourself the truth and believe that you could find yourself with cancer tomorrow. And anyone could be a cancer patient.
You know, there is someone, it could be our parents, it could be our brother, it could be our sister. If anyone, if no human being is immune to cancer, then we should know that we can really make a remarkable progress if we all did not believe that we are potential cancer patients. And on this premise, I strongly believe that CSOs across the country are really missing it at some point.

And I can tell you the truth. They are missing it in the sense that most CSOs dive more in cancer awareness and do less in cancer advocacy. However, they all tell you they do cancer advocacy.
This is the same also across Africa. Many of our organizations are all involved in cancer awareness. And the reality is that it’s different.

Cancer awareness is just when you are creating awareness, educating the public, right? Cancer advocacy, if you are trying to change practice, you are trying to change a policy. And you cannot do that without government.

You cannot. Government is one of the most powerful tools to bring a change anywhere after people. People are number one, but government is number two.
But the thing is that we will see, I will give you an example. Project Pink Blue has been existing for the past 10 years or so, right? And the number of people we have screened have not even been up to 1 million people.

But with one single government policy today, right, that every woman who attend antenatal must get breast cancer or cervical cancer screening, or any man who attend any form of care in the hospital must get prostate-specific antigen test, you’ll be shocked that in less than one year, over 15 million people will be screened. So why can’t we engage this system that we know that can really change everything that we’ve been doing? And I keep saying it.

I’m doing what I’m doing today at Project Pink Blue because I want to lose my job and get government to do their job. Because right now, we’re all doing the work the government is supposed to do. So to answer the question in a very smart way, I would say that we all need to engage in advocacy and continue to engage the government to understand that we are doing your job.
We want you to do your job and we don’t hate you. We want to work with you. We want to see how we can really work together to make a difference in our community.