The act is going to enable UCI operate as an autonomous entity. That means that there are certain things that it will do that it cannot do under its current status. For instance it will be able to coordinate all the cancer control activities in the country, guide government on policies and other programs that are related to cancer in the country. Undertake research, provide care to cancer patients in a way that it cannot currently do. Medicines that we use to treat cancer are considered to be highly classified. The signing of the act means that we can directly interact with the manufacturers. The current drug procurement system has got a lot of intermediaries which the act has eliminated. The end result of this is that the procurement process will take a very short time. That means things like shortage of drugs will be dealt with and their quality improved. This in the long run will make the patient the overall beneficiary because everything will be controlled under one roof. All those and much more are the things that the act will help UCI do.
In the past UCI was highly engaged in research and it is because of this that it gained international stature. This was achieved because UCI at the time was autonomous. Although it derived that mandate from two source which included; the fact that it was initiated as a collaboration with the National Cancer Institute of America, Makerere University and Ministry of Health. This arrangement lasted up to 1977 and was replaced with a presidential declaration by President Iddi Amin, which meant that UCI would directly manage its affairs. But this did not last longer than Amin’s presidency. It collapsed when he was deposed.
That political upheaval adversely affected the performance of UCI because we began experiencing shortages in funding with no donors. Even government through the presidential declaration was no longer an option. This saw the institute being degraded to become a mere unit under Mulago hospital.
With the restoration of funding in 2009 many things started improving. But funding alone without a legal basis was not strong enough. That is why issues like shortages of drugs and inability to decentralize services came in. With the presence of an act which clearly states the mandate, functions of the institute and the governance structure through its board, I think I should say that the future is very bright. For the very first time we are going to meaningfully implement the strategic national cancer control plan. The fight against cancer is going to be done in a very systematic way because there will be an entity/authority that is directly in charge to make sure that happens.
There are critical functions that the act will enable us perform within the shortest time of its operation, which were unheard of here in the past. For instance bone marrow transplantation. It is a very simple procedure to carry out but it cannot be done if you do not have certain factors under your control like specialised medicine and equipment. With the act in place we have hope that it will not take us more than two years before we achieve it.
There are quite a number of research projects that UCI has done that have shown the whole world how things can be done. For example we pioneered on giving information on how Combinational Chemotherapy Treatment should be used. We contributed to the techniques for treatment of Kaposi sarcoma. We were the first to provide evidence for treatment of liver cancer using chemotherapy. We were also the first to devise the essential drug list for cancer treatment. We cannot forget the discovery of burkitt lymphoma and infections that cause cancer like Epstein - Barr virus (EBV). These are very big achievements that UCI has been part of and therefore proud of.
It should be noted that research requires a conducive environment with people who can come up with ideas. All these are things that will eventually come back because we are now the center of excellence for East Africa. The main driving agenda behind this is training which brings us to the East Africa Oncology Institute which is going to be established here at UCI. This will provide specialized training in cancer care and treatment at graduate level which will include masters and PhDs and research is the main driving force of that program. Through research a lot of ground breaking innovations should be expected to come out of UCI.
Currently we are engaged with top cancer research organisations internationally. For instance the Fred Hutchinson Cancer Research Center, a much acclaimed cancer research institute that is helping us establish infrastructure. We are also working with the Texas Children’s Hospital, probably the biggest cancer hospital in the world. The fact that these two work with us means that there’s something they have seen us provide that other places cannot. The research opportunity here is very high.
The research we want to conduct will to be across the continuum of our cancer control agenda. That means there will be research on prevention, diagnosis, treatment, palliation and quality of life. There will also be social science research to understand people’s perceptions and the dynamics within the society and is focused on cancer. That is going to be a comprehensive approach in as far as research is concerned.
We have won a number of grants that are coming in. For example we are about to launch a study which is going to be funded by Glasgow Seth Klein (GSK), a world rated pharmaceutical company. They are going to sponsor a very big study in breast cancer at UCI. Then we also have a grant award from our collaborator the Hutchinson Cancer Research Center to test an immunotherapy. Immunotherapy is the new way for treating cancer, by boosting the body’s immune system and you’re able to clear cancer. An example of what that type of drug can do is the treatment of skin cancer (Melanoma). Jimmy Carter one of the former presidents of the USA had this cancer but has since been declared as cured from it, thanks to immunotherapy. It is the exact type of drug that we are going to experiment here in Uganda. We want to use that drug to treat Kaposi Sarcoma which is another cancer of the skin.
Another grant is coming in the pipeline through the International Agency for Research on Cancer. We are part of a consortium that is going to do a study on the genetic makeup of cancer that is trying to see whether there is uniformity across the world on certain cancers. At UCI our interest will be on cancer of the esophagus and that of the colon.
Uganda Cancer Institute is going to be celebrating 50 years since its inception. I consider those years as very formative because of the highs and lows that we have gone through. This has helped us understand better how we should position ourselves for the future. UCI is a prototype institution that does not have an equivalent in this country. It started as a research project in a university which survived to become a national program and now a regional center of excellence. A sequence like that to be accomplished by any project within a university or government is no mean fit. What UCI has gone through has been a subject for a PhD thesis. During that celebration to mark 50years, that thesis is going to be highlighted because there are so many lessons from the resilience of UCI. During the celebration we plan on bringing scientists from both within and without to ensure that we can drive our cancer agenda and messages to our country.
After celebrating the 50 years we need to look at the future of cancer care and treatment in our country. We must demystify cancer. Cancer must be perceived as one of the diseases that people get just because they are human beings. We need to come up with measures of ensuring that people with cancer are treated just like other people suffering from any other disease. This means that cancer patients should be treated optimistically. Cancer should not be looked at as a death sentence and resources invested in treating it should not be seen as pouring something down the drain. Now that we have the capacity, we should be in position to have treatment systems, programs and arrangements that ensure people who have cancer have timely diagnosis, treated promptly and offered support when needed.
There have to be ways in which we can measure outcomes. This means that we should be able to see that people treated with cancer testify with success stories of cure, people should be living longer with good quality of life. We should also ensure that there’s no stigmatization associated with cancer. Cancer can also attract the attention and resources like other diseases. We can talk confidently about the measures to prevent cancer in our community. These and many more are the things we should focus on for the next fifty years.
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