Improving Access to Vitally Important Chemotherapy Treatments in Northern Nigeria Through the African Access Initiative

Abstract

PURPOSE Cancer now kills more Africans than malaria. Without intervention, the number of cancer deaths in Africa is projected to double by 2040. BIO Ventures for Global Health (BVGH) launched the African Access Initiative (AAI) to address Africa’s cancer crisis by establishing sustainable access to cancer medicines. Through AAI, BVGH and the Ahmadu Bello University Teaching Hospital (ABUTH) are piloting a first-of-its-kind program focused on improving Nigeria’s access to affordable, gold-standard cancer drugs manufactured by multinational pharmaceutical companies. METHODS BVGH, the Federal Ministry of Health, and Nigerian oncologists held a stakeholder meeting to prioritize cancers and their associated drugs. After the meeting, pharmaceutical companies were invited to submit proposals outlining the terms by which the prioritized drugs could be made available. In parallel, Nigeria’s regulatory agency, the National Agency for Food and Drug Administration and Control, was engaged to discuss expediting its review and approval of priority drugs. RESULTS Forty-one priority cancer drugs covering 8 of Nigeria’s most prevalent cancers were selected for this program. Requests for proposals were sent to 14 multinational pharmaceutical companies. Companies responded with deeply discounted access prices, the majority of which were more affordable than cancer drugs available through ABUTH’s current procurement structure. On the basis of the companies’ proposed prices, BVGH crafted a budgeting tool tailored to the cancer treatment protocols offered at ABUTH. Using this tool, ABUTH, together with 7 northern Nigerian teaching hospitals and under the leadership of Ahmadu Bello University, calculated the number of patients they could treat and drug quantities they could purchase with their current budget. The relevant funds will be placed in an externally managed escrow account to ensure oversight of the drug procurement process. BVGH is working with the pharmaceutical companies and National Agency for Food and Drug Administration and Control to hasten approval of priority drugs. CONCLUSION The AAI drug access model is not donation based. Instead, it is an innovative, demand-driven program that is uniquely positioned to ensure affordable and sustainable access to cancer drugs in Africa.