In 2006, the first-ever pediatric oncology program in sub-Saharan Africa was launched at Princess Marina Hospital in Gabarone, Botswana, and Texas Children’s was asked to provide critical support and personnel. It marked a new era for Texas Children’s Cancer Center – the first time we put medical boots on the ground overseas to provide treatments, build programs and train teams of local clinicians to carry on this work.

In just a short time, the scope of our program has expanded to include eight countries in Africa, with more than 2,750 local health care professionals trained and over 700 new cancer patients diagnosed and treated annually. Today, the first pediatric hematology/oncology fellowship program in East Africa allows local physicians to get the advanced training they need without having to leave their home continent.

In partnership with local governments and hospitals – and supported by a generous $50 million grant from the Bristol-Myers Squibb Foundation, to be matched by additional funds raised over the next 10 years – this ambitious effort to transform pediatric cancer capabilities in Africa is already beginning to have a real impact.

Global Hematology-Oncology Pediatric Excellence (HOPE) has set seven primary goals that will be common to all pediatric hematology/oncology center of excellence sites. These high level goals will be adapted for each country based on its current capabilities and priorities.

Health Equity. Global HOPE will improve access to care for pediatric hematology-oncology patients, accuracy and timeliness of diagnoses, and delivery and adherence to treatment. This will be accomplished through the construction of the Global HOPE Pediatric Hematology-Oncology Centers of Excellence.

Health Outcomes. Global HOPE aims to improve the quality of care for pediatric hematology-oncology patients to positively affect clinical outcomes. In Botswana, we plan to train more than 2,400 healthcare workers and provide diagnosis and treatment to more than 650 new patients. In Malawi, we aim to train more than 1,300 healthcare workers and provide diagnosis and treatment to more than 1,700 new patients. In Uganda, we will train more than 1,000 healthcare workers and provide diagnosis and treatment to more than 3,000 new patients.

Capacity Building. Global HOPE will train physicians, nurses, and other members of the local healthcare workforce in pediatric hematology-oncology to establish local expertise and leadership. A major aim initiative is to create a unique and comprehensive pediatric hematology/oncology training program at the center of excellence. This program will produce fully trained pediatric hematology/oncology sub-specialists, as well as the nurses, pharmacists, other physicians, and healthcare providers necessary to deliver the comprehensive multi-disciplinary care needed to treat pediatric cancer effectively.

Operational Excellence. Strengthen local healthcare systems and infrastructure to support excellence in pediatric hematology/oncology care. Global HOPE will build Pediatric Hematology-Oncology Centers of Excellence to deliver the comprehensive multi-disciplinary care needed to treat pediatric cancer effectively.

Community Involvement and Mobilization. Global HOPE will develop advocacy at every level to increase community involvement and mobilization. A critical strategic element will be to emphasize increasing awareness through education and advocacy among the stakeholders in each country. A key component of this approach will be the establishment of community advisory boards in each country made up of government representatives, patient survivors, parents, community health works, and other influential individuals.

Sustainability and Replication. Global HOPE will ensure program sustainability and replication across all sites. During the initial five-year period of Global HOPE, Global HOPE will focus on building pediatric hematology/oncology centers of excellence in Botswana, Malawi, and Uganda. In the long-term, Global HOPE anticipates that this initiative will expand to other countries through and beyond the existing Global HOPE pediatric hematology/oncology sites and Baylor International Pediatric AIDS Initiative (BIPAI) Network.

Research. The Global HOPE pediatric hematology/oncology centers of excellence will serve as true flagship institutions, and as foundational centers of clinical, education, research, and healthcare management excellence. To do this, Global HOPE intends to establish a network of pediatric hematology/oncology centers of excellence in pediatric cancer and blood disorders throughout sub-Saharan Africa that will serve as a vehicle for the conduct of cooperative clinical trials. This network, the Children’s Hematology-Oncology Group of Africa (CHOGA), will advance clinical care in sub-Saharan Africa by implementing common clinical trials, quality improvement initiatives, evidence-based guidelines, and educational, research, and healthcare management programs. The Children’s Hematology-Oncology Group of Africa will set a high standard of care and ensure continual improvement in patient prognoses.