By Cathy Scheepers
Africa Region Head for The Max Foundation
A group of women sits around a lunch table, smiling and engaged. A burst of laughter catches my attention, and for a moment, I can imagine the scene unfolding on the patio of a restaurant not in a hospital cafeteria.
Today is the first time these women have met. They are mothers, caregivers, and survivors in the making, each living with advanced breast cancer. At one point, every one of them faced the fear of a dreaded diagnosis, the isolation of uncertainty, and the overwhelming weight of hopelessness. They speak about the financial strain, not just from treatment, but also the costs of testing, consultations, and transportation. They recall the desperation of realizing they may not have the strength or resources to survive. And then, they speak of the slow fading of hope.
In 2023, The Max Foundation launched a program to provide humanitarian access to treatment for advanced breast cancer. The program quickly expanded across multiple low- and middle-income countries.
We were able to help patients in resource-limited settings in Kenya through Lilly’s support of The Max Foundation. Before offering our program, we needed to understand: Is this intervention needed? And what impact will it have on patients and on the health system?
A stakeholder meeting in October 2023 confirmed what we suspected: there is a vast unmet need. Many patients present with late-stage disease due to fear, a lack of awareness, fragmented referral systems, and the financial burden of diagnostics and specialist care. Therapeutic options are limited, largely due to cost, and access to innovative targeted therapies is rare. Despite these challenges, there was a strong commitment among stakeholders to expand the existing Max partnership to address advanced breast cancer and improve patient outcomes.
With Lilly’s commitment to support The Max Foundation in January 2024, Max was ready to act. The first step in a program of this scale was for the Max team to engage with the Ministry of Health (MOH). Since 2021, the MOH in Kenya has been an official Max country partner, supporting the decentralization of care and physician engagement. Following a series of communications, the Ministry endorsed the new initiative, aligning it with the National Cancer Control Program. Two treatment centers were identified for the program launch.
Behind the scenes, our Program Strategy and Data Solutions teams were hard at work, building the necessary platforms within our in-house software, Patient Access Tracking System (PATS). These systems were tailored to support patient enrollment, prescriber oversight, support services, and supply chain logistics. Every element was designed to ensure that the right patient could access the right treatment at the right time.
Country visits and follow-up meetings ensured that all stakeholders and all critical variables were aligned. During one visit, our partners from the Advanced Breast Cancer (ABC) Global Alliance, led by Dr. Fatima Cardoso, joined us. Under her guidance, a stakeholder meeting mapped out the full patient journey, identifying resources, gaps, and local barriers to early detection, diagnosis, and treatment.
Physician workshops provided insight into national protocols and helped introduce the new targeted therapy available through the Max program. At the heart of our efforts is the patient. Representatives from the breast cancer patient community participated in all the discussions. Dr. Cardoso also led a workshop for patients and advocates, offering space to share voices, experiences, and concerns all within the local context.
In August 2024, the first humanitarian aid shipment for advanced breast cancer, provided by The Max Foundation, arrived in Kenya. With support from the MOH, the import process was seamless, and distribution to partner sites was swift. The first patient was enrolled, and by the end of the first month, 22 patients had received access to critical, life-extending treatment at no cost!
Additional support by Max followed: travel reimbursements for those unable to afford transport, system navigation assistance, and reminders to help patients stay on track with treatment. These seemingly small interventions have made a big difference in improving outcomes.
Over the following months, the program grew. Our local Max team got to know every patient. We listened to their stories. We celebrated with them as their bodies healed and their hope returned.
Today, those same women gathered around a lunch table in Nairobi are not just participants in our program. They are now part of my story, and the story of Max. They again have hope and laughter. Their resilience, their dreams this is the return on our investment.
And what greater return is there, than helping someone live to see another sunrise?
Our journey is still young, and the road ahead long. But with the solidarity of our donors, global partners, healthcare providers, and local champions, we know we are building a better future today.
The Max Foundation is a leading global health nonprofit organization dedicated to accelerating health equity. For 27 years, Max has pioneered practical, scalable, high-quality solutions to bring life-extending treatments and patient-centered health care to more than 100,000 people living with cancer and critical illness in low- and middle-income countries. Max believes in a world where all people can access high-impact medicines, where geography is not destiny, and where everyone can strive for health with dignity and with hope.
The journey from experiencing the first symptoms of chronic myeloid leukemia (CML) to finding an effective treatment can be long, difficult, and painful, especially in low- and middle-income countries. That was the case for Chamu from Harare, Zimbabwe. It took him more than a year to get a diagnosis, but he kept fighting and is….
Being a patient or I better call myself and others as a Spartan, someone who is fighting for something each and every day.” –Thilip Kumar Ragavan
We first met Thilip Kumar Ragavan in May 2014. He was a young chronic myeloid leukemia Spartan in the patient workshop at Hospital Ampang and was newly diagnosed with CML at that time, but the smile never left his face. Bright, vibrant, energetic, and positive – that’s Thilip.
Last week ASCO launched the inaugural issue of the Journal of Global Oncology. This new open access, online journal focuses exclusively on cancer research, treatment, and the delivery of care in middle and low resource countries.
Among the first seven articles, published on September 23rd, are original research, commentaries, and review articles, including a special article looking at the Glivec International Patient Assistance Program (GIPAP), authored by our CEO Pat Garcia-Gonzalez, MS, and others.
