A roadmap to establishing global oncology as a priority initiative within a National Cancer Institute-designated cancer center

Abstract

As the burden of cancers impacting low- and middle-income countries is projected to increase, formation of strategic partnerships between institutions in high-income countries and low- and middle-income country institutions may serve to accelerate cancer research, clinical care, and training. As the US National Cancer Institute and its Center for Global Health continue to encourage cancer centers to join its global mission, academic cancer centers in the United States have increased their global activities. In 2015, the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco, responded to the call for international partnership in addressing the global cancer burden through the establishment of the Global Cancer Program as a priority initiative. In developing the Global Cancer Program, we galvanized institutional support to foster sustained, bidirectional, equitable, international partnerships in global cancer control. Our focus and intent in disseminating this commentary is to share experiences and lessons learned from the perspective of a US-based, National Cancer Institute-designated cancer center and to provide a roadmap for other high-income institutions seeking to strategically broaden their missions and address the complex challenges of global cancer control. Herein, we review the formative evaluation, governance, strategic planning, investments in career development, funding sources, program evaluation, and lessons learned. Reflecting on the evolution of our program during the first 5 years, we observed in our partners a powerful shift toward a locally driven priority setting, reduced dependency, and an increased commitment to research as a path to improve cancer outcomes in resource-constrained settings.

Figure 1.

Global Cancer Program mission, objectives, and values. Mission: To accompany our partners to reduce the global cancer burden. Objectives:Objective 1: To collaboratively perform innovative research and quality improvement that addresses disparities in the burden of cancer in LMICs. Objective 2: To empower leaders in global cancer care and research through education, training, and mentorship for trainees and early career faculty in LMICs and at UCSF. Objective 3: To foster bi-directional collaborations to sustainably impact the global cancer burden. Values:Partnership & Accompaniment: Work together as equals, with a commitment to bi-directional collaboration, through providing support and empowerment for the self-realization of goals and desired outcomes. Responsiveness to Partner Priorities: Make decisions with LMIC leaders that prioritize their goals, needs, and interests. Innovation: Develop new or improved systems, services, technologies, or other products that improve people’s health in the form of improved efficiency, effectiveness, quality, safety, and/or affordability. Empowerment: Enable investigators from both UCSF and our international partner sites to develop and thrive as authentic, values-driven leaders in global cancer control. Cultural Humility: Embody a mindset of self-reflection, continual learning, awareness of bias, and esteem for others. Impact: Inform and change cancer care practices, policy, and outcomes. Equity: Equip individuals with comprehensive tools and resources to achieve equal success. Sustainability: Foster progress that can independently continue.

Figure 2.

Timeline for the development of the University of California, San Francisco Global Cancer Program. EAB = external advisory board; GCP = Global Cancer Program; HDFCCC = Helen Diller Family Comprehensive Cancer Center; HPV = human papillomavirus; UCSF = University of California, San Francisco; WHO = World Health Organization.