While the UN General Assembly was going on in New York, something strange happened. Heads of state, first ladies, and health ministers from more than 25 countries got together to talk about sick children, not trade or borders. The event was titled “A Global Movement to Improve Survival and Reduce Suffering for Children with Cancer and Other Catastrophic Diseases.” Uzbekistan, the World Health Organization, St. Jude Children’s Research Hospital, and the Zamin Foundation all put on the event. There were many powerful people in the room. But a voice that most people have never heard of is one of the most important ones in that conversation.
Sharon Kapambwe is the Technical Officer for Cancer Control for the WHO. On a broad level, her job is to help countries set up the systems that keep kids from dying needlessly. She has worked on this for years, first in Zambia as Assistant Director of Cancer Control at the Ministry of Health and in charge of creating a national cervical cancer screening program. Later, as a technical advisor for WHO, she worked all over East and Southern Africa. She is not a well-known person. She doesn’t have the power to speak at a podium like heads of state do. But the plan she helps make is the kind of thing that will be used to explain why survival rates changed years from now.
Kapambwe was clear when she talked about what Uzbekistan is doing at the meeting in New York. “The adoption of a national strategy on childhood cancer, with clear goals, paths and resources, is a critical step for Uzbekistan,” she stated. “WHO remains committed to supporting the government, especially in building strong governance, improving coordination and the use of data to make the strategy work.” It sounds like the language used in businesses. But if you think about it for a moment, there is something clear being said. It’s not just the plan that she likes. She is putting on record the three things that cause plans to fail: bad data, bad coordination, and weak leadership.
There is a big gap that Uzbekistan wants to close. The survival rate for kids with cancer is above 80% in countries with high incomes. That number can drop below 30 in places with low income. First Lady Ziroat Mirziyoyeva of Uzbekistan, who is also the head of the Zamin Foundation, called it what it is: “an unacceptable gap.” A National Strategy to Combat Childhood Cancer for 2025–2030 has been approved by the government. It is based on the WHO’s CureAll framework. The goals are big: getting 65% of people to be diagnosed early, getting 60% of people to survive five years, and making sure everyone has full access to multidisciplinary care. It’s still not clear if they’ll reach those numbers. But since changes were made two years ago, survival rates for childhood cancers have gone up from 37% to 42% and for blood cancers from 17% to almost 37%. It’s not a rounding mistake.
Kapambwe’s background helps explain why she takes the time to read these numbers carefully. The woman made programs. She is aware of the gap between a policy document and what takes place in a clinic. She ran a national program to prevent cancer and worked at the Center for Infectious Disease Research in Zambia before she joined WHO. People in the government have heard her make the case for money, data systems, and training for staff. In the absence of resources, she knows that a strategy is at best an idea.
As this project develops, it seems that the people who really matter in global health aren’t always the ones giving the speeches. The head of WHO, Tedros Adhanom Ghebreyesus, was in that room in New York. President of St. Jude James R. Downing talked about a new global initiative to fight sickle cell disease. These promises are very important. However, the kind of technical work that Kapambwe does is what makes a commitment last in the real world.
Oncology experts in Uzbekistan said that a blood test can find changes in cancer a month before the symptoms show up. Easy. Not expensive. You can get it at any pediatric clinic that has the right systems. Setting up those systems and keeping them running is not a fun job. It’s also the difference between life and death for more than a thousand kids. For a long time, Sharon Kapambwe has known that. It’s good for Uzbekistan. The rest of the world is also quiet.
