In developed countries pediatric oncologists have built collaborative communities that have made tremendous progress in the cancer management for children. Children in these countries not only enjoyed significant healing chances (up to 75-80%) but the approach also went beyond the need for healing to embrace life quality issues during and after treatment. In Africa in spite of the team success in the field, only 1,000 children, ie less than 15% of children with cancer in French-speaking sub-Saharan Africa, have reached a pediatric oncology unit in 2015, often too late (especially due to the referral to other actors such as tradi-practitioners who waste precious time). The number of new cancer cases for children under the age of 15 is now estimated at around 10,000 per year (and at least 6,000 deaths per cancer) in French-speaking sub-Saharan countries.
* For the 18 countries with 280 million inhabitants (based on an incidence of 85 new cases / year / million children under 15 years old, Cancer in Children, The Cancer Atlas 2nd edition, The American Cancer Society, 2014)
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PROJECT : accommodate 30% of the children with cancer by 2020, whereas today only 10% to 15% arrive at the hospital
The reasons for this relatively small percentage are diverse :
  • The absence of a pediatric oncology unit or their very recent creation in some countries
  • An insufficient number of units in densely populated and/or very large countries with difficult access to existing units due to remoteness (in most countries, there is only one unit, most often in the capital)
  • Insufficient trained staff
  • A lack of awareness of the effectiveness of the child cancer treatments by the authorities, the population and even health staff
  • A lack of means for the most deprived to access examinations, diagnosis and care (most often at the own expense), which is responsible for a high rate of non-treatment, delays and discontinuation of treatment.
The GFAOP's 2015-2025 development project, which targets Francophone African countries and particularly the sub-Saharan countries where competent structures remain scarce, aims to improve the care of sick children by responding to the needs mentioned above.
PROJECT : in 2017 at least 40 onco-pediatricians and other specialists essential to the management of cancer (surgeons, pathologists, radiotherapists...)
  • Training in the center in Morocco
  • Internships in France
  • «Pain and palliative care» training
  • Collegial training
  • Internships and trainings in France for certain specialties
PROJECT : At least 50 nurses in 2017 and 2018
  • General training
  • «Pain and palliative care» training
  • In-situ training during experts visit
Early diagnosis of childhood cancers is an absolute necessity for at least 3 major reasons :
  • It improves recovery chances : a child with advanced cancer, especially with distant metastasis, is very unlikely to recover while recovery chances at an early stage may exceed 90 % for some tumors.
  • It reduces treatment duration and cost, thus reducing refusals and withdrawals of treatments.
  • It reduces treatment aggressiveness and therefore the risks of complications and late sequelae. Due to the rarity of each type of cancer encountered by children, early diagnosis requires a voluntarist action which must be structured and regularly repeated, after making sure that existing means allow rapid management from the first consultation, with the agreement and support of the health authorities of the country. Each unit of pediatric oncology must implement :
    • first, an information / training plan with signs revealing child cancers and how to deal with a suspicion of child cancer for staff at health centers, general hospitals and clinics
    • then and only then an information program for the population (parents, especially mothers and traditional practitioners) on the signs of childhood cancers and on the way to behave (with the use of different media and the publication of an early diagnostic manual (similar to the one prepared for Morocco)
    • finally regular results presentation obtained by the units at various local, national and international medical meetings, in scientific journals and also in the press. These actions must be regularly repeated by all available means.
In order to forge privileged links within the Franco-African network of pediatric oncology, African units of pediatric oncology are twinning with French units under the aegis of the GFAOP. Among the twinning projects that are operational or well underway are the Marrakech unit with the pediatric oncology unit of the Montpellier University Hospital, the Dakar unit with the pediatric oncology unit of the Toulouse University Hospital, the Bamako unit with the Department of Pediatrics at the Institut Curie in Paris. Others are in preparation.

Effective communication is the key to a network. Regular communications are a real challenge, since nearly 20 countries are involved. That is why the GFAOP will set up telemedicine :

  • To facilitate telecommunications within tumor committees between the participating units (for data transmission, meetings and data analysis)
  • To facilitate exchanges (particularly of medical data for difficult cases) between the twinned units and services
  • To allow the conduct of certain GFAOP's member meetings in addition to the physical meetings.
PROJECT: open 3 to 4 houses in 2017-2018, and 4 others by 2020. Eight houses to be opened within five years, each time supported and managed by a local association.

At the hospital, living conditions are difficult, children are often several per room, accompanied by a relative who lives on the spot, sleeping on the ground or outside in the hospital garden. The family must ensure the patient's meals. Some children stay in the hospital between 2 chemotherapy cures (the treatment lasts between 3 months and 6 months) because returning to the village is too far, too expensive (the cancer services are installed in capitals and many children come from isolated agricultural regions). In order to prevent hospitals from being overloaded with children and to allow beds to be used more effectively for children undergoing treatment, the GFAOP wants to set up Parents' Homes. These "Parents' Homes" close to each unit are non-medical supplements of the Pediatric Oncology Service, where children can live and rebuild themselves between the chemotherapy cures.

The GFAOP's experience shows that, unfortunately, many families referred to the Oncology Unit have interrupted the care of their children at different stages :

  • Before the diagnosis is even made (on an abdominal ultrasound, a cytology or a biopsy)
  • At the start of treatment
  • During the treatment, and especially after tumor surgery

The examination or care cost for family is probably one of the major reasons for these withdrawals. This support fund aims to reduce drop-outs by taking care of the costs of the initial assessment and the treatment of the most deprived children.

The aim of this project is to enable families and local associations to structure and carry out actions complementary to those of medical units : support and psychological follow-up of families and patients, management of parents'homes, search for partners.

  • Informed families can act faster for their children
  • Clustered families can take more effective action
  • Families organized in structured associations are listened to and credible with institutions and financial partners

The examination or care cost for family is probably one of the major reasons for these withdrawals. This support fund aims to reduce drop-outs by taking care of the costs of the initial assessment and the treatment of the most deprived children.

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