How did MEPI shape your career?
I was already qualified as a pathologist when I started on the MEPI program, but it provided me with a platform to advance as a cancer researcher. More broadly, though, the MEPI helped Malawi lay the foundations for home-grown research and capacity building. Through a MEPI project that I was an investigator on, we developed pathology laboratories at Queen Elizabeth and Kamuzu central hospitals and trained Malawians in the use of medical technology. More than a dozen people in Malawi have been trained in different areas of cancer care through MEPI.
What were the aims of Malawi’s MEPI?
The goals were to expand resources for cancer diagnosis and treatment and build capacity by training Malawian doctors, scientists and medical personnel to diagnose, treat and conduct research on cancer, particularly malignancies associated with HIV. When the University of Malawi College of Medicine was awarded the MEPI grant in 2010, there were just three pathologists in Malawi, serving a population of 15 million in a country with a very large burden of HIV - the prevalence among 15- to 49-year-olds was 15 percent. HIV-associated malignancies such as Kaposi’s sarcoma and cervical cancer were on the rise, but because we lacked diagnostic capacity and had few qualified medical personnel or support staff, such as lab technicians, we had little data on cancer.
Under MEPI, we trained two pathologists, three technologists, five oncology nurses and one participant earned a master’s of public health. In addition, we offered short-term training programs to doctors, nurses and pharmacists in areas such as cervical cancer screening, colposcopy and chemotherapy preparation.
How has research advanced health in Malawi?
Our cancer research projects have helped inform the management and treatment of cancer in Malawi, and enabled us to identify areas where we have to prioritize our resources and research. Prior to 2010, when we were awarded the MEPI grant, cancer was not one of the 10 diseases on the Ministry of Health’s list of priorities, and efforts to control, prevent or treat cancer were minimal. Since 2010, however, cancer has been included on the ministry’s strategic plan for noncommunicable diseases and we continue to build capacity and develop infrastructure for cancer care.
Why did you choose to go into pathology?
I made this decision because Malawi needs more pathologists, and because pathology forms the core of cancer care. It’s by getting a pathology diagnosis that you know you have cancer. That diagnosis will inform your treatment. Pathologists like me are the centerpiece of the work we do on cancer.
We’re working with partners including the
College of Pathologists of East, Central and South Africa (COPECSA) to develop a regional residency program in Malawi. I would like the program to be an example of how international collaboration and south-south cooperation feed off each other to create opportunities for research and bring more investigators through the pipeline.
What is your research focus today?
At the moment, it’s breast cancer. At the Malawi Cancer Consortium - which is a collaboration between NIH’s National Cancer Institute, the University of North Carolina at Chapel Hill (UNC), Malawi’s Ministry of Health and the College of Medicine - we have a breast cancer study through which we want to establish a well-characterized cohort of women with breast cancer in HIV-endemic areas of Malawi in terms of risk factors, clinicopathologic characteristics and outcomes.
I want women and girls to know that, despite the barriers we face in life, we can achieve something and move our country forward. Things are changing in Africa - more women are getting leadership roles. One of my students was inspired by my career and is now Malawi’s second woman pathologist. Trends like those must continue.