Brian, you’re representing the Pink Ribbon Red Ribbon initiative, the partnership, what exactly is that?

Pink Ribbon Red Ribbon, the partnership, is based on a simple premise – we’re going to leverage the AIDS platform in sub-Saharan Africa to screen and treat women’s cancers.

So that includes breast cancer and a whole lot of other cancers as well?

Right, our focus in Pink Ribbon Red Ribbon is breast and cervical cancer and the opportunity that we saw was to take an existing platform that was designed to treat one disease and use it to treat another that’s related. Because of the linkage between HIV/AIDS and cervical cancer there’s an opportunity here that we recognised for the cancer and the AIDS communities to come together. What we’re trying to avoid is a circumstance where we save a woman from dying of AIDS only to have her die of cancer.

You said one platform, what is that platform?

That would be the HIV/AIDS platform. President Bush in the early part of 2000 launched the President’s Emergency Plan For Aids Relief, PEPFAR. That is the largest amount of money ever spent to treat a disease in the history of civilisation. We have a fantastic platform there that exists and you can integrate the screening and treatment of women’s cancers on this platform to save women’s lives.

So how did your Pink Ribbon Red Ribbon initiative actually start? It was quite recent, in September wasn’t it?

That’s right. We launched it in September and you had a core group of people come together and see this opportunity. So the principle founders, were Secretary Hillary Clinton, President and Mrs Bush, Ambassador Nancy Brinker from Susan G Komen for the Cure and the Director General of UNAIDS, Michel Sidibé.

You’ve got a lot of very important people behind it, what’s happened so far?

We launched it in September and in December we announced our first Pink Ribbon Red Ribbon country in Lusaka, Zambia. So I travelled with President Bush in November and President Bush and other founding partners announced that Zambia would be our first country. So we’re already up and running in Zambia. Last week President Bush flew to Botswana and announced our second Pink Ribbon Red Ribbon country so we’ll have more countries that we’ll be announcing over the course of the year but we’re already underway and screening and treating women for cervical and breast cancer.

So screening and treating, physically what’s happening on the ground then?

There are two very different approaches on cervical and breast cancer. In a lot of these countries where we already have some cervical cancer screening and treatment taking place we want to expand it. And breast cancer, which obviously is a little bit more difficult, but we want to start where we can start. So you begin with cervical cancer and then you build to breast cancer. Some of the stigma that applies to cervical applies also to breast cancer. So we’re in these countries now and we are expanding the services that are being provided to women for cervical screening using the vinegar wash and where they detect precancerous cells using cryotherapy. Then on the breast cancer side trying to get more screening and create referral protocols so that we can get people, if they need mammography or surgery, into cancer hospitals.

Now, clearly you’re a highly motivated and very well meaning organisation, but we’ve been hearing from African participants at this meeting here in Lyon and from other parts of the world such as Pakistan that actual care on the ground is very thin, there’s not a lot of it and it’s hard to actually implement care, for instance for cancer. Will you be able to introduce effective things?

What we’re doing, yes, I think we can and part of it is driven by being very strategic about the countries that we initially start in. We want to demonstrate early success and so the countries that we’ve chosen we have leaders and ministers and NGOs who are committed to moving the needle on women’s cancers. These are governments that are investing in their citizens and trying to improve health outcomes. And that there’s some infrastructure that we can build on so we have the AIDS platform and we have clinics and we have places where we can try to then get women and help them get to where they need to get the screening and the treatment they need. So many of these women present at a very late stage and at that point it’s too late for stage 4 in some of these cases. We want to downstage this disease and get more women presenting in stage 1 or even doing primary prevention where we can.

What was your motivation for starting in Africa?

The motivation for or the logic of starting in Africa is you have the leading cause of cancer death among women, you’re looking at cervical and breast cancer as the core of it and because you can so rapidly improve services on cervical cancer because it costs pennies to treat. So we see a chance to rapidly scale up the work we’re doing and our goal is an ambitious but a realistic one – we plan to reduce cervical cancer deaths by 25% over the next five years in the countries where we’re working. So as soon as we announce a country the clock starts ticking and we’ve got five years to meet our goals.

And because of the platform of HIV you are able to do that at a relatively low cost.

That’s right, that’s right because we already have the clinics in place. So you have women coming in to be either screened or treated for AIDS with anti-retrovirals, or what have you, and while they’re there we then want to create that opportunity for them to get screened for cervical cancer and to get screened for breast cancer and to get breast health education so that we can downstage the disease and try to get interventions much earlier on the scale so that they’re not presenting in late stage cancer.

But breast cancer, of course, is a bit difficult, as you yourself just mentioned. What are your hopes there in places like Africa?

Well part of it is we need to do our job to improve the technology on the breast cancer detection side. Susan G Komen for the Cure is partnering with a number of different device companies to try to make the detection more portable and something more precise. So we need to get better on the technology side and then also we need to expand the infrastructure in a lot of these African countries so that they can deal with the enormous cancer wave that’s coming their way. People are living longer because they’re not dying of AIDS, TB and malaria on the scale that they used to. We’ve had enormous success because of PEPFAR and so people are moving into that cancer demographic and we need to have the health ministries start preparing for this, people moving into that cancer demographic.

And your goals would be? Overall what would they be?

Well on cervical 25% reduction in deaths and on breast cancer we want to destigmatise, we want to increase awareness about breast health education, we want to increase the availability of screening and also where surgery is required help women get to the care that they need.

What about other countries? Which countries are you going to go to? You’re working in Africa, will this be confined to the continent of Africa?

No, we’re also going to be in Latin America. You have some countries in Latin America that have a very high prevalence of cervical cancer, certainly breast cancer is also an enormous problem. The PEPFAR clinics are obviously much more located, that’s the centre of gravity for PEPFAR is in sub-Saharan Africa. But we can also work with other entities in Latin America. Our initial focus is sub-Saharan Africa but we’re doing work in Latin America.

But again you’re looking for a platform that’s already there and being serviced and taking advantage of that.

That’s right. Given the global economic crisis that different parts of the world are still struggling with, governments and other entities don’t have the means to create another PEPFAR. So it’s really important to not duplicate efforts; let’s leverage the kinds of platforms that are out there, let’s start working across disease communities. So what we’re doing is instead of just trying to solve our solutions within just the cancer community we’re reaching out to the AIDS community, we’re reaching out to the maternal health community, and we want to start partnering more broadly across disease platforms and not be as siloed as historically the cancer community has been.

So how would you summarise the importance of the Pink Ribbon Red Ribbon initiative and what would you say to people at this point about how they should think about it?

Pink Ribbon Red Ribbon is one of the finest examples of integration in the world today. One of the really fine things about it is we’re moving at enormous speed. The challenge is enormous, the cancer burden is enormous and we launched this in September, we’re not even at the one year mark and we have already announced two countries where the work is already underway. We like how nimble and ambitious this initiative is.

And what can anybody do to help?

Well, we have a website, Pink Ribbon Red Ribbon, if you go and type that into Google it will bring it up. There are opportunities to donate. For those who live in the countries that are Pink Ribbon Red Ribbon countries, and more will be announced, there are ways for them to contact people at the secretariat, which is located in Dallas, Texas, and express their interest in supporting the initiative. We would welcome it.

Well, Brian, thank you very much for joining us on ecancer.tv.

It’s a pleasure, thank you.