Partners for Cancer Diagnosis and Treatment in Africa Telepathology Lab Goes Live in Rwanda

Nov 02, 2016

Dr. Jean Baptiste Mazarati, Head of the Rwanda Biomedical Center/National Reference Laboratory, representing the Rwandan Ministry of Health and the Honorable Minister Diane Gashumba, announced the official "go live" of an innovative telepathology laboratory in Butaro, Rwanda. The laboratory—an initiative of Partners for Cancer Diagnosis and Treatment in Africa—is providing patients in resource limited areas of Rwanda with access to rapid cancer diagnostics and appropriate care and treatment. The telepathology lab is further enhanced by the simultaneous installation of a fully automated tissue processing system which has transformed the capacity of the laboratory towards 1000 blocks per day and allows for same day turnaround on biopsies.

"Histopathology was a major gap in Rwanda," Dr. Mazarati said. "This package of equipment will allow us to take our cancer patient care to the next level. ASCP is giving the gift of life. We want to be sure that we have histopathology so that we can say 'this patient with this cancer at this stage can have this treatment.' This laboratory is the realization of that possibility into reality." 

Partners for Cancer Diagnosis and Treatment in Africa, a coalition announced in 2015 by the White House and as a Clinton Global Initiative Commitment to Action, is led by the American Society for Clinical Pathology (ASCP), the world's largest professional organization for pathologists and laboratory professionals. The coalition has developed an economical, scalable, and secure telepathology approach to help millions of people across Sub-Saharan Africa and Haiti who previously had no access to cancer diagnostics, or care and treatment. Cancer is the leading cause of death in Sub-Saharan Africa. Over the next five years, the annual number of new cases is predicted to increase to 1 million.

The new telepathology laboratory is located at the Butaro Center of Excellence in Cancer Care at the Butaro District Hospital in northern Rwanda. The coalition is using a cloud-based system that allows physicians in Rwanda to upload complete whole slides images of patient biopsies and receive diagnostic results from pathologists in the United States within 24-72 hours.

"This is a great example of collaboration between physicians on opposite sides of the globe," said ASCP President William E. Schreiber, MD, FASCP. "Through this initiative, thousands of patients will benefit from access to earlier detection and treatment of their cancers."

World-renowned partners in the coalition are contributing their expertise and best in class practices to implement this commitment. These partners include Sakura Finetek, the National Cancer Institute (NCI) at the National Institutes of Health (NIH), Partners in Health, Pfizer, and 
Roche Diagnostics. Sakura Finetek has provided histopathology instruments for preparing biopsies. Pfizer has provided funding support for the initiative. Internationally renowned global health expert Paul Farmer, MD, PhD, and his team at Partners In Health are a critical member of the coalition, providing on-the-ground support to make care and treatment available for patients after diagnosis.     

A team of ASCP volunteer pathologists in the United States will use the telepathology equipment to perform rapid diagnostics and review patient specimens for therapy in conjunction with the one pathologist currently stationed in Butaro. The system has multiple uses including primary diagnostics (when the pathologist is absent), secondary consultation, clinical correlation conference, and teaching Rwanda pathology residents.

"This is a herculean endeavor," ASCP Chief Executive Officer E. Blair Holladay, PhD, SCT(ASCP)CM, said. "The systems we have installed are the most advanced diagnostic equipment available in the world. These ASCP systems—designed in collaboration with our crucial partners—have never been implemented before. Most importantly, because of access to ASCP's 8,000 dedicated pathologist members, we will provide free diagnoses to all patients."

In October 2015, ASCP and a coalition of world-renowned partners responded to a call from the White House Office of Science and Technology Policy to provide patients in underserved areas of Sub-Saharan Africa and Haiti access to rapid cancer diagnostics and appropriate treatment.

Rwanda will serve as the launching ground for the seven-country, three-year initiative: Botswana, Rwanda, Uganda, Haiti, Swaziland, Lesotho, and Liberia.

"The concept being put into practice is unique," said Dan A. Milner, Jr., MD, MSc(Epi), FASCP, ASCP's Chief Medical Officer. "While providers have done telepathology for years, it has often been just one person or one service. The concept of creating an entire system—selecting sites for laboratories, installing pathology equipment, using whole-slide imaging in a cloud-based way, and creating teams of 15 pathologists focused on that site to review those slides for a diagnosis within 24 hours—is unique. It is a focused effort to create systems for a given large region, at a scale that has never been done before, and certainly not for free."

To learn more about the initiative, visit www.ascp.org/globalimpact.


Dr. Mazarati and Dr. Holladay participate in a ribbon cutting at the laboratory.


Dr. Holladay, Dr. Mazarati, and Dr. Milner visit the innovative laboratory.


Dr. Holladay inspects the new equipment in the laboratory.