The Angola Sickle Cell Initiative, a public-private partnership of the Angola Ministry of Health, the Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI), Texas Children’s Hospital and Chevron, is teaming up with the global biopharmaceutical company Bristol-Myers Squibb to provide children with sickle cell disease in Angola with an effective medication to which many patients in the country have lacked access.
The program will provide thousands of Angolan children regular access to Droxia (hydroxyurea), which is indicated to reduce the frequency of painful crises and the need for blood transfusions in patients with sickle cell anemia with recurrent moderate to severe painful crises. This new five-year demonstration program is intended to build understanding of the effectiveness of treating children in resource-limited settings and to establish the cost benefits to the healthcare systems.
“World Sickle Cell Day was June 19, so this is a momentous time to announce this new partnership to provide potentially life-altering medication to thousands of children in Angola, one of Africa’s countries hardest hit by sickle cell disease,” said Dr. David Poplack, director of Texas Children’s Cancer and Hematology Centers and professor of pediatric oncology at Baylor College of Medicine. “Hydroxyurea is known to lessen the devastating complications of sickle cell disease.”
Sickle cell disease is an inherited disorder in which red blood cells become irregularly shaped. These sickle-shaped cells can get stuck in small blood vessels, which can slow or block blood flow and oxygen to parts of the body, resulting in painful episodes, serious infections, chronic anemia, damage to body organs and stroke, among other complications.
Angola has one of the world's highest rates of the genetic blood condition with up to 10,000 babies born with the disease each year. By some estimates, up to 50 percent of these children die before five years of age. However, most patients in the country have not had access to hydroxyurea.
Bristol-Myers Squibb will provide Droxia for up to 1,200 children during the first two years of the program, increasing this to up to 4,100 after that pilot period. The program will launch in Luanda and Cabinda and later expand to additional sites. Last year, Bristol-Myers Squibb made an initial donation of Droxia to the Angola Sickle Cell Initiative.
“We are proud to partner with the Angola Sickle Cell Initiative to help bring much needed treatment to infants born with this painful and deadly disease,” said John Damonti, vice president of corporate philanthropy at Bristol-Myers Squibb and president of the Bristol-Myers Squibb Foundation. “As important as providing treatment to the 4,100 children is that at the end of this five-year demonstration project, we should have ample data needed for governments and funders to consider providing the resources necessary to support large-scale treatment programs.”
The Angola Sickle Cell Initiative will provide medical care and management of the drug to children in the treatment program. The Angolan Ministry of Health has committed to the continued treatment of all the children on hydroxyurea when they reach 10 years old. The emergency response and global health organization AmeriCares also is a key partner, shipping the drug from Bristol-Myers Squibb to Angola.
Leaders of this new initiative hope to demonstrate over the five years the health benefits and cost effectiveness of a hydroxyurea treatment program for infants with sickle cell disease, and use patient data and outcomes as the foundation for an advocacy plan to provide treatment to all children in Angola and throughout the continent. Hydroxyurea currently has generic status and is on the World Health Organization List of Essential Medicines.
“Agreements like this public-private partnership allow governments to address gaps in healthcare to meet the needs of its most vulnerable citizens – sick children,” said Michael Mizwa, chief operating officer of BIPAI and director of Texas Children’s Global Health. “We hope BIPAI’s legal and operational framework in Angola will provide a foundation for many more such partnerships in the future.”
The Angola Sickle Cell Initiative has been in place in Angola since 2011. Before its launch, newborns were not screened for the disease. Since 2011, more than 150,000 babies have been screened and more than 1,700 babies and children are now in care and treatment.
Led by Dr. Gladstone Airewele, associate professor of pediatrics at Baylor and head of the Global Hematology Program at Texas Children’s Hospital, the Initiative also includes an education and training component. More than 1,500 Angolans have been trained through the program, including local physicians, nurses, laboratory technicians, phlebotomists, social workers and research coordinators.
The Baylor International Pediatric AIDS Initiative at Texas Children’s Hospital, or BIPAI, is the foundation on which the Angola Sickle Cell Initiative is based. BIPAI treats more than 250,000 children with HIV/AIDS across a network of clinical centers in Africa and Romania in which the Bristol-Myers Squibb Foundation is also a major partner.
Texas Children’s Cancer and Hematology Centers have provided key support in the success of the Angola Sickle Cell Initiative, and Chevron has provided $9 million in funding over nine years to the Angola Sickle Cell Initiative.
According to Bristol-Myers Squibb, hydroxyurea is indicated to reduce the frequency of painful crises and need for blood transfusions in adult patients with sickle cell anemia with recurrent moderate to severe painful crises (generally at least three during the preceding 12 months). Hydroxyurea should be administered under the supervision of a physician experienced in the use of this medication for the treatment of sickle cell anemia since treatment of patients with hydroxyurea may be complicated by severe, sometimes life-threatening, adverse effects.