St. Jude Global: Where We Are

Fostering relationships and sharing resources across multiple regions to facilitate worldwide collaboration

 

For more than a quarter century, St. Jude has forged powerful relationships with 24 partner sites spread throughout Brazil, Chile, China, Costa Rica, the Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Jordan, Lebanon, Mexico, Morocco, Nicaragua, the Philippines and Venezuela.

Building on those relationships, St. Jude Global will develop regional networks to promote self-sufficiency and the sharing of knowledge and skills among international sites. Through this model, we aim to accelerate global improvements in the clinical care of children with cancer and other life-threatening diseases.

The regional structures are integrated into St. Jude Global to form the St. Jude Global Alliance, which facilitates collaboration, research and transfer of knowledge across regions and programs. This alliance can integrate all stakeholders in advocacy, global health, and research and innovation.

By sharing expertise and experience among countries, regions and institutions, the St. Jude Global Alliance will achieve our vision in which all children have access to quality care no matter where they live.

Regional Programs

  1. A diverse part of the world spanning a large geographical area, the Asia Pacific region encompasses nearly half of the global burden of childhood cancer. After more than a decade of formal collaboration in the Philippines, St. Jude Global currently has institutional and national collaborative programs in three countries, with extended engagement regionally.

    Philippines

    • A partnership with Southern Philippines Medical Center in Davao in 2006 supported the expansion of care for children with cancer from four beds shared with other services to a 25-bed Children’s Cancer and Blood Diseases unit in 2011. This partnership demonstrated the value of dedicated pediatric oncology providers, including trained nurses. Collaborative efforts supported locally have since led to a new Children’s Cancer Institute inaugurated in 2016 with a full complement of multidisciplinary staff dedicated to the care of children with cancer. An active regional network has been created on the island of Mindanao to facilitate timely diagnosis and referrals.
    • More recently, St. Jude Global partnered with Philippine General Hospital in Manila. Initiatives in the past year include formalization of the embedded roles of pediatric oncology nursing education and palliative care; establishment of quality-improvement processes in blood bank safety and pathology; development of a regional referral model for retinoblastoma care; and establishment of resources for families and providers to optimize the use of national insurance.
    • Building on these and other relationships, St. Jude co-hosted the country’s first National Childhood Cancer Control Workshop in August 2017. This meeting occurred in concert with the national Pediatric Oncology Society and the Philippines Department of Health to address the needs of the estimated 4,000 children expected to be diagnosed annually. Diverse stakeholders throughout the country met for two days to define the situation and opportunities for childhood cancer care and to establish a national collaborative action plan for the Philippines.

    Myanmar

    • With an anticipated 2,000 new cases of childhood cancer per year, only two primary hospitals have dedicated units for children with cancer: Yangon Children’s Hospital and Mandalay Children’s Hospital. St. Jude Global, along with other organizations such as World Child Cancer and the Dana-Farber/Boston Children’s Cancer Center, established a national program to strengthen childhood cancer capacity, working through these two key institutions since 2016. At the invitation of the World Health Organization (WHO) and local leaders, St. Jude has led a national collaboration of government, civil society, academic and hospital leaders together with international partners. This group will define the first national cancer control program to include pediatrics.
    • The number of children diagnosed in Myanmar each year since 2013 has increased more than 40%. An organized national referral network has been created. A parent group has been established at each of the primary centers. Donor and volunteer engagement have increased nationally. To guide progress, St. Jude Global meets regularly with local and international stakeholders, including hospital leaders, the Ministry of Health and WHO partners.

    Cambodia

    • St. Jude Global partnered with Calmette Hospital in Phnom Penh in 2017, focusing on capacity building, needs assessment and technical support for regionalization of care. In early 2018, Calmette Hospital, in partnership with the Royal Government of Cambodia, opened the country’s first National Cancer Center. This center includes a dedicated unit for children with cancer.
    • In March 2018, the National Cancer Center and St. Jude Global hosted the first multi-institutional Childhood Cancer Seminar in Cambodia. This event included a nationally televised press conference involving all major institutions that manage children with cancer across the country.
    • About 700 children are expected to be diagnosed with cancer each year. A national working group is uniting the institutions managing these children. The progress has built on initial site assessments and strategic planning discussions that have occurred with St. Jude Global since 2012.

    Other programs

    • In addition to institutional and national programs, St. Jude Global coordinates regional opportunities that extend our reach to more than 40 institutions across more than 15 countries. Sample initiatives include online meetings via Cure4Kids, with emerging regional collaborations. These meetings include the St. Jude-VIVA Asia Pacific Tumor Board, St. Jude Leukemia Lymphoma Hour and Asia Pacific Supportive Care.
    • St. Jude Global is also partnering with key institutions in Singapore to provide a central location to develop regional educational programs. These include an annual meeting, the St. Jude – VIVA Forum. This scientific forum helps global experts and local providers exchange information and resources. In addition to the main scientific forum, the annual meeting features a nursing symposium and a pre-forum dedicated to low- and middle-income country needs. St. Jude Global co-sponsored and co-organized specialty training symposia on retinoblastoma in 2017 and Pediatric Cancer Pathology in 2018. These meetings connected providers across institutions and countries to facilitate practice improvements and collaborations. St. Jude Global ensures access to this educational and networking opportunity for participants from institutions and countries throughout the Asia Pacific region, involving a core of more than 35 institutions and 11 countries.
  2. El Salvador

    A large region with a strong network, the Central and South America region incorporates multiple sites and projects.

    The first international outreach program ever initiated by St. Jude occurred in 1993, at Benjamin Bloom Hospital in El Salvador. Later, programs were developed in Guatemala, Honduras, Costa Rica, Nicaragua, the Dominican Republic and Haiti. These programs have national reach and aim to provide access to care to most children with cancer in the region.

    Through the years, the collaborative nature of the Central American programs led to the creation of the Asociación de Hemato-Oncología Pediátrica de Centro América (AHOPCA). This regional network has adopted the structure and functions of a consortium. Participants include programs in Guatemala, El Salvador, Nicaragua, Honduras, Costa Rica, Panama, the Dominican Republic and Haiti. AHOPCA has standardized treatments, with thousands of children treated through its guidelines and research protocols.

    AHOPCA also provides education and training. The Unidad Nacional de Oncología Pediátrica in Guatemala City offers a pediatric oncology fellowship program. Twenty-one pediatric oncologists have graduated from this program. They provide specialized care to children with cancer in the region.

    During the past two years, St. Jude Global has developed a series of strategy workshops. These workshops strengthen regional health systems. They also advance the development of high-quality national pediatric oncology programs. Participants include representatives of the Ministries of Health of all the countries in the region and the Pan-American Health Organization.

    In South America, St. Jude Global has long-standing capacity-building, education and research activities in Ecuador, Chile and Brazil. In Chile, St. Jude supported a National Hematopoietic Stem Cell Transplant program for nearly 20 years. This program is one of only two ASH-designated training centers for pediatric bone marrow transplantation in Latin America.

    St. Jude Global plans to develop national initiatives in Bolivia, Paraguay and Peru. Strategic planning meetings and focused workshops have been conducted, and plans will be consolidated during the next year.

    In addition to AHOPCA, St. Jude Global helped develop two other clinical research consortia in the region:

    • The Consorcio Latinoamericano de Enfermedades Hemato-oncológicas Pediátricas (CLEHOP) began because of the success of AHOPCA’s program for the treatment of children with Hodgkin lymphoma. Those excellent results triggered interest to extend this work to other parts of Latin America. CLEHOP integrates groups from Argentina, Peru, Ecuador, Mexico, Venezuela and Brazil to expand beyond the treatment of Hodgkin lymphoma and become a true Latin American cooperative group. In addition to a protocol for Hodgkin lymphoma, the group is developing a new clinical trial for acute promyelocytic leukemia.
    • Grupo de America Latina de Oncología Pediátrica (GALOP) originally started when a few institutions in South America teamed up with the Children’s Oncology Group to run common protocols. GALOP will now be part of the St Jude Global Alliance. This will allow more centers to take part in the group and reach more children with cancer in the region.
  3. Ching-Hon Pui, MD

    St. Jude Global’s work in China is a testament to partnerships formed by St. Jude through the decades.

    Each year, about 50,000 children are diagnosed with cancer in China, about 12,000 of whom have acute lymphoblastic leukemia (ALL). Prior to 2010, fewer than 10% of children with cancer received treatment because individual families were required to shoulder the financial burden of therapy. But thanks to St. Jude, the number of children receiving cancer treatment in China has skyrocketed.

    A few of the achievements in this region include:

    • In 1991, St Jude partnered with Shanghai Children’s Medical Center and Beijing Children’s Hospital to train physicians and nurses to treat children with ALL.
    • In 2005, St. Jude worked with Partner in Hope Foundation to raise funding to treat underprivileged children with ALL. To treat these patients, St. Jude designed a cost-effective clinical trial jointly with Shanghai Children’s Medical Center and Beijing Children’s Hospital.
    • This effort was a success, with 86% of more than 140 of the patients remaining in continuous remission. This excellent result with affordable cost was published in an international journal. As a result, China’s Minister of Health selected childhood ALL as one of the first diseases covered by the New Rural Cooperative Medical Care System in 2010.
    • To provide optimal treatment to a large number of patients, St. Jude worked with Shanghai Children’s Medical Center to establish the China National Childhood ALL Study Group. Since 2015, more than 4,000 patients with ALL have enrolled in a national clinical trial across 20 sites.
    • In 2017, the Chinese government approved the creation of the first National Children’s Medical Center, which had been proposed by St. Jude. Shanghai Children’s Medical Center and St. Jude are developing a framework for cancer treatment, training and research for the center.
    • To further strengthen research on childhood cancer and blood diseases in China, St. Jude Global staff are forming partnerships with two other outstanding institutions in China: Guangzhou Women’s and Children’s Medical Center, and Tianjin Institute of Hematology and Blood Diseases Hospital.
  4. Global director and staff in Jordan

    Unrest in the Middle East has resulted in an escalating refugee crisis. St. Jude Global is dedicated to helping bring quality medical care to children with cancer even in times of strife. This goal has been possible in collaboration with a strong St. Jude Global regional network.

    Lebanon

    • St. Jude has strong ties to the Children Cancer Center of Lebanon (CCCL) at the American University of Beirut Medical Center (AUBMC). This collaboration has fostered the development of national programs, unified standard-of-care protocols, and the formation of a Lebanese pediatric cancer network. These additions benefit all children in Lebanon.
    • During the past five years, St. Jude Global faculty have worked with the AUBMC and CCCL to establish a sustainable program to treat displaced children with cancer. This shows that such collaborations can save young lives even in times of crisis in a country with the highest number of refugees per capita in the world.
    • Several educational programs to enhance the region’s workforce are based at the AUBMC. These include fellowships in pediatric hematology-oncology and other subspecialty training.

    Jordan

    • Another longtime partner of St. Jude is the King Hussein Cancer Center (KHCC) in Jordan. St. Jude has recently begun a program for displaced children with cancer in Jordan. This country has the second highest number of refugees per capita in the world.
    • The KHCC is also a regional St. Jude Global training center.

    Humanitarian Efforts for the Care of Displaced Children

    • Our successes in Lebanon and Jordan demonstrate that in the presence of a strong network, curative cancer care can be delivered to children even in times of crisis. St. Jude is engaging other regional partners to help rebuild patient capacity in Syria and Iraq. St. Jude is also coordinating the care of displaced children with cancer, facilitating their return home when the crisis subsides. 

    Pediatric Oncology East and Mediterranean Group

    • The Pediatric Oncology East and Mediterranean Group was established in 2013. This network of physicians, scientists and health care professionals is spread across more than 80 childhood cancer centers in the Middle East, northern Africa and southern Asia. The network includes sites in Algeria, Armenia, Bahrain, Egypt, India, Iraq, Iran, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Sudan, Syria, Tunis, Turkey, the United Arab Emirates and Yemen.
    • This St. Jude Global-supported group has several collaborations in patient care, epidemiology, education and research.
  5. Group from Moscow meeting on Eurasia Region in 2018

    The Eurasian Region, referring to the Commonwealth of Independent States, encompasses 13 countries with more than 80,000 children with an expected 10,000 to 11,000 new cancer diagnoses per year.

    St. Jude Global’s work in this region has stemmed from longtime connections and partnerships with the Dmitry Rogachev Medical Center in Moscow, Russia. The Eurasian Regional Program was formed in 2018 from this relationship.

    The first workshop on pediatric cancer care in the Eurasian region was held in Moscow in April 2018, in partnership with the World Health Organization (WHO) Non-Communicable Disease European Office, the Dmitry Rogachev Center, the Russian National Society of Pediatric Hematologists and Oncologists, and the Ministry of Health of the Russian Federation. The meeting was attended by 21 delegates from Eurasian countries, including Russia, Belarus, Azerbaijan, Armenia, Moldova, Kazakhstan, Turkmenistan, Uzbekistan, Kyrgyzstan, Tajikistan and Mongolia; and 41 invitees from the WHO, St. Jude and the Dmitry Rogachev Center. Themes discussed at the workshop included education, research, patient-centered care, health systems development projects and the formation of multi-center collaborative networks.

    The following priorities were identified. Action plans to address these are underway:

    1. Collaboration: Form a collaborative network for pediatric hematology-oncology specialists that will be integrated in the St. Jude Global Alliance.
    2. Health Systems: Create integrated standards for childhood cancer care.
    3. Patient Care: Launch an initiative to improve pediatric palliative care and enhance growth and development in other patient-care related fields.
    4. Education: Increase opportunities for pediatric hematology-oncology education, especially nursing education and specialization.
    5. Research: Establish pediatric cancer registries, to enable further research and organization in the region.

    A second strategic planning workshop is planned for fall 2018 in Kazakhstan.

  6. Group at St. Jude Mexico Regional Program

    In Mexico, 5,000 to 6,000 children through age 18 are diagnosed with cancer each year. About 60 pediatric hematology-oncology units are accredited by the government-sponsored health insurance program. These units are spread throughout the 32 established, federated states. The first capacity-building partnership in Mexico was established in 1999 with the Hospital Pediátrico de Sinaloa in Culiacán, followed by Hospital Civil de Guadalajara in 2001 and Hospital Pediátrico de Tijuana in 2007.

    During the last two years, the Mexico program has increased significantly. With the development of a broader and more comprehensive regional initiative, the three-institution program has expanded into a network of 11 institutions.

    Through strategic planning meetings and workshops, the group set the following priorities and areas of work:

    • Collaboration: Integrate more than 10 pediatric disciplines in this multidisciplinary group. The group includes more than 100 health care professionals from 11 pediatric oncology units.
    • Modernization: Standardize and modernize the diagnosis of acute lymphoblastic leukemia through a clinical trial that features risk-adaptation with minimal residual disease evaluation.
    • Quality improvement: Implement quality improvement initiatives for a broad range of topics, from cancer treatment delivery to supportive care.
    • Evidence-based interventions: Develop a clinical and epidemiological research platform in pediatric oncology to help generate evidence-based interventions.

    The goal of the Mexico region is to increase the survival of children in that country from a baseline of less than 50% to greater than 75% in the near future.

  7. Nearly of a quarter of the world’s children ages 0–14 live in Sub-Saharan Africa, one of the world’s most resource-limited settings. Through a new regional program within St. Jude Global, local physicians and leaders of existing partnerships in high-income counties have been engaged to develop mutually beneficial collaborations and build a regional alliance. Initial efforts involve countries such as Zimbabwe. In that country, work has started to improve the quality of care for both childhood cancer and life-threatening blood diseases such as sickle cell disease.