THE METRONOMICS GLOBAL HEALTH INITIATIVE

How did you find this company? What are the main facts about its activities?

The Metronomics Global Health Initiative (following MGHI) is a non-governmental and non-profit initiative that aims to develop alternative anti-cancer strategies for children in low- and middle-income countries (following LMIC). It mainly sees itself as a global community, where everybody, scientists, medical associations, healthcare companies, international institutions, governments and concerned citizens, finds a platform to realize a dream: finding an approach for alternative anti-cancer strategies in countries where conventional therapies and business models are out of reach, because of economic, social, technical and ethical reasons.

By combining cutting-edge scientific research, new business models and social innovation, the community tries to develop innovative strategies that rely on (1) the frequent oral administration of ‘old’ anti-cancer drugs at low doses (metronomic chemotherapy) and on (2) the use of ‘old’ anti-cancer drugs which anti-cancer properties have been unveiled (drug repositioning) at a very low cost. This allows developing a non-toxic, affordable and easy to administrate cancer treatment that is well suited for treating patients living in LMIC’s.

The initiatives long-term goal is “to play a role in the implementation of sustainable anti-cancer strategies in the developing world”. It aims to demonstrate that the metronomic approach can improve the lives of children with cancer in LMIC’s and besides, to give a novel view on cancer disease and cancer cares. Furthermore the community wants to rise funding for developing or help to develop projects that are based on the metronomic approach. The MGHI wants to facilitate cross-sector partnerships which might result in projects that could revolutionize the management of cancer in the developing world and in turn in industrialized countries. However it also aims to become a major partner in developing new strategies to fight cancer. Moreover, MGHI wants to change the mentality towards cancer in LMIC’s, which often equals cancer to an anticipated long way to painful and distressing death, because treatment and care are lacking. Ultimately, if once convinced that cancer is not fatality, people might be ready for early diagnosis and prevention.

In the beginning, the project wants to specify the conditions under which the above explained therapies are truly effective. Due to this and at the service of scientific excellence, the initiative wants to launch a series of cutting edge clinical studies that will hopefully establish the precise conditions of the scientific validity of metronomics and drug-repositioning techniques to cure cancer in LMIC’s, while not compromising on scientific rigor, objectivity and prudence.

MGHI focuses mainly on children in LMIC’s, because of all children on this world, 80% are living in developing countries and 200,000 of them are being diagnosed with cancer each year. These children have limited access to curative treatments and only 25% of them will survive in the end. Waking numbers, compared to high-income countries, where approximately 75% of the 50,000 children diagnosed with cancer each year survive. Although the main focus is children suffering from cancer in developing countries, the community will also develop and facilitate new projects concerning metronomic treatments for adults and in industrialized countries.

The Metronomics Global Health Initiative is a community that is open to everybody and welcomes people to “Join in!”, if they are sharing the initiatives vision and dreams.

What are the ethical challenges this company is addressing?

The ethical challenges, this project is facing, are not very surprisingly at the same time the major problems, difficulties and resistances the project is facing itself in order to be successful.

Obviously the main challenge is to provide children with cancer in developing countries with anti-cancer strategies. The availability of drugs and treatment facilities, cost and toxicities of treatment, distance to pediatric oncology units, compliance with treatments, delayed diagnosis, prior consultation of traditional practitioners and cultural barriers are just some of the problems, that preventing the development of efficient anti-cancer strategies in LMIC’s. The biggest challenge therefore is to build up constraint-adapted, realistic therapeutic strategies for children suffering cancer in these countries. Furthermore, local governments and policies are most of the time a slowdown or even a reason for non-viability for global health projects. Translating excellent and scientifically proofed theory or even clinical trials into actions is especially in countries suffering from dictatorship, corruption and underdeveloped infrastructure a challenge.

Another ethical problem the initiative is facing is the so called ‘10/90 gap’. This term describes that the health research applied to the needs of LMIC’S remains grossly under-resourced in many areas. Only 10% of the worldwide financial resources for global health research is addressed towards the needs of the developing countries, while the remaining 90% focusing on the need of the 15% richest. Additionally, the epidemiology of diseases in these countries has shifted substantially, due to the fact that LMIC’s are now experiencing high burdens of injuries and non-communicable diseases such as cancer, diabetes, heart disease and stroke, as well as continuing high burdens of infectious diseases. This shift in the epidemiology also might not be acknowledged by the allocation of the poor financial resources.

The MGHI is trying to raise awareness for major upcoming issues that might be invisible for some people, due to the fact, that the world seems to be rather concerned about health issues like HIV, Malaria and Hunger in developing countries. According to the WHO, when it comes to cancer, approximately 1/3 of the patients could be prevented, 1/3 could be effectively treated with early diagnosis and 1/3 could have their quality of life improved with palliative treatments and care. Unfortunately, this live saving prevention and early treatment is hard to achieve in LMIC’s. Unless there will be actions now to make a difference, the existing health care infrastructure in LMIC’s will be overwhelmed by the predicted increase in cancer incidence. Because of this upcoming importance, the initiative additionally tries to change the attitude of patients in developing countries, which are often seeking for help in a final stage where nothing can be done anymore.

Another ethical challenge the initiative might face, is the dealing with ‘old’ anti-cancer drugs, which are not any longer of use in our industrialized countries. On one hand it reveals once again in how far we are treating developing countries, by using them for our waste disposal, even though it would have a positive impact in this scenario. But still, the initiative, implicitly, points out how we are positioned towards the rest of the world. On the other hand, our society might even want to point out the MGHI’s as being unethical, by providing ‘old’ and maybe ‘impractical’ or ‘unreliable’ drugs for children and parents that are not having the resources to use them effectively or efficiently.

As we can see, the community will face serious challenges on their way, which will hopefully as much as possible facilitated by supporters and partners.

What makes this company really inspiring to you and why would you trust it?

Opening the website of the initiative, one is immediately confronted with a ‘problem’. How to not be inspired by the powerful and broad message or better vision embraced by the initiative. The MGHI manages to describe its goal and strategy while inviting and persuading you to join it.

The MGHI was founded and is managed by people that instead of enjoying their free time on the couch prefer to abdicate a part of it and endeavor efforts to make a stand against a monopolized process on global health care assistance. Rather than business people at the helm of the campaign, there are individuals with a mainly medicine background. Moreover, there cannot be found the stereotype of focusing the project either on developed or developing countries. The objective is to add something to the society, not to a part of the society. This offer is not just about technical practices or new business models in order to answer old problems. This is also a proof to each of us at the outside that there is more than one way to make things happen and that it doesn’t matter how elaborated a dream can be, as it’s always feasible.

Furthermore, the notions of reality and ethic in this project are emphasized by more than a decade of laboratorial research in the recent past. Metronomics does not set deadlines to achieve its goals, but rather commits itself fully to its principles that therefore are proliferating by themselves.

The emphasis on the concept of non-profitability is clear in the way the website is conducted and actions are taken. There is no trace of marketing, or even corporate social responsibility claims on the internet platform. The focus is on doing something instead of how to present what might have been done or might going to be done, e.g. everyone is invited to contribute.

Overall, the purpose, and the way to achieve it, seems to be genuine and credible. The transparency of the words and feelings delivered to the reader is hard to fake. The MGHI’s is as trustable as inspiring.

What are the possible challenges facing the company in the future and how do you think this company may improve?

As a natural consequence from a project that is situated in its beginning, the MGHI has several issues to deal with, in the short and long term. Without taking any credit for what was developed until now, there are some areas where the project can strengthen itself.

In the long run as now, the community but especially the founders will always be tempted by various forms to shorten the throughput time in order to see their ‘baby’s’ result in the field. The line, between the principles that brought the idea to live and an easy to achieve profitability, will not always be clear or simple to draw. By having its values as a competitive advantage towards similar organizations, they are giving additional pressure towards a constant self-reflection and criticism.

In the short term, the initiative will need to overcome the pressing challenge of choosing a business model. This is a key element to fill the gap of clarity undergoing in the metronomics project. The major advantages of this step would be a flawless definition of where and how to go, both in the short and long term. Without the correct signaling of the carried-out practices, all the effort may fall in an implosive spiral. The initiative has to approach itself, not just as an ethical and different way to face health problems, especially from a business point of view. In the end, it’s not very different from what is a business product that has to deal with financial and strategic decisions as many others.

One of the main difficulties presented until now, that will continue to last, is to find sustainable and fitting partnerships. Here the raised questions are many. Partnerships, why, how and where and therefore in the end who? A possible partnership for the initiative should be thoroughly proofed in order to don’t be cannibalized on the process. Safeguard intellectual property while minimizing costs of failure has to be considered and placed in a possible business plan.

Another main struggle, at least on these first steps, will be how to achieve credibility. How can a solution that states to be also possible for the industrialized world, not be considered as looking for profit? Only a good alignment of the ‘companies’ principles with an innovative approach will answer to this question. For example, opening the initiative to a bigger audience in order to be a bigger community could trigger an exponential grow of the project bringing acknowledgment to the value added by the project.

Without a clear line of thinking and action there will be always a threat of remaining stuck and don’t pass to a phase of implementation of the ideas in the field. Is the initiative successful today and will it be in the future? It is hard to tell at this stage of developments. What we can say, is that the timing and capacity do adapt to the involving reality, while sticking to its genesis values, will be of key importance to fulfill, or not fulfill, the promising future of the initiative.