The Foundation of Global Health

By James L. Wisecarver, MD - November 16, 2022


In last year’s April issue of Critical Values, American Society for Clinical Pathology (ASCP) Past President Dr. Wes Schreiber discussed the rationale for ASCP’s participation in our various global health initiatives. He detailed the Society’s involvement with the President’s Emergency Plan for AIDS Relief (PEPFAR) initiated by President George W. Bush. ASCP assisted in this effort by providing training to laboratory workers in Sub-Saharan Africa who were on the frontlines of the battle to contain the spread of HIV throughout that region.

However, our involvement in helping improve global health actually began a few years earlier. The ASCP Board of Certification (BOC), anticipating a global need for certification of laboratory professionals, began to survey countries abroad to learn if there was interest in such a certification. They quickly learned that ASCP certification was held in high esteem by lab workers and employers worldwide. In response to this demand, the BOC developed and began offering an international form of its certification program dubbed the ASCPi. This included an assessment of the important technical skills of the applicant without the management and regulatory component required of lab professionals here in the United States. This certification began in Seoul, South Korea, in 2005, and was rapidly expanded to include other nations in Asia, Central and South America, and the Middle East. As of September 2017, more than 9,100 laboratory scientists have been certified through this program worldwide.

Around this same time, the PEPFAR program was in the planning stages and the United States Centers for Disease Control and Prevention (CDC) began looking for a partner to help improve the laboratory testing capabilities in African nations that were being decimated by the HIV epidemic. The Society was uniquely positioned to provide laboratory personnel and educators possessing the expertise to expand the testing capabilities and train the lab workers in those countries to perform the testing that would be necessary to curtail this epidemic. This program proved to be highly successful. With timely and accurate diagnosis, and subsequent treatment, the deaths from HIV-related disease have decreased dramatically.

Now that people in these regions are living longer due to successful HIV treatment, noncommunicable diseases are now more prevalent, and this has presented another opportunity to serve those in need. Many of these countries have a significant shortage of trained pathologists to perform diagnostic examination of surgical specimens. Last year’s article pointed out that many of these countries have fewer than one pathologist per million people. Without adequate tissue diagnosis, the patient’s treating physician is left with no basis to determine an optimal course of therapy for these patients. To make matters worse, there is also a shortage of instrumentation and trained histotechnologists to process these surgical specimens and prepare slides for a pathologist to examine.

In response to these critical workforce shortages, President Obama launched the Partners in Cancer Diagnosis and Treatment in Africa (Partners) initiative. ASCP was asked to lead the effort to improve access to diagnostic services through an innovative program that would bring together industry partners to provide the critical pieces of instrumentation and pathologist volunteers to provide diagnostic expertise using telepathology with remote viewing and reporting to provide physicians in those countries with the diagnostic information necessary to plan proper treatment. As of this writing, more than 10,000 patient samples have been analyzed on ASCP-deployed systems with accurate, rapid diagnostic reports relayed to the healthcare provider.

Our involvement with both the PEPFAR and Partners programs have helped identify additional opportunities to provide assistance for people in need. Here in North America, most of us take access to health care for granted. Many Americans have opportunities to participate in wellness programs offered through our employers. We have relatively easy access to healthcare providers when care is required. In many parts of the world, such services are not easy to find. The nearest healthcare provider may be located far away, several days’ journey on foot, which is often followed by days-long waits to be seen and then limited access to the therapeutic agents necessary for proper treatment. Our participation in these programs has been able to improve care in these resource-limited countries.

Helping ensure that our Society has the financial resources to continue with this important mission is more important now than ever. The ASCP Board of Directors, when creating the ASCP Foundation in 2017, recognized the importance of global healthcare to the goals of the Society. They designated assisting with global healthcare efforts as one of the three pillars of this fundraising campaign. At present, over $1.5 million has been either contributed or pledged to help build the Foundation. This is truly a remarkable accomplishment. However, in order for the Foundation to be self-sustaining, more donations are needed. The Foundation board is looking into ways to help facilitate giving by the membership. With more than 100,000 members worldwide, if each member were to give even $5 at membership renewal time, we would be in the position to make some significant positive changes in areas that are in need of our assistance. Please look for these opportunities while visiting the ASCP website, and while attending ASCP workshops and educational programs, and our annual meeting in Baltimore in October. While donations targeting specific areas are certainly welcome, donating to the Foundation’s general fund provides the greatest flexibility to meet the opportunities that will present themselves going forward. One example is the emergency shipment of medical supplies that the Foundation was able to provide support to healthcare efforts following the October hurricane in Puerto Rico. As parts of that island are still without power and utilities, healthcare workers there are still in need of our assistance.

ASCP is an organization made up of a remarkable group of pathologists and lab professionals, many of whom unselfishly give of their time, energy, and dollars to support efforts to improve healthcare around the world. There are people in other parts of the world who rely on us for this assistance. It is critical that we do not fail them. Please consider giving to support this effort.

James L. Wisecarver, MD

2017-2018 ASCP Foundation President