CIRGO Reflects on Five Years of Funding

In 2019, during a critical meeting of the African Organization for Research and Training (AORTIC), a clear consensus emerged among researchers and scientists: there was an urgent need for increased funding and support for cancer research in low- and middle-income countries (LMICs). Responding swiftly to this call, several key organizations—including the American Society for Clinical Pathology’s (ASCP’s) Center for Global Health, the Parker Institute, and the University of Pennsylvania—collaborated to establish the Coalition for Implementation Research in Global Oncology (CIRGO). CIRGO has become a dynamic platform dedicated to promoting cancer implementation research and practical healthcare solutions, explains Ken Landgraf, M.Sc., Executive Director for the ASCP’s Center for Global Health. 

In the five years since its inception, CIRGO has significantly affected global oncology by awarding over one million dollars in research grants directly to investigators in Africa. These grants cover the entire cancer care continuum—from prevention and early diagnosis to treatment and palliative care—providing essential resources to regions that critically need them, Mr. Landgraf adds. 

Major partnerships and collaborations 

CIRGO represents “a really successful public-private partnership and a great example of partnership with industry,” Mr. Landgraf says. 

It has relied upon collaborations with such key people as Dr. Larry Shulman from University of Pennsylvania and Dr. Ute Dugan, formerly Chief Medical Officer at the Parker Institute for Cancer Immunotherapy. Additionally, the initial donation from Bristol Myers-Squibb (BMS) allowed CIRGO to get off the ground, according to Debby Basu, PhD, Senior Manager, Global Health and Workforce Development Grant Programs for ASCP. 

“The program was also supported by numerous ASCP members who volunteered their time either to review award applications or serve as mentors to awardees,” Dr. Basu says. 

“CIRGO’s work depends upon funding to thrive, and this year, with significant reductions in available federal funds and an ever-growing need for cancer research, it's even more important for the private sector to fund these research initiatives,” Mr. Landgraf says. 

Significant milestones 

Dr. Basu describes CIRGO’s “initial conception” as its first major achievement, since it was no small task to put a program like this into place. The initial installment of funds from BMS allowed the program to meet its intended goal of making awards on the ground in LMICs. 

“Now we are in a new phase where we are assessing the impact of this program and leveraging this information to both pitch to new potential funders, communicate the impact of the work, and maybe even expand CIRGO’s reach beyond the African continent,” Dr. Basu says. 

The funds it has awarded have “facilitated some really impressive achievements,” Mr. Landgraf says. 

Dr. N’Da Marcelin Homian, a medical oncologist at the University Teaching Hospital of Treichville in Côte d’Ivoire, personally witnessed CIRGO’s positive impacts. He describes patient visits during treatment as deeply meaningful, noting that such interactions brought warmth and encouragement to patients undergoing breast cancer treatment. Professionally, the experience strengthened his project management capabilities, enhancing everything from timeline setting to project assessment. 

Similarly, Professor Bakarou Kamate, a pathologist from Université des Sciences des Techniques et Technologies de Bamako in Mali, described his team as “overjoyed” at receiving CIRGO funding. The research opportunity not only enriched their academic experience but also strengthened team cohesion. 

“Last but not least, publication has enabled us to add value to science and enrich our CV,” Professor Kamate adds. 

Numerous achievements 

CIRGO’s achievements are numerous. Here are just a few of the successful programs initiated by CIRGO across key areas of oncology, including prevention, early detection, diagnostic capacity building, treatment access, healthcare workforce training, patient navigation, and palliative care: 

• Community education initiatives to raise awareness about cancer symptoms and risk factors (Côte d'Ivoire). 

• Provider-initiated screening strategies for breast and cervical cancer in primary healthcare (Tanzania, Côte d'Ivoire, Rwanda). 

• Training gynecology residents on colposcopy & LEEP for pre-invasive cervical disease (Mozambique). 

• Providing free neoadjuvant chemotherapy for low-income breast cancer patients (Côte d'Ivoire). 

• Cancer support groups and survivorship programs to improve long-term care (Nigeria, Rwanda, Côte d'Ivoire). 

• Expanding oncology training for primary healthcare providers (Côte d'Ivoire, Mozambique, Tanzania, Zambia). 

• Training healthcare workers in primary palliative care to expand access (Mozambique, Zambia). 

Overcoming challenges 

Securing sufficient funding remains CIRGO's biggest challenge. However, an ASCP report that reviewed CIRGO projects identified specific local barriers to cancer care that the funding does address, including:  

• Late-stage diagnoses due to lack of widespread screening and early detection programs. 

• Limited diagnostic and treatment infrastructure, particularly in rural areas, leading to inequities in care delivery. 

• Shortage of trained healthcare professionals, including oncologists, radiologists, and pathologists, exacerbating diagnostic delays and treatment inefficiencies. 

• Weak healthcare systems struggling to integrate cancer care into national frameworks, hindering patient access to timely and appropriate interventions. 

• Inconsistent access to essential medications and treatments, limiting patient survival rates and quality of life. 

• Stigma and misinformation surrounding cancer, contributing to low health-seeking behaviors and delayed presentation. 

CIRGO’s influence and legacy 

Dr. Basu says it has been exciting to reflect on the scope and impact of what CIRGO investigators have achieved for cancer diagnosis and care with their initial CIRGO seed grants. 

“In many cases, the programs have continued to be sustained and have made lasting impact in their institutions and countries,” she says. 

Tawonga Mkochi, MPH, Assistant Data Manager at UNC Project Malawi, heard about CIRGO through a colleague who knew of her interest in implementation science and cervical cancer research. 

“CIRGO helped me refine my skills in research methodology, grant writing, protocol development, and IRB navigation. Most importantly, I gained hands-on experience in running a study and leading a research team, skills that I continue to use today,” Ms. Mkochi says.