Last Mile Cancer Technologies: Improving Cancer Survival Rates in LMICs

Adaorah Enyi
Co-founder and Chief Operating Officer
Omolola Salako
Lecturer, RBRR Digital Health Hub
Wilfred Ngwa
Professor of Global Health Associate Professor of Radiation Oncology Chair Lancet Oncology Commission for sub-Saharan Africa
Matthew Allsop
Associate Professor of Palliative Care
Valeria Arango V.
CEO/Founder

Video Transcription

Good morning. Yeah. Good morning, everyone, and welcome to the Women in Tech Global Conference.Our session today is hosted by Oncobody Technologies Limited, and we are a digital health innovation company that is empowering confident cancer care decisions for patients, clinicians, and leading health care companies. And we're excited to have you all here join us this in this session today. Thank you for your commitment to improving cancer care in low and middle income countries. I am doctor Adora, and I will be your moderator for the session today. And our session today is titled last mile cancer technologies, improving cancer survival rates in low and middle income countries. Now I have the Slido link, because we we love polls at Oncopathy, and it's just a quick poll for you to share with us, why you are attending this session.

We just want to know, your basic understanding. Now to provide a bit of context to our discussion today, last mile cancer technologies refers to innovations that deliver cancer, care products directly to patients regardless of their geographic locations, and these innovations, are provided to end users. Now one thing you must know is that there's a global shortage of oncology professionals and resources, especially across low and middle income countries. This notable shortage has resulted in significant health care disparities. For example, in Nigeria, we have 18 only 18 out of the 6 states have a clinical oncologist. And as such, the burden is increasing every year. Each year, with, low and middle income countries each year, cancer deaths recorded about 9,000,000 cases, and low and middle income countries alone contribute to about 72% of these untrue deaths.

And so, to talk more about this topic, this topic that is very dear to us, I want to introduce my amazing speakers, who are, trail builders by their by their right. They are global innovators and researchers who are committed to generating evidence and solution. So first up, I have professor Will Fred Unguah, and professor Will is, professor of global health. He's also the founding director of the Global Health Catalyst. Doctor Will is an associate professor of radiation oncology at Johns Hopkins Medicine in the United States of America, he's also the chair of Lancet Oncology Commission for Subsiran Africa. Welcome, doctor Will. Next, I have doctor Matthew Alsop. Doctor Matthew Alsop is an expert on digital health for people living with advanced cancers. Doctor Matthew is an associate professor of Palliative Care School of Medicine, University of Leeds in the United Kingdom.

His research explores the development of palliative care services with a focus on the role of technology primarily in the UK, in those Indonesia, and so many other countries in Sub Saharan Africa. You're welcome, doctor Matthew. And next up, I have doctor Molalla Salako. Doctor Molalla Salako would educate us on mobile health research and data intelligence in oncology. Doctor Molalla Salako is a lecturer at the RBRR Digital Health Hub in the College of Medicine, University of Lagos, Nigeria. She's also a clinical and radiation oncologist, and she's the founder of Shebegley Cancer Care, pale oncology, and the Oncobady app. You're welcome, doctor Salako. Alright. So we would like to know from our audience how familiar which you are with this topic that we're about to discuss today. Our goal for our session is really to reflect on the potential benefits of last mile cancer technologies.

And to get us started, doctor Mateo, I'd like to ask, can you I know you've led a multi country qualitative discussion qualitative study in 3 African countries that access the digital health needs of cancer patients. Can you highlight for us your research findings of mobile phone based interventions and how they can be used to deliver cancer care directly to patients irregardless of their geographic location.

Yeah. Absolutely. Thank you very much, Adam. It's, it's it's great to be here. Really, really privileged to be able to talk today. And just to pick up on the point you made in the introduction, there are increasing numbers of cancers, cancer cases in low, middle income countries. And often when we look at the data in the context of low, middle income countries, most people, so around 60, 70% of people with cancer, are presenting with quite late stages of disease, so advanced stage of disease. And and that means there's limited treatment options. They might have a range of symptoms, concerns, and these could be, for example, physical, such as pain or fatigue, but also psychological, social, spiritual. So my my role is really thinking about how digital health can support delivery of palliative care to support people with, with with advanced cancer.

And it's so it's so crucial to to to have access to palliative care to enable, you know, good quality of life to address problematic symptoms. So, really, that's been the focus of of of my work today. And a big problem across, low, middle income countries, also the work we do in sub Saharan Africa is access to palliative care. So thinking about how can people in urban, rural, you know, across countries, how can they access palliative care, when you've got very, very limited, provision of palliative care? So the multi country study you mentioned, involved us working with a range of clinical and academic partners in 3 countries. So we did we conducted the research in Nigeria, Uganda, and Zimbabwe, and we interviewed patients, carers, health professionals, and policymakers to really understand and explore how, digital technology can support people with, advanced cancer.

And and what we found from that work was that patients and carers really find find digital technology an acceptable approach. So using that as a means of access in palliative care, and we're particularly keen to see different ways of it being used. So this this from from our interviews with patients and carers, they were really keen to have sort of 24 or 7 access points to train professionals. So whether helplines, text messages, online chat, without fear or concern that they'd be disturbing health professionals. So thinking about kind of triage, phone lines, and other support lines. They also wanted to, access and share details about their concerns, around cancer. So any problematic symptoms they're having, and they want us to be able to share that. And and quite practical things such as fact checking drugs and lab tests that were ordered by health, health staff.

So particularly, thinking about opioid supply and understanding whether pharmacies had opioids in stock, before going to get a prescription. Pain's a really, really highly prevalent, symptom in in in, people with advanced cancer. So we found lots and lots of different ways that it could be used. And and more recently, we've been applying some of those findings, particularly the desire to contact and share, patient patients being able to share their experiences and symptoms they're having with clinical teams. So So picking up on the geo geographical point, we've been doing some work in Northern Uganda in a refugee settlement, the Bidi Bidi refugee settlement. And this settlement alone stretches over huge distances. It's 100 of miles away from, Kampala, the capital in Uganda. And it really provides a nice example about how you can kind of overcome geographical distances. So we've, we've designed a mobile application that's used by the village health team.

So these are health workers based in the communities, across the refugee settlement. And then village health team members use the mobile application to record information about symptoms, concerns that patients with advanced cancer report to them. And that information is then summarized and shared with clinical teams, in the refugee settlements. And that means the clinical teams can then review any continuous, or problematic symptoms and concerns that that arise. They can call and speak to the patient if they need to. They can respond with treatments, interventions when they're necessary, or they can also support the referrals that are needed out to larger health facilities outside of the, outside of the refugee settlement.

So that means that even though patients are living across broad massive geographical areas, the services are still able to identify problematic symptoms through routine assessment, that, you know, a lot of these symptoms might otherwise be missed, and people would be living with very, very complex difficult symptoms, and a lot of distress associated with them.

And, also, it helps the coordination of care as well. So involving the clinical team, helping them to facilitate, any referrals that are needed out. And and just the the final point where the codesign was really, really important as part of this process. And when we spoke to the clinical teams when we were developing the intervention, it it it it showed that, they told us that hepatitis b and tumor colosis in particular were really highly prevalent in the camps. So it'd be really helpful if the mobile application could capture not only symptoms and concerns related to advanced cancer, but also hepatitis b and tuberculosis to to help sort of save them time. They'd they'd want to try and collect this data anyway. So so that co design process was really, really important. So we we're just piloting that at the moment. Patients are really, valuing the time they have now sitting down systematically discussing the symptoms with the health workers and the village health teams.

And, yeah, we're we're really sort of excited to see where the where the project goes next.

Yeah. So it it's great to know that there are global partners, both clinical and academic, that are investing in technology to sort of advance and improve access to cancer care. And so I'll go over to, professor Will. So, professor, we know that technology is an play an important role in enabling cancer care in low and middle income countries. Recently, the Lancet Oncology Commission for Sub Saharan Africa, which you chair, highlighted the importance and the potential benefits of teleoncology with a clear call to action for government and stakeholders to invest in teleoncology. So please can you tell us more about this call to

action? Sure. Thank you very much for having me. I think, you know, Internet, I mean, telehealth is was one of the things that as the chair of the commission, we really thought that, you know, we know a lot of data that has shown the Internet penetration into Africa, the mobile phone usage. I believe when I saw sometime last time, you say, in Nigeria, over 51% Internet penetration and and, 84% of that mobile users. I think you know, to increase access to care, like, doctor Matthew just mentioned. I think, so the it this was not even a debatable point, in the call to action. So the call to action, we saw that telehealth can be a way for Africa to leapfrog, into an era where I mean, I grew up in a in in Africa where, you know, we didn't have landlines.

Right? So but now, you know, we have mobile phones, and we're talking about VR. So if you can get that, you know, you can really increase access to patients, you know, in locations that, otherwise, they will not be able to because of geographic barriers. And so, so this is what the one of the all the other calls to action. We had 8 calls to action. There were 7 of them. I mean, the first seven were familiar, you know, national cancer control plans, all of that stuff. But I thought, we thought 8th was really, important to have because it's a really great opportunity for Africa. Just one last thing. I mean, we know that, you know, I think it was NIH, Fogarty, mentioned that, you know, from the data that we have, you know, people may not have toilets in Africa, but they do have mobile phones.

They have you know, you have a mom in the remote village who has WhatsApp. Right? So if they are sick, you know, you can do the symptom management. You can do the follow-up. You can have consultation. And, and so we've actually shown that this can really, really work where, you know, you can have somebody, you know, you know, really, really access the best doctors in the world at the top institutions, you know, not only in Nigeria or Africa where you wanna have the doctors, but, you know, the whole idea of brain drain and, and, being able to access even the best specialists, whether it's from the UK, Europe, Africa, United States, becomes possible.

And so this is a great opportunity. And so I'm very excited that I see, companies like, and, you know, you guy the innovations that are being made. As you remember, when I heard you guys present at UICC, I was super excited about that. So

Thank you. Thank you so so much. Thank you, professor. So it's interesting to note that both speakers have sort of educated us on the fact that as much as timely oncology is very important, there's a call that really requires every stakeholder. So stakeholder engagement from the patients to the caregivers, to your loved ones, to family or friends, to governments, to academ commissions, to researchers, technologies, engineers. It really is a global call for all types of partners. So doctor Stella Kor, over to you now. I know I understand that Uncle Patty has launched 2 pubs in the College of Medicine, University of Lagos and at the Olabisi Onobanjo University teaching hospital. How are these hops, you know, generating insights and clinical services for cancer patients?

Okay. Thank you so much for, the question, and, it's a pleasure to be alongside professor Linguan, doctor Matthew and you, Ada. And so our idea around the hubs is is twofold. It's actually 2 pillars. One hub is a research hub that is focused on generating evidence, generating data on how patients are using mobile apps or mobile based in interventions for their health. As as far back as, 6 years ago, we it was clear that cancer patients, especially in urban, cities, hospitals in urban cities, that these patients were leveraging technology to source for information to make some decisions, and we are lacking a lot of data on how patients are using the Internet or mobile health interventions for their care.

And so the whole at Onco PADI, which is domiciled in the College of Metin University of Lagos, is focused on bridging that gap. 1, to promote mobile health research within the academic community. 2, to generate evidence on how we can, you know, improve mobile health research and how patients are utilizing apps. And it's also focused on how health care innovators within the academic community can specialize in digital health. Of course, we don't we don't have digital health curriculums yet in many universities. So this hub is some form of, a bridge that exposes students and faculty members to research. And so the digital hub in the college of medicine is, sort of harnessing, you know, incubating.

We used to call them divergence many years ago, but it's sort of identifying people who are interested in health tech who want to build products, and we're sort of encouraging, promoting them, connecting them to resources, to brands, to networks, and and we are saying, look.

Let's begin to generate evidence in diabetes, how apps can improve diabetic care, how we can use technology to remotely monitor cancer patients and their side effects. After all, we know that cancer patients and many other patients spend a few hours in the clinic or spend a lot of time at women in their communities. So how can we bridge this gap? And it's so important that the continent and all the LMICs must generate data so that we we know how this would work and how patients will benefit from it the most. I would say the research hub also at the College of Medicine is sort of an advocacy hub, where we are trying to show the right way to go into digital health without dabbling or making mistakes as as we do research. I'm very, very strongly we're collaborating with, with experts like, Matthew, with experts like Will, because in in many parts of the world, they they already have experience.

So it's not just us setting up a hub and doing things the way we want to. It's also about collaborating on peer to peer learning and knowing which direction are we going towards. Now we have started to generate some products and some papers which we will publish very soon, and the second hub is basically last mile. It's similar to what Matthew said earlier about there are cancer patients in very remote locations and to Will's point, whilst they're in remote locations, they do have a mobile phone. How can we serve them? If they have a mobile phone in their hands, how can we provide adequate information? How can we tell them the right hospitals, doctors to see?

How can we provide them with some clinical advice

when they

need it, and they don't have to travel 2 to 3 hours and spend maybe $10 just to see the doctor, and wait for maybe 4 hours to see the doctor, and the doctor would, you know, just give them a clinical advice of 10 minutes. And so our hub at Olabisi Onobanjo Teaching Hospital is is a clinical hub, and through that clinic through the hub, we run virtual cancer clinics there. It's a state hospital. They have, a fantastic cancer workforce. They have the surgeons, the radiologists, pathologists, but they don't have the clinical oncologists. And we all know that you cannot provide quality cancer care in the absence of a complete team. So with our hub, we're able to take in virtual oncologists into the hub with the cancer patients seated in the hub, and we have a quick consultation in collaboration with the local surgeon radiologist. So the the the those are the 2 hubs I hope we do.

Fantastic. Fantastic work being done both globally and taking global perspective and translating it into global and local initiatives. That's really interesting to note. So I think I'll just have I just have one more question for doctor Matthew because I know that you are pressed for time. So, doctor Mathieu, I would like to learn a bit more on, what do you think would be the key takeaway for, people working in the cancer technology space? What's the one thing or one area that most innovators should focus on right now in improving access to cancer care?

Oh, there's lots of, lots of lots of things and challenges. I think I think one of the key things and, Amalelo was saying a few times is data, and I think what we have with digital technologies is the perfect data collection tool. I'm just thinking for advanced cancer patients, there are still lots of unknowns. We don't really understand which symptoms are most problematic, when they occur, how they change over time. So these are really fundamental questions that we need to understand to design services that best meet the needs of patients. And so so I think it's it's it's understanding how we can best use the data to inform development of services, particularly palliative care for advanced cancer patients. Yeah. That and then also, I guess, as part of that, it's using it for advocacy.

You know, if we are highlighting a real need for service development, how can we best use data gathered by digital technology for advocacy? I think they're the kind they're the kind of key areas for me really using that data and, yeah, capitalizing on it.

Alright. Thank you so much, doctor Matthew. Thank you. So data being the focus of, would you say the the future of digital health? So doctor Will, I know that you lead many impactful initiatives, and one of them is the comprehensive cancer center in the cloud, which is also data driven. And so can you share with us how this delivers last mile, cancer care to end users?

Sure. Yeah. And just to kind of, put a framework on that, you know, the background on that. So, you know, it actually was one of the examples we highlighted in the Lancet Commission, the comprehensive cancer center, and the cloud. And, the whole idea is, you know, if you imagine taking, like, the the Dana Farber Health Cancer Center or a cancer center in Lagos, where you have the kind of multidisciplinary care that doctor Omo just mentioned, where they have that kind of care where everybody where patients can have comprehensive care, you know, from diagnosis prevention all the way to palliative care.

You know, noting that palliative care actually starts can start from prevent from from the diagnosis. So, you know, but if you put that in the cloud, essentially, it means that, you know, if you have a phone from anywhere in the world or Internet access, you can essentially, access cancer care services. I mean, COVID 19 taught us that. In fact, the Lancet Commission we did was, 2 years over during the period of COVID. And, really, what we are looking to do, one of the key recommendations, which most countries have picked up on, when we've launched this across Africa is, you know, we really have to invest in this telehealth, and and information and communication technologies. And now there are many countries that are looking at launching satellites, to increase the penetration and stuff like that. But what we really thought was if you can have that, you know, as we have this call to action to invest in telehealth, if you don't have a cancer center that's in the cloud, then basically, you know, patients can access that from anywhere in the world.

It's a it's kind of a vision, but in reality, we've actually had some really good results on that, beginning in the United States itself. So you talk about, doctor Omo mentioned about hops. So, you know, think think about putting a health care kiosk or a hop in a church, or in a religious, it could be in, in a mosque. Right? So we know how much if you talk about last mile, you know, you know how much, you know, we can do all the wonderful science that we have in, at the top top cancer centers or or universities in the world about cancer or the best discoveries. But if they don't get to patients, they don't go that one last mile into the patients, to reach patients, then it doesn't mean anything. Give an example. So if you come up with a COVID vaccine, but, you know, it doesn't get to the patient, you know, then, it's almost like you wasted the money. Right?

So but if you go to, if you can create those kiosk or hops in churches, what that opportunity provides is that, you know, patients who are skeptical or who may otherwise, due to transportation barriers, economic barriers, cultural barriers, may get screened, you know, right there, and the information can be uploaded online.

They can see a doctor directly when they leave church. Really kind of bring holistic health care into, into those settings, into communities. So instead of waiting for the patients to come and present, sometimes already with late disease, as we know, it's very common for minorities, including African Americans in the US and Latinos. By the time they present, it's late. So instead of waiting for them to come to the clinics, you basically take the clinics to their communities. And, every community basically has their majors. Most communities, I would say, have a church or or mosque. And so working with these leaders who also have a lot of influence, on whether there's adoption of the new interventions, becomes really important. So in 2,021,018, you know, we got this funding from the IBM, $500,000 to kind of set up these, contact center in the cloud initiative.

And, it's been very successful in, you know, being able to provide that kind of, access. Now we just need to secure that, and I think that's part of the reason why we're looking at partnerships with organizations in Africa like Europe, like, because I think there there's some really great opportunities there. And lastly, I just wanna mention that, you know, the importance of artificial intelligence with that. So I think, you know, the future right now is a world with artificial intelligence. It creates a tremendous opportunity where, you know, people can really have more higher quality care. I mean, they know it as long as we have their appropriate regulations, in place for that.

But, I think that that's the another place where as we invest in telehealth, can really leapfrog is by investing in leveraging AI into this. So the comprehensive customer center in the cloud integrates that as well. So you can do remote treatment planning, remote monitoring, econsultation. You can do follow-up. You know, you can, send send evidence based cancer prevention messages, you know, things like that. So that that is the kind of vision that we

have. Alright. Alright. Fantastic. Work being done in the comp the comprehensive cancer center in the cloud is a very robust, center, and I think this is a call to all innovators here. If you're working in cancer technologies, if you're working in dig in the digital oncology space, it will be important that you, plug into the comprehensive cancer center in the cloud. So I have I actually have 2 questions here from our audience, and I'll just quickly go over to that. So the first question I have here is, from an anonymous person. And the person asks, does patient experience have a role to play in cancer care and how? So Yep. I'm sure this is open to any of you to answer.

Maybe, Omo, you go first. Send it now.

Okay. So so I'll leave it to you, doctor.

Okay. So absolutely, if you build a product or service without the patient's, the patient's contribution, then that product is likely to fail. And from our experience at OncoPaddy, we we started off as rookies building products without, understanding what the patient wanted, what their experience was like, and what they really wanted to improve along the cancer continuum. So there are several problems that patients experience as they access treatment, you know, as they go back home. And whilst they are, say, for example, 10 problems, 1 or 2 of them are present. So it's important that whatever you are doing, you pull in the patients, the users, the end users of your product or service, and you understand their journey, the patient's journey from the beginning to the end. And you can do this, you know, through some of these focus group discussions, talk to the direct end users, and then identify the secondary end users who sometimes are like the caregivers, the family and relatives of the patients.

You know? Extensively, it's almost like the Pareto principle. Like, you have to spend 20% of your time planning and understanding the entire, thing. So patient experience is absolutely important.

Okay. Alright. Doctor Wu, would you like to add something to that? No.

Actually, that's that's where I

said. Alright. And so the next question here is, how can African innovators plug into so I think, doctor Will, this question would really be most useful to you. The question here says, how can African innovators plug into data and AI? Yeah.

That's a good question. Yeah. How can we do that? I think, like, the Lancet Commission caught investing in telehealth. That that that government really need to make create up to those pathways, you know, to be able to pluck into this. The the they really need to create that enabling environment. You know, what do I mean by that? So I think, you know, as we we we, experience AI currently, and we still see when we're looking at telehealth in Africa that there's a lot of gaps in terms of, 1, the regulatory landscape. You know? You know, in the US and Europe, you know, that's already well established, Good and bad. I mean, they are good sites in the sense that in Africa right now, there's a great opportunity to because there are no rules and no rigorous rules, about data sharing.

I mean, peep most people don't really care as long as when they're accessing health, whether you share their data, or not. We have to make those protections put those protections in place. But, but right now, there's actually an opportunity where, you know, you know, that we can really make sure that the governments, come in and invest into, you know, creating the data chip cloud platforms that, you know, can accommodate this data in a safe way, in an ethical way.

And I think that, TrackGPT, or AI in the sense has come up, has highlighted a big opportunity here where we can really tap in. Everybody has access to it. And what that does is, you know, one way people can tap into that, it can basically, I think one easy way this is one way that we actually, started developing with the IBM was really where you know, because of the access to evidence based cancer information that, AI has. You can basically create these, you know, I think you can have a mobile phone or or or tablet where, you know, the the AI can recommend to you, the doctors. I know one of the things you mentioned at the beginning, doctor was the idea that, the fact that, there are not a lot of oncologists, you know, in different different places in Africa or in communities in Nigeria. You know? Some of those states do not have clinical oncologists. But what can happen is you can have AI essentially make recommendations. And so, you know, what what we're developing in the past was basically if I put in the symptoms of a patient, you know, basically, the AI can be able to read through all the clinical trials or the evidence base or the protocols and can be able to say, okay.

Based on these patients' symptoms or data or diagnostic report, here are the recommendations, that you can make, for treatment. You know? Green, red, yellow. I mean, give you 3 suggestions, and you, the doctor, has to finally make the final decision. But, but he gives you the second opinion, essentially, because sometimes you're by yourself. You are the doctor yourself in the clinic, and you're wondering, is this actually right? What am I prescribing? Is it correct? You know? But the AI can give you that if, support, second opinion. So I think that that's one area where it will be very useful. Now there's the the dangers, the misinformation, and then it thinks that because AI only reads what's on the Internet.

So we have to be very careful about what, you know, it fits, you know, fits us. So sometimes there may be there may be need for you know, that's why I meant the regulations. We need to be able to regulate some of the, on how this is used. But, there are tremendous opportunities now for people to use AI.

Alright. Thank you so much.

Can I chime in?

Oh, yes. You can add. Okay.

So and I think the very fantastic point made by professor Will. The last 6 months, I felt overwhelmed by how AI is flourishing in health care. And if you're an innovator, you have to be alert to the trends. And in my mind, I'm like, okay. We're still trying to get this side of things right, and now we have to sort of pay attention to AI so that you don't go extinct. And I'm like, okay. Like, I might as a doctor and oncologist in digital health, must I know how to, you know, code? What exactly do I want to use AI along the patient continuum. But to make myself feel comfortable and, you know, come out of the overwhelm, some of the strategies I'm adopting, and I hope it'll be useful to some people is 1, following a few thought leaders in the AI health space.

Identify a few of them, look at their content, and it's it's just like when you read from them, you get knowledgeable, and you can apply it to your local setting. The second thing is to join some very ethical AI health care groups, probably academic institutions, you know, who are focused on research. And that way, to Will's point on ethics, you won't flout the ropes. And, I would say the third thing is around, you know, going for a cost. AI in health care, there are quite a lot of them right now on Coursera, Udemy that are quite affordable. The pricey ones are provided by the Ivy League Schools abroad. You know? And that that's where I am at. Like, we have to learn how to use AI. Otherwise, we will go, you know, become extinct. But at the same time, we mustn't be overwhelmed by by AI. Thank you.

Thank you so much, doctor Will. Thank you so much, doctor Salako. So we're coming gradually to the close of our session, and I want you, my speakers, to leave my audience with one key takeaway from this session. What would you leave my audience with in 1 minute?

August.

Okay. So I would say, that I'll talk about the OncoPaddy app, which is a friendly cancer app for cancer patients and their caregivers. We understand that, when faced with cancer, you have to make a lot of decisions, and we've developed the OncoPaddy app to guide and navigate anyone dealing with cancer. On the app, you can learn about cancer and how to cope, which is very important. We have articles. We have blogs. We have videos, which is like a cancer coaching program. Through the app, you can have your econsultation or telemedicine consultation if you need a second opinion from an oncologist or any cancer specialist. We have dietitians, nurses, oncologists on the app.

You also you know, if if you if you're on cancer treatment, radiotherapy, chemotherapy, you can report your side effects on this app so that, doctors at our back end can, you know, identify if you're having mild moderate CVN. They can provide you with clinical advice. So if you know anyone dealing with cancer,

I just reiterate the Lancet Commission call to action, invest in telehealth, which is really that governments. If you are government or you are industry or you are in a space where, you have the potential to invest into this, This is something that we should invest in. It's the future. You know, there's gonna be a major return on that investment. And and for for, for for for doctors, you know, the key message would be that, you know, you really need to do what, doctor Salako has mentioned, which is that you need to learn about AI and I mean, using our information and communication technologies. I mean, you know, tele COVID 19 taught us that, you know, you have to do it. If you don't, in the US, most doctors were hesitant about adopting technology, had to migrate to that. Now with, you know, with Chargept, it's even gonna be worse.

You're gonna be extinct, like she said, if you don't learn. So, that's that's the key message.

Alright. Thank you all so much. Thank you, my amazing speakers, and thank you all for staying with us to the end of this insightful, engaging, and really practical session. Please describe to us, with an emoji using a Slido link, how you feel about the session and what you've learned from this session. And, of course, if you know anyone who is dealing with cancer or you're caring for a cancer patient, you can create a free account on ww.onco Patty.com, or you can connect with us and the email. Follow us on socials on on, all our social media platforms at Onco Patty app. And if you'd like to support the work we do, you can send us an email. Thank you all so much for your time. Until we meet again, it's been a wonderful, wonderful session having you all, and thank you to my amazing speakers. Bye bye from me.