Pathology services are critical across the continuum of care, from cancer screening and primary diagnosis, to clinical trial design and implementation of public health initiatives. In 2011, building on the existing infrastructure (through the UNC Project-Malawi and the Institute for Global Health and Infectious Disease) we developed anatomic pathology services to support the Kamuzu Central Hospital (KCH) Lymphoma Study. Diagnoses are generated by a Malawian pathologists using conventional microscopy and a basic panel of immunohistochemical stains. Weekly telepathology conferences provide diagnostic support and maximize communication between the clinical and diagnostic teams. Interactions with clinical teams maximized information exchange, identified needs and resource gaps, and provided a platform to address identified issues.
The KCH Lymphoma study has become a unique resource in cancer, supporting AIDS Malignancy Consortium and NIH/NCI-funded clinical trials. The system is a model for scale-up of diagnostic capacity in the region.
We further plan on expanding this work through the development of the UNC-Malawi-South Africa Cancer Consortium (UMSACC), that will develop regional pathology infrastructure and build capacity for cancer care.