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The pale blue walls of the day care unit in Korle Bu Teaching Hospital are covered in art: one work shows two kids, one of whom is holding onto the Nyame Biribi Wo Soro Adinkra symbol, which translates to “God, there is something in the heavens.” Below the artwork, young patients lay in rows of beds with their families beside them. A cartoon plays on a small TV hanging above while a nurse comes around, replacing IV liquid bags.
“He said he wants to be an engineer in the future,” says Zeinat Hussein with a slight chuckle. She is the mom of 11 year old Anwar Alhassan. They have been at Korle Bu l in Accra, Ghana, for the past ten months for Anwar’s Leukemia cancer treatment. “I pray he’ll become one.”
The family has come from Tema, about a 45-minute drive from the capital, but others travel longer distances, even coming from nearby countries like Nigeria and Togo. The hospital is where most people who require specialized care are referred in Ghana, and it is the third largest hospital in Africa.
Ghanaians face significant financial and psychological strain due to stigmas associated with reaching out to community members about cancer diagnoses. Because of spiritual interpretations of cancer as an evil disease, the community faces difficulty when trying to talk to friends and family about a diagnosis.
With environmental risk factors and rising life expectancies, cancer is only expected to become more prevalent in Ghanaian society. However, this also means that common stigmas might decrease with more awareness, explained Yaw Bediako, who holds a doctorate in Microbiology and Immunology from Northwestern University.
“So what makes the headlines is Ebola,” says Bediako. “However, hidden beneath all of the noise about infectious disease in Africa, is a rapidly growing epidemic of cancer. So already in Africa, cancer is responsible for over a million new cases and about 700,000 deaths.”.
Africa’s health systems do not have the capacity to deal with cancer, explains Bediako. “Our health systems are largely derived from our colonial past, which focus heavily on tropical medicine.”
For cancer diagnoses, Korle Bu mainly focuses on pathology testing, where blood, urine, and tissue samples are interpreted to determine treatment. “It’s just the more recent types of molecular diagnostics, cytogenetics, those things we cannot do here,” says Dr. Lorna Renner. The hospital does not have as much access to precision medicine, which can be expensive but is most helpful when treatments are time sensitive.
“I lost my dad to cancer,” says Yaw Bediako. “So I have a personal beef with cancer.” He is the co-founder and CEO of Yemaachi Biotech, a 2020 private US startup based in Ghana that presents itself as “Africa’s Cancer Research Company.”
With most of the team also having their own connection to cancer, Yemaachi is determined to improve precision medicine by building a comprehensive knowledge base focused on the African genome – something that has not been done before.
“There is very little research done on anybody who’s not white,” says Bediako, noting that only 2% of globally available genomic data comes from African populations. Due to this lack of information, he estimates that some precision medicine may be four to five times less effective in Black populations, compared to white ones.
With the African population being the most genetically diverse in the world, Yemaachi would not only help Africans like patients at Korle Bu Teaching Hospital, but would create a foundation for effective global drug discovery while narrowing the disparity gap.
The idea behind Yemaachi came from the urge to see real and faster results compared to relying only on academic research. “If you don’t move, you die, right?” says Bediako.
“Obviously, it’s a long road to drug discovery, and unfortunately, some of the participants in some of our studies have passed away,” says Aida Manu, the Director of Operations and Regulatory Affairs at Yemaachi.
She talked about a recently published breast cancer study which noted that up to 70% of breast cancer diagnoses in Ghanaian women are advanced-stage. The study, sponsored by Yemaachi Biotech and Lucence Health, found that liquid biopsy, which detects cancer cells or DNA in blood, identified genetic variants in Ghanaian women with breast cancer. When only tissue analysis was conducted, the variants were missed.
Yemaachi Biotech works with eight African countries, and have developed an ethical standard to gather samples and run sequencing in their private lab. But whether it be tissue and blood samples or online information, there is a need to keep data safe, as Manu explains.
And as co-founder and chief technology officer David Hutchful explains, there are some working in computational biology trying to identify interesting variants, as well as a software development team that builds tools to enable clinical partners to organize collected data.
Yemaachi’s lab was built from what used to be an office for a shipping company. In other words, basically everything — lights, floors, biosafety cabinets, machinery – was installed specifically for Yemaachi’s research.
The company started off using typical home freezers for some samples, before obtaining ultra-low temperature scientific models. However, Manu notes some logistical constraints, saying, “It could be $800 for something little and a couple more thousand dollars just to ship.” She says it can be more expensive to build a lab in Ghana compared to other places closer to manufacturers or with established supply chains.
With challenges in price of shipment and the occasional blackout caused by tropical rain, the company needs multiple backup power sources and voltage regulators to avoid destroying machines and the samples inside.
During a tour of the lab, Manu points out their digital droplet PCR technology and full genome sequencing machine, which are sparse across the continent.
But while they may face limited access to domestic scientific resources, their sequencing contribution to national and world databases allows them to appeal to foreign venture capital. They have had some success raising funds for operations and are currently working on a deal with a global pharmaceutical company.
Bediako, the CEO of Yemaachi, believes that money invested into capacity building can build the industry in Africa. But he remains frustrated at the focus on academic research over industry and infrastructure in sub-Saharan Africa. He says that when people have difficulty finding jobs after training, many leave for Europe or North America.
Many Ghanaians cite unemployment, record inflation, and difficulty accessing health services as reasons to seek opportunities elsewhere.
One parent at Korle Bu Teaching Hospital says the family paid roughly 7,000 Ghanaian Cedis (about $615 USD) for their 14 year old’s weekly lymphoma medication treatment. While an engineering company that employs one parent helps pay for treatment, some pay with the National Health Insurance – though not all cancers are covered by public health insurance – and some look for sponsors. While cancer treatment in Ghana is more affordable relative to other countries, it is still out of reach for many.
Bediako emphasized the importance of improving equity, but at the same time the need for profit at Yemaachi. He mentions the subsidized HPV Sheba test created by the company, which might still be expensive for the average Ghanaian, but costs about $35.
Closing an equity and racial gap in cancer research is not easy, says Bediako — in fact, the gap has expanded over the past 30 years since the first genome studies began.
But Yemaachi’s research will attempt to bridge more than just a 30-year gap. Because of Africa’s colonial past, there is also the point that African genome studies would benefit global Black populations, like African Americans, as well.
Many of the Yemaachi team members studied at universities in the United States, and Bediako notes how nearly every cancer has poorer outcomes in people of African descent in the U.S. than others, saying, “The work we are doing to try to understand that cannot necessarily solve some of the institutional problems, but it can certainly help solve the scientific gaps.”
Black women have a 40% higher breast cancer mortality rate than white women. Black men have twice the mortality rate from prostate cancer as white men. On this subject, Bediako could go on and on, as he believes that people are not getting adequate diagnosis or care, “Whether it is socioeconomic status that leads to increased rates of obesity among certain populations or whether it is structural institutional racism.”
The biology behind cancer in Black people is not well understood, but because of this, the company can use this fact as a value proposition for U.S. pharmaceutical companies. “You have a whole population who are underserved by the research you are doing,” Bediako says. “And by the drugs you are providing.”
Bediako likes what he calls a kind of poetry behind working for the brothers and sisters descended from Africa, but also the prospect of redefining a continent that has been taken advantage of and cheated throughout history. Africa is not a charity case, Bediako believes, but one with a global contribution beyond the extraction of natural resources.
“We’re trying to build a real Wakanda,” says Bediako, referring to the fictional African scientific superpower in the popular Black Panther films. Yemaachi is only a small piece of that, but he wants everyone to know about it, from those in Accra to a woman in rural America.