Pathology in Favour of Developing Countries:

 

Introduction:

The Italian NGO "Associazione Patologi Oltre Frontiera" (APOF, "Pathologists Beyond Borders Association") proposed the creation of the Working Group (WG) "Pathology in Favour of Developing Countries" in 2010, with the goal of creating projects in developing countries that focus on anatomic pathology and fostering local preventive medicine initiatives.

The APOF planned a special session for the European Congress of Pathology in Florence, Italy, the year before to present and discuss issues pertaining to the management of surgical pathology in low-resource settings. After that, the ESP made the decision to carry on and build on this experience through a working group (WG) devoted solely to these subjects.

Research topic:

·        After 2015, the African Association for Research and Training in Cancer (AORTIC), a significant organisation founded in 1983 by African cancer care specialists working abroad, joined APOF as a permanent partner of the organisation. The AORTIC's mission is to support cancer control in Africa.

·        The major objective of this working group is to provide space for colleagues from developing nations, allow them the chance to share their professional expertise and academic research, and include European pathologists in the creation of health cooperation programmes focused on anatomic pathology. This is being done to maintain and broaden the synergy among pathologists from various regions of the world who each provide unique information.

·        While many developing nations struggle to offer even the most basic pathology services, our ability to fine-tune diagnoses, and the personalization of medicine, will inevitably lead to an increase in the technological sophistication of our pathology laboratories, causing this health care gap to widen even further. Many pathologists and medical specialists have been motivated by this to try to close the gap.

·        In addition to many other industrialised nations, the US, Canada, and other countries have a number of significant such projects. However, because local conditions are typically complicated, efforts to address them may run into problems on a range of fronts, from the educational and cultural to the political and economic.



·        For pathologists, who are highly trained to conduct intricate assessments on issues relating to a specific patient, a disease, or pathobiologic occurrences, this may be very intimidating. Our education does not adequately educate us to deal with the social problems that the emerging world faces.

·        Pathologists and even doctors face these difficulties on a regular basis. Both the theoretical and practical components of help have long caused the developed world to struggle, and significant effort has been invested in this area.

·        Some contend that there is not much evidence to support the $2.3 trillion that is estimated to have been spent on various aid initiatives over the past five decades in Africa alone. 1 Others contend that the effort has simply not been large enough, and that if rich nations invest sufficiently, inequality and poverty will eventually be abolished because the issues mainly revolve around a "poverty trap," whereby poor countries stay poor because they are poor.

·        Economists have devoted a lot of time to examining a vast amount of economic data in an effort to determine if foreign aid benefits, hinders, or has no impact on economies. These economists may be employed by academic institutions or by various international organisations.

·        There is disagreement on whether a "major push"—a massive, centrally planned effort—is necessary or whether creative individuals "on the ground"—what Easterly1 likes to refer to as "Searchers"—will inevitably find the solution for developing nations. Microcredit, a notion that Muhammad Yunus, the 2006 Nobel Peace Prize winner, presented, is an illustration of the latter.

·        Not getting involved in this argument is not our goal. However, it is advisable for any pathologist who wishes to participate in underdeveloped nations to become acquainted with the problems.

·        The philosophical tenets are more than only theoretically important; they also give one a framework within which they would like to make a contribution and assist in understanding how their efforts can fit into a bigger picture of assistance.

·        We have adopted the viewpoint in our own work that the most beneficial contribution a Western-trained pathologist can make in a low-resource environment—which yet will always have its own particular strengths—is to react to local needs through teaching, training, and collegial support.

Conclusion:

Pathologists, in particular, are in severe demand in the majority of developing countries. Despite the fact that there are typically 14 to 40 pathologists per million people in North America and Europe, many poor nations only have a small fraction of this, ranging from zero to low single digits. For instance, Tanzania's 38 million inhabitants are served by 15 pathologists, whereas Uganda's 28 million residents are served by 18 active pathologists. Structured programmes are hard to come by and have a significant degree of variability in training. Due to costs, training sessions are typically brief. Conversely, trainees who are lucky enough to travel overseas and enrol in courses at Western universities may find it challenging to put their new talents to use when they get back home. This, together with economic incentives and employment market realities, contributes to an excessively high rate of "brain drain" from developing to developed nations, as Western nations have historically relied largely on physicians with foreign training to meet their own labour needs. Aside from the direct emigration, there is also an indirect impact when nations with a high level of training, like South Africa, lose their qualified staff to the West.

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