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EF: Elekta has over 50 years of presence, could you elaborate on the footprint that you have in Africa?
CS: Founded over half a century ago by Professor Lars Leksell, Elekta, a Swedish company, has nurtured a culture of innovation throughout its entire organizational fabric. Our history is marked by game-changing ideas, predominantly geared towards the radiation therapy market. Our journey began with the introduction of Leksell Gamma Knife® radiosurgery, which marked the inception of numerous groundbreaking technologies that have redefined the field of radiotherapy such as CBCT, Monte Carlo Based Treatment Planning systems, image guided-brachytherapy, new multileaf collimator (MLC) design with Agility, Oncology Informatics, new versions of Gamma Knife systems and all other software solutions regarding analytics, remote planning and contouring capabilities and personalized treatment solutions.
Our global reach encompasses radiotherapy devices distributed throughout the African continent, spanning from North Africa to West Africa to Sub-Saharan Africa and down to South Africa. Notably, in Morocco, South Africa, and Egypt, we have achieved modularization within our installed device base. Elekta solutions have been available in Africa for almost three decades and we maintain a widespread presence across the continent with multiple installed bases in various countries.
We have access in most African countries, either through our partner organizations or the Elekta team. Furthermore, in alignment with the International Atomic Energy Agency, we have been improving access to radiation therapy globally for many decades. Radiation therapy supports the UN’s Sustainable Development Goals regarding non-communicable diseases and the campaign to eliminate cervical cancer. As part of our ongoing growth, we're on the verge of introducing pioneering radiation therapy devices in several countries, including Niger, Malawi, and Burundi. These projects are actively progressing.
EF: I noticed you recently released your annual report, and I was curious to see what Africa's contribution to the organization was. I am aware of your significant growth in terms of access as well.
CS: Elekta's ACCESS 2025 strategy is underway with a pronounced focus on the African continent. In the past fiscal year, Africa has seen double-digit growth compared to the previous year, reflecting our dedication to expanding access, particularly in underserved regions. Our primary objective is to provide effective solutions and comprehensive coverage in countries with limited access. This is facilitated through our extensive distributor network and business partners across 95% of the countries where we operate.
Our investments extend to training medical physics and radiation oncology professionals, both within our business partners and on the client side's clinical teams. Beyond financial resources, addressing the shortage of human capital is paramount for effective implementation. The significance of skilled personnel becomes evident when considering a scenario where machines exceed capacity due to human resource constraints.
Collaboration with key opinion leaders within Africa and globally is crucial to building and upskilling human capital. In addition to the training provided by Elekta’s application specialists, we offer knowledge-sharing programs from clinicians to clinicians or physicists to physicists that go beyond traditional training.
Elekta's collaborative efforts span Ministries of Health, government bodies, NGOs, and various stakeholders across business, private and public sectors. Our philanthropic arm, the Elekta Foundation (elektafoundation.com), plays a key role in developing awareness as well as prevention and treatment initiatives.
Software solutions, like remote contouring and treatment planning, offer collaborative capabilities that transcend geographical constraints. Our legacy of 50+ years enables Elekta to deliver tried-and-true solutions in cancer and radiation therapies. During this time, we have also built up expertise and capacity within spare parts, maintenance, and service support, ensuring the seamless operation of machinery vital for cancer treatment.
EF: Could you elaborate more on your ACCESS 2025 initiative?
With our strategy, ACCESS 2025, we are aiming “towards a world where everyone has access to the best cancer care.”
Specifically, we are focusing on the following areas:
• Availability of care: improving the physical access to radiotherapy globally
• Elevation of care: improving the quality of the care available
• Participation in care: improving patient involvement in their own care journey
According to the World Health Organization (WHO), More than 50% of cancer patients require radiotherapy as part of cancer care and it is frequently used to treat the most common types, such as breast, cervical, colorectal, and lung cancer. Paradoxically, only 10% of the world's population has access to 95% of available radiation equipment, indicating a lack of resources. Studies project that 5.7 million cancer patients globally will need radiotherapy by 2030, indicating an increasing demand for radiation therapy devices.
In my role as the regional head for the Middle East, Africa, and Türkiye, our efforts encompass establishing reference and training centers in North Africa and South Africa and expanding this approach to other parts of African countries. We utilize diverse training facilities to deliver both physical and virtual instruction. Collaborations with radiation oncology and medical physics societies enable remote training through cloud-based system infrastructure, enabling on-the-job training for users worldwide.
Our approach transcends Elekta's interaction with medical professionals, fostering connections among clinicians themselves. By harnessing the full potential of our systems, practitioners exchange knowledge, cases, and experiences across Africa.
While training centers and references are essential, we also offer customized training packages to address unique needs. This flexibility extends to customers acquiring our medical and auditory equipment. Tailored training programs cater to clinicians in various African countries, aligning with our mission to provide comprehensive support.
EF: You mentioned that you are bringing a great deal of software innovation. What do you think about local stakeholders' understanding of and willingness to use digital solutions in Africa?
CS: Regarding software solutions, our portfolio offers diverse options, including a remote treatment planning and contouring solution benefiting doctors and medical physicists. This solution supplements local efforts with external support. Our commitment extends to empowering Ministries of Health and public and private hospitals with tailored data management for oncology through comprehensive patient registration metrics. This pillar receives paramount attention due to its significance. Our digital health solution further enhances care, featuring intelligent symptom tracking and patient-reported outcome monitoring, fostering real-time collaboration among doctors, patients, and medical physicists.
Elekta collaborates closely with customers, those who use our solutions, to develop them according to their needs. Our example of this approach is our pioneering linear accelerator, called Elekta Harmony, designed to meet Africa's multifaceted demands. This flexible solution addresses various treatment approaches intelligently and effectively, catering to the region's specific requirements. As we acknowledge the prevalence of cobalt machines with limited bunker space, Harmony's footprint eliminates the need for extensive rebuilding efforts. Our strategic approach encompasses innovative techniques tailored to Africa's unique requirements, reinforcing the value of these advancements in cancer treatments.
We are committed to advancing brachytherapy, a vital treatment for women with cervical cancer, which accounts for 10% of annual cancer diagnoses in Africa. To address this, we are actively expanding brachytherapy availability, aiming to bridge the current 38% coverage gap across the continent. Anticipating substantial needs by 2030, we project a demand for approximately 200 additional brachytherapy machines to supplement the existing capacity.
Elekta's legacy dates back to 1972 with Leksell Gamma Knife. It has continued to evolve to address current demands in radiosurgery primarily for brain tumors. Today, Elekta Unity MR-Linac is our flagship device. The device integrates a state-of-the-art radiotherapy system and a high-field MRI scanner with sophisticated software that allows a physician to clearly see the patient’s anatomy in real-time. What distinguishes Unity from traditional linear accelerators (linacs) is that can improve targeting of tumor tissue while reducing exposure of normal tissue to radiation beams. It allows physicians to precisely locate a tumor, as well as lock onto it during delivery, even when tumor tissue is moving during treatment or changes shape, location, or size between treatment sessions. With unparalleled visualization and precision, Elekta has pushed the boundaries of what is possible. Unity systems have already been installed and are treating patients in Africa.
When considering radiotherapy's future, software solutions, enhanced imaging, tumor tracking, improved treatment methods, and hypofractionation will be crucial. We have dedicated ourselves to ensuring that the needs of cancer patients in Africa are being met and will continue to be met with future innovations.
EF: Please share any knowledge or data you may have with us if it relates to Africa.
CS: By 2030, Africa is projected to witness a rise in annual cancer cases from 1.2 million to 1.5 million, reflecting a 4% increase in cancer incidence over five years. This growth surpasses the global average, which is lower due to improved diagnostic capabilities. Our focus resides within the treatment facet of the comprehensive oncology framework.
In the current landscape, Africa has 400 linear accelerators to serve its population of 1.5 billion. The World Health Organization advocates for a minimum of one linear accelerator per one million people. This suggests a requirement of 1,500 machines for a population of 1.5 billion. However, the existing count of 400 machines underscores a significant disparity, limiting accessibility. Some patients who can afford it seek treatment abroad, while others, unfortunately, lack access to essential cancer therapies.
Brachytherapy's significance is evident especially in cervical cancer cases, constituting 10% of all instances in Africa. The impending demand for brachytherapy machines to serve an estimated 130,000 individuals underscores the need for proactive measures. Our foremost aim for 2025 is expansive access, commencing with comprehensive education and training coverage, forming the foundation for subsequent financial options.
The struggle against cervical cancer and other cancers common to people in Africa is monumental but not insurmountable. Collaborations with the International Atomic Energy Agency augment our efforts, as their initiatives and programs bolster the proliferation of radiotherapy solutions in Africa. These partnerships also expand our reach. I've witnessed the profound impact of these initiatives.
EF: What do you think, from an Elekta standpoint, about the role of AI in healthcare?
CS: The significance of artificial intelligence (AI) is underscored by its growing prevalence across diverse sectors, notably within healthcare. Elekta is a software leader, investing significantly in advanced solutions to enhance treatment methodologies, precise tumor tracking, real-time navigation, and improved visualization. These research and development pursuits are paramount to elevating patient care, directly impacting lives, and notably enhancing survival rates, particularly in Africa.
Elekta is pursuing dozens of AI initiatives, independently and together with research partners around the world. A stellar example of existing technology is our IntelliMax®. Elekta IntelliMax services are built around real-time data monitoring, remote access and screen sharing. Harnessing artificial intelligence for predictive service allows us to anticipate issues before they even occur and, in many cases, resolve them remotely. As a result, the treatment system can achieve the highest uptime possible and thereby ensure that patients can receive their treatments as planned without disruption.
AI also is a part of our newer family of linear accelerators allowing automation and validation in certain workflows to drive faster and better treatment outcomes.
EF: What will you say to your staff and the headquarters in 2025 when you are celebrating your fifth year in your position?
CS: Fulfilling our ACCESS 2025 strategy promises a momentous celebration. Upon achieving this milestone, I anticipate a celebratory occasion. Elekta's multifaceted departments, spanning project management, commercial, education and training, and service provision, will converge to ensure accessible care for patients.
Elekta remains committed to fostering partnerships, driving innovation, being the customer's lifetime companion and driving adoption, particularly in Africa, through ACCESS 2025. Our collaborative efforts encompass diverse stakeholders, including market participants, NGOs, business investors, and industry leaders. To uphold our role as a lifelong companion to all our customers, Elekta is dedicated to delivering exceptional services to our clients and partners worldwide. Our objective is to facilitate widespread adoption, not only within Africa but also across the global landscape.
By addressing the pronounced shortage of medical devices in the market, we are resolute in bridging this gap. Our focus is centered on empowering countries to provide essential patient care within their borders, thereby reducing reliance on external sources.
Central to Elekta's mission is our dedication to radiotherapy. We are actively concentrating on emerging markets across various regions, with Africa occupying a prominent place in our strategic priorities.
