Advancing childhood cancer care in Ghana

Dr. Emmanuella Amoako, a pediatric oncologist at Cape Coast Teaching Hospital in Ghana, is the winner of the 2026 Roux Prize. We talk with her about how she has used evidence to improve early diagnosis, expand access to treatment, and strengthen locally led cancer research, including a shared-care service that brings treatment closer to families and a program that trains parents to help detect childhood cancer early. Learn more about Dr. Amoako's work: https://www.healthdata.org/news-events/newsroom/videos/roux-prize-2026-recipient-dr-emmanuella-amoako

Nominations for the 2027 Roux Prize are open on November 1: https://www.healthdata.org/about/awards/roux-prize

__________________ Transcript

Rhonda Stewart: Welcome to Global Health Insights, a podcast from IHME, the Institute for Health Metrics and Evaluation. I’m Rhonda Stewart.

In this episode, we’ll hear from Dr. Emmanuella Amoako, winner of the 2026 Roux Prize. Known affectionately to her patients as Dr. Ella, she’s a pediatric oncologist advancing childhood cancer care in Ghana.

The Roux Prize, supported by David and Barbara Roux and awarded by IHME, recognizes a person who has used health evidence in bold ways to make people healthier and includes a $100,000 award.

Childhood cancer survival exceeds 80% in many high-income countries, compared with less than 30% in many African settings. As lead pediatric oncologist at Cape Coast Teaching Hospital, Dr. Amoako established a shared care pediatric oncology service in 2019, bringing treatment closer to families who had traveled up to nine hours to reach specialist care. The service has since cared for more than 150 children.

Dr. Amoako also developed COMPASS, a community program that trains parents of childhood cancer survivors and primary care workers to recognize warning signs and guide families to specialized care. And through the African Cancer Atlas, she is helping build evidence that better represents African patients in cancer research.

Thank you so much for joining us. Dr. Amoako. What drew you to pediatric oncology? Was there a particular moment or a particular patient that made you decide this was your life’s work?

Dr. Emmanuela Amoako: Thank you very much for having me. Pediatric oncology, I always – whenever I’m asked this question, I always laugh because it was like the last thing on my list when I became a pediatrician. I always used to think I would do something related to maybe procedures or just genetics. I always wanted to do genetics.

And then I quite remember as a resident rotating through the pediatric oncology rotation, I sat once with a senior colleague of mine, Dr. Nihad Salifu, and she was asking me like what my future plans were. And then I looked at her and I’m like well, it’s not going to be oncology. I want to do something I want, like genetics. And then she looked at me like very seriously and said yeah, if you do genetics, just like clinical genetics here in Ghana, what are you going to use it for? I’m like, well, I’ll make the diagnosis – like then what?

Then what? And I’m like okay, I do not know. And she’s like, well, cancer genetics is emerging. If you really want to do something in genetics, you should consider it. Go read on it and then let me know what your thoughts are. I mean the next obvious thing I said was, yeah, you just want me to do it because it has oncology in it, and she said, no, no, really, just go think about it.

So that sat with me for a bit. And then when I completed my residency and went back to the station where I was to practice as a general pediatrician – so I started in September 2019 and then in November 2019, this child comes in to us at the Cape Coast Teaching Hospital. So a 14-year-old boy, he had lymphoma – he was very sick, and he had one of the side effects that comes with that particular cancer, which is the cells break down quite quickly, we call it tumor lysis syndrome. When the cells break down, there’s this overload on the kidneys, so he was in acute kidney failure. He was very ill.

Now at the time in Cape Coast, what we always did was we would see the child and when we suspected cancer we referred to Accra. So just for context, Accra to Cape Coast is about a four-hour drive. And so we had to put this child in an ambulance to move to Accra. But I picked up the phone, I called the person who trained me in Accra and I called her, Prof. Lorna Renner. And I’m like, Prof., I have this child who is very sick. I need to move them. Do you have a bed? Do you have space?

And she just is like, Ella, from what you’re describing, you know this child is not going to be able to travel, right? I’m like, yeah, Prof., but I cannot do anything here in Cape Coast. She’s like, well, I trained you, so you can try. I can guide you from here.

And I’m like, Prof., I don’t think I want to get my hands dirty. And she’s like, well, I believe you can do something. It’s two things: He’s not going to make the trip. He would probably die before getting to care, so you need to do something.

And so thankfully, Cape Coast is very close like the, what do you call them? The units are very closely knit. So I call the dialysis unit. The were willing to hemodialyze the child. I called – at that time the service that was provided there was for adult cancer, so I called the pharmacist. They were able to prepare some chemo. And so we would give chemo, would dialyze. We would give some chemo, would dialyze. And he lived. He actually lived. Yeah.

And I remember when we were out of the woods, I called Prof. Renner. I’m like, Prof., I’m going to send him now his stable. She’s like, you’ve done the hard part. You can do whatever is left. I’m not taking this patient. Okay?

So I’m like, wow. Okay. So she sent the protocols. And it was not just me – there was a team that was there that was willing, and we worked with him, and it was quite timely, I must say.

So subsequently, every child that came that was not even very ill, she’s like, well, you can do it. I’m not gonna take this patient.

It was quite timely because then 2020 COVID hits, and mind you, Cape Coast serves three different regions and one of the farthest regions would be like nine hours from Accra, the center. And most of the patients came from there.

So then it was like, well, we would have to start treating children in Cape Coast. And so that piqued my interest in pediatric oncology, and I had to go and get formal training. So 2019, 2020, I didn’t have formal training in pediatric oncology but I was treating the patients, and then 2021 I had to go get formal training.

Rhonda Stewart: That’s incredible. So it sounds like your mentor really changed your career by pushing you to think about then what. So you were going to do genetics, but then what? And just to keep going.

Dr. Emmanuela Amoako: Yeah.

Rhonda Stewart: Then to give you the confidence, to push you, to say that you could treat this child locally, which then made it possible for you to treat other children locally. That’s incredible.

Dr. Emmanuela Amoako: Yeah. And I must say that it’s been amazing being in this field.

Rhonda Stewart: Wow, that’s fantastic. Let’s talk a little bit about the survival gap. In many high-income countries, more than 80% of children with cancer survive, but in many African settings, unfortunately, fewer than 30% do. What drives that gap, and what part of that gap can be closed by having better evidence?

Dr. Emmanuela Amoako: Yeah, sad, these statistics. I mean, I think it’s always daunting when you hear it and to think, actually, it’s quite interesting because 80% survive in high-income countries, less than 30% in low- and middle-income countries.

However, the burden of disease, 80% of the cases are actually found in low- and middle-income countries. And only 20% of those cases are found in high-income countries. So it’s quite a very weird balance. But yeah, there’s a lot of data evidence to suggest that people present late to clinical settings, people abandon treatment, there’s a lot of toxic death. And for me, most important is the kind of protocols that we used are all adapted from clinical trials that were conducted in people that were not or are not of African descent.

Rhonda Stewart: Right.

Dr. Emmanuela Amoako: I mean, it is well known that clinical trials really across the world have only about 2% of people of African descent. Not to talk about clinical trials in Africa, and then in children in Africa, which barely exist.

So again, if these clinical trials are not happening in a certain population, but then the protocols are adapted to them, would it really work? So then I’ve always asked the question, is it that we have more aggressive disease, or the protocols are just not working?

Again, when it comes to genetics and genomics, it’s not been fully studied in people of African descent. Only about 2% to 3% of the global genome data bank consists of people of African descent. So we really do not understand the genetic basis of the cancers that we do see in our children.

Rhonda Stewart: You mentioned Cape Coast with the example of your 14-year-old patient. And with respect to shared care at Cape Coast, before 2019, as you mentioned, families sometimes had to travel up to nine hours to reach specialists. Tell us how you designed that shared care service and what’s changed for the children who’ve been treated – and it’s more than 150 children at this point.

Dr. Emmanuela Amoako: Yeah. So again, that initial conversation with Prof. Renner, like, you know what, I would guide and you can treat, I’ll send you the protocols, I’ll make sure I guide you, was what gave the whole idea of the shared care center.

And so what we started with was to treat critically ill patients who could not make the journey. We could also treat, for lack of a better term, easy cancer. So there are some cancers where the protocols are not too toxic. And so we could provide that kind of treatment for the children there.

We did build up a very good referral network. So it’s sort of a hub-and-spoke model where the hub was the Korle Bu Teaching Hospital, which is the biggest referral center in Ghana. And then the spoke was the Cape Coast Teaching Hospital, which is a smaller teaching hospital in Ghana.

Korle Bu Teaching Hospital, of course, had all the members of the multiple discipline team. They did have all the tech and all the protocols, like we had all the specialists there. And so we made that link with good referrals, discussing cases, having MDTs [multidisciplinary teams], making sure that we referred on time. And very interestingly, some of the cases that were being treated at Korle Bu that were stable requested to start receiving their chemotherapy closer to home, which was Cape Coast.

So yeah, for me, that whole system brought families closer to home and it has reduced abandonment, something that we are working on publishing hopefully soon. But that model does reduce abandonment because imagine that you have to take a nine-hour drive for treatment and then you manage to go home for a break one time during your treatment. When you go home, you’re like, okay, I don’t think I want to go back to the hospital.

Because usually they didn’t. Sometimes during the treatment, the children look way better – they are fine. So parents are like, okay, I do not need to go back. And so all of that sort of increased abandonment.

But having a shared care model and having a center closer to home also made it easy for parents to have their children receive treatments closer to home. The other thing was that they did not have to drive back and forth in and out of the main center. They could just come to this shared care center and receive their treatment.

And again, this is quite interesting, most of the things that have happened around people. So we did have a mom who unfortunately lost her child to cancer. She lived in Cape Coast, and during her time, she had to make the journey in and out from Accra to Cape Coast or Cape Coast to Accra. And on her way back, after the child had received chemo, sometimes the child would vomit in the car. And when she lost her child, she walked into the ward one day and was like, why can we not do this here?

And I’m like, well, we’ve already started. And she’s like, okay, I want to be part of this. I want to have a purpose for this loss. I do not want parents to make the journey. So she started like a support system for the parents, shared her story with them. And yeah, I mean, all of that has been very interesting. Jane Williams, who lost her child to Wilms tumor.

Rhonda Stewart: Oh, that’s incredible. Out of something so terrible with the loss of a child,

that mother was able to do something to help support other parents in that situation. That’s fantastic.

Dr. Emmanuela Amoako: Yeah.

Rhonda Stewart: And let’s also talk about parents as navigators a little bit. So the COMPASS program trains parents of childhood cancer survivors to help other families spot warning signs and get through referrals. What do they bring that health workers can’t?

Dr. Emmanuela Amoako: Oh, yeah. As I said, I’ll always tell you a story around almost every question you ask. So COMPASS is community parents navigating early warning signs of childhood cancers. And it was born out of an idea that sort of came on a Christmas morning, I would say.

During Christmas, we almost always have Christmas parties for the survivors. And during this Christmas party, one of the mothers had approached me. One of the mothers whose child was well had approached me, and she was like, oh, Dr. Ella, I saw a child in my community who has what I think my son had. Can I send them to you? And I’m like, yeah, why not?

And then subsequently, she sends, I think, four children, or six – I don’t remember the exact number. But then all of them were actually diagnosed with cancers because she had seen symptoms of what her own child had. And so I’m like, oh, okay, if a mom who had gone through this can advocate for other parents, this could be a model that we could adapt. Number one, they had their story. They had a lived experience.

As health care workers, we try to tell the patients’ stories, but I find it more powerful when the patients tell their own stories. What if, especially given how stigmatizing childhood cancer still is in many communities in Ghana, what if parents who have children who had survived use their children as a medal of honor and share their stories, and then through that, are able to convince other parents to bring in their children to hospital, advise them that childhood cancer is actually curable when detected early?

And so that idea was born. I discussed with my mentor, I discussed with my colleague, Dr. Gloria Tagoe, who is always buying into my crazy ideas. And reports down this together and started working on it.

But then one thing that we quickly realized was that it wasn’t only the parents of survivors who wanted to be part of it. We had parents that had lost their children, who wanted purpose, who wanted to do something out of that loss. So a few of them reached out, like, even though I’ve lost my child,

what can I do to help?

So then the question was, okay, how do we tell other people that you’ve lost your child, but you still have faith that treatment works? Right? And so, I mean, I feel like when it’s coming from the one who has the lived experience, it’s a more powerful story, whether the child is dead or alive. As a health care worker, I could tell you that, yeah, even though this person died, we can cure. I think people will look at me like, yeah, you’re a doctor. You just want to see the children. When it comes from a parent who has lived that experience, it is more powerful.

And so with that, we were able to put together a grant. We also wanted to make it technology-facing and also didn’t want people to refer children directly to the treatment centers if it wasn’t confirmed. So COMPASS is like three-layered.

The first layer is the parent who goes out to advocate and hopefully have people see children and have people come to them to seek help. The next phase is like a primary health care center. So we train parents to be able to advocate and to be able to pick up early warning signs. But we also train primary health care workers to be able to triage: Is this cancer? Is this not cancer? Now when they see all of that, they are able to refer to the treatment center. So it’s three-layered, and with all of this, we have technology in between.

So I have a very good friend of mine who just likes building apps, and he came up with this excellent app that we work with. So the parents put in details of who they’ve seen with a phone number. And because the parent is the COMPASS, one parent might have like six primary health care facilities matched to them. So when they put in the referral, it goes to the nearest health care facility.

Now they receive that notification and then if in 24 hours they have not received any patient, they start making calls like, how can we get you here? And once they make the confirmation, the same is for how to refer to the major treatment centers. But one major challenge that we faced is, and I think we didn’t think of it very early on, is transportation, like how do we move them? Because people do not come because they do not have the money to even pick transportation to get to the centers. And so it’s something that we are working on, maybe looking for another grant to sort of buffer the transportation part.

Rhonda Stewart: There are so many different components to consider. Transportation is one part of it, as you said. You talked earlier about the fact that people of African ancestry make up a very small fraction of global cancer genomic datasets. Tell me a little bit about the African Cancer Atlas. How might that change things, and what might that mean for African children with cancer?

Dr. Emmanuela Amoako: Right, so currently the African Cancer Atlas is an initiative by Yemaachi Biotech, which is an African research company startup, actually headquartered in Ghana, fully African owned and if I remember quite well, started operations in 2020.

And what Yemaachi brings to the table is that Yemaachi wants to diversify precision oncology. And I do sort of work part time there as the director of clinical affairs, working together to make sure that research projects go on smoothly.

Now the African Cancer Atlas is aimed at diversifying the pool that exists. And so currently we are working with various partner facilities in Ghana, Nigeria, Côte d’Ivoire, Seychelles, Kenya. And what we are doing is recruiting participants into studies. We are taking blood, which would look at germline, and then we are taking tumor samples, which would look at somatic mutations, and trying to build this whole bio-databank of different cancers that exist for people of African ancestry.

And the goal, the hope, is that we find mutations that are sort of specific to people of African descent, maybe a founding mutation. I know that it’s going to be difficult because people of African ancestry are actually very genetically diverse. And their goal, actually, is not to find the cure just for the Africans, because that genome is so diverse. Finding, like unlocking the code to the African genome would unlock it for everybody.

I’ll take you back: Evolution started in Africa right there – Namibia, Ethiopia. I mean, there’s evidence to all of this. And so everybody sort of came from the motherland, and that’s why it’s called the motherland, right? And so the hope is that unlocking this would lead to finding new targets that are druggable, new targets for cancers among everybody, not just people of African descent, and for children.

Currently, the African Cancer Atlas does not include children, but subsequently, the hope is that we’ll be able to fund it to include children. And I think that when we are able to do this – I mean, the cancers that we see in African children definitely behave very differently from the cancers that we see in other people of other ancestries. And I would say this because I’ve worked on both sides. I’ve worked in Ghana, worked in South Africa, and currently working in Canada. And I see the difference with the kind of cancers that we see in these children.

Rhonda Stewart: And so you’re now a cancer genetics fellow at SickKids in Toronto. What skills or approaches or experience are you most eager to bring back to Ghana in terms of bringing really precision oncology and making it realistic there?

Dr. Emmanuela Amoako: Right. I didn’t know this until a few weeks ago that I’m actually working with a world superstar when it comes to cancer genetics, Dr. David Hawkins. So he came up with the whole surveillance protocols that survey people who have cancer predisposition syndromes. And I had no idea up until recently. So it’s quite humbling working under him and picking up all the skills and learning from him.

I think one of the things that I hope to pick up is how to even incorporate surveillance into our setting. Because for most cancers over here, genetic studies have become very straightforward. Like, almost every child gets their blood sequenced or their tumor sequenced, right? And then whenever anything is found, of course, they do move on to the next stage. So the goal is to learn all of that. And just earlier this week, I did have a chat with him to sort of discuss projects that we could link SickKids to the facilities back in Ghana to see how easy it would be to sort of sequence almost every child who comes through, which is a project that we started in Ghana a while back but ran out of funding.

So we’re looking at ways to sort of bring that back and fully understand exactly what happens genetically to the children who have cancers in Ghana and then hopefully expand. Of course, the goal is to definitely expand beyond Ghana to across Africa, because, as I mentioned, we are very genetically diverse. And so just looking at one, like a small country in West Africa, would not do justice to the African genome.

Rhonda Stewart: You are, of course, the 2026 Roux Prize winner. What will the prize allow you to do that you weren’t able to do before? And then also I would ask, if governments and funders across Africa took one step on childhood cancer, what would it be? So let’s talk about how you plan to use the prize and how policymakers and other decision-makers might benefit from your work.

Dr. Emmanuela Amoako: Yeah, it’s still quite surreal being the Roux Prize winner. For me, it’s going to advance the work that I do, whether advocacy, whether policy, whether the research work. And I think really, it has sort of put me in the space where people are reaching out, looking out, and reaching out.

So it’s not just the prize money, but what comes with the prize, because now people are asking questions – oh, does something like this exist in Africa? Is someone doing this? And I’ve had, since the announcement in August, I’ve had a few people reaching out, willing to collaborate.

So for me, it’s really not just about the prize money. It’s about the network that this prize has brought for me. And I believe that would definitely advance the work that I do. It’s going to be definitely beyond the shores of Ghana, beyond Africa. I believe it’s going to open doors to even bigger things.

So, yeah, still, thank you very much, IHME, and thank you to the Roux family. I mean, to say that I’m grateful is an understatement, but I am truly grateful.

One thing I think governments should do is most governments should have a policy on childhood cancers. And because again, unfortunately, children are always an afterthought. Last month, September, was childhood cancer awareness month. I didn’t see a lot of likes – I’ve been fighting a lot with my friends because I see their status. Since yesterday, everybody’s putting up pink. I’m like, hm, last month you didn’t put up gold. I’m not happy with you.

Unfortunately, in many places, people still think childhood cancer is a death sentence, but it is not. People think that children might not survive, but they do. And they are quite resilient. And if we go back into history, in fact, the cure for cancers generally came from children with leukemia receiving chemotherapy. So childhood cancers have been the pointer for many, many cancers in the world.

Unfortunately, when it comes to advancements, our children still have to receive chemotherapies because of course, there are not so many studies that exist with immunotherapies and targeted therapies in children. So I generally think that governments should have a national childhood cancer plan. I think research institutions and grantors should also look into funding childhood cancers.

I always say that if you’re able to cure a child, you are looking at your future employment of the country. They are the ones that are going to hold the country. And people might think that children are a small population. Last week I was making the point somewhere that children are 30% of the population in the world right now, but they are definitely 100% the future, and we definitely cannot leave them behind.

So even though childhood cancer is supposed to be rare in certain settings, they are not as rare as they are thought to be. They are just under-reported. And so we should actually make efforts to make sure that we are diagnosing these children, treating them, and knowing that they would definitely contribute to the future work pool and the economy of the country.

Rhonda Stewart: Wonderful. Well, Dr. Amoako, thank you again. Congratulations, and continue to do your amazing work.

Dr. Emmanuela Amoako: Thank you. It was really nice meeting you.

Rhonda Stewart: Details about the Roux Prize, Dr. Amoako’s work, and past winners can be found at healthdata.org. Nominations for the 2027 Roux Prize open on November 1.

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An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health. Learn more about IHME.

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