As a young medical student in Nigeria, Segun Afolaranmi was shocked by the disproportionate rate of death from treatable cancers across Africa.

To help bring about change, Segun is supporting knowledge sharing and skills training for students in Africa. He also co-founded an initiative to provide career guidance and mentoring for schoolchildren in Nigeria. In Cambridge, he hopes his PhD will lead to a way to enhance  immune cells to deliver a ‘kiss of death’ to cancer.

What’s the aim of your research?

Cancer is an incredibly complex disease and one of the biggest breakthroughs in treating it has come from using our own immune system to fight the disease. But cancer cells can develop ways of evading it, and so we are working on understanding how the immune system functions so that we can improve therapies for patients.

We found that immune cells use a particular pathway to optimally deliver their poisons to cancer cells. Insights from this work will potentially enable better design of advanced cellular therapies, enhancing the ability of immune cells to deliver what we call the ‘kiss of death’.

How did your interest in cancer begin?

Before I started my PhD at the Cancer Research UK (CRUK) Cambridge Institute, I did my medical training in Nigeria. I was deeply moved by the experiences of cancer patients, especially with the very limited treatment options available.

In 2017, I attended the World Healthcare Students' Symposium in Rwanda – the first to be held in Africa. I heard about the disproportionate rate of death from treatable cancers across other African countries and I realised this is something that needs a lot of attention.

For me, it became a personal passion. I thought, if I get very well trained in medical school and beyond, I could contribute to meaningful work, and by extension contribute to reducing the inequities in mortalities from cancer globally. This has now morphed into a better-formed career goal of doing global translational science alongside compassionate patient care.

What do we need to do to expand access and reduce disparities in cancer care?

I think it is multi-layered. We should start with patients. Cancer is a very heterogenous disease, but enrolment in cancer clinical trials is vastly unequitable. That means that many of the results cannot be truly generalised.

A very good example comes from my clinical experience in Nigeria where we see a much higher incidence of triple negative breast cancer – a type that is not amenable to hormonal therapy – than you would see in the UK, for instance.

“We need better global representation in trials as well as home-grown solutions so that we can find treatments that are going to work in different contexts and for different people.”

The other thing that’s important is training – giving people the skills and opportunity to be able do more locally and globally.

How have you helped to bring about change?

After the World Healthcare  Students’ Symposium in 2017, my colleagues and I felt we needed to do something. The following year we organised a conference on the future of African healthcare with the Federation of African Medical Students’ Association, a pan-African initiative aimed at building a network of medical students.

We brought together 600 students and 30 speakers from across Africa and beyond to discuss sustainable solutions to healthcare challenges with workshops across multiple healthcare domains. We attracted the support of the World Health Organization-Africa region, the Bill and Melinda Gates Foundation, and Johnson & Johnson. Thankfully, the meeting was a success, with attendees leaving inspired to drive change and many of them have gone on to do great things in their respective ways.

I want to continue to do work that’s relevant within Africa. One of the reasons I enjoy being in my lab is because the CRUK Cambridge Institute has a collaboration with the Uganda Cancer Institute, which has a focus on training programmes for young scientists. We went to Uganda last September to train and exchange ideas with students, researchers and staff as part of the Cambridge Makerere Summer School.

You sound passionate about supporting others in gaining skills. How did this develop?

I am the youngest member of an extended family in Nigeria, and grew up in a setting where resources weren’t particularly available. However, I have been incredibly fortunate to have individuals and institutions who have provided me with opportunities that shaped my life and career.

I was privileged to get high-quality medical training at the University of Ibadan, Nigeria, after which I received a scholarship for a Master’s at the University of Oxford, and then a Gates Cambridge scholarship for a PhD in Cambridge.

The Gates Cambridge community is special, with a structured programme to support you beyond just providing financial support. I wanted a place where you feel like you are in a second home and there are many activities to make you feel that way. I am particularly fond of the monthly Gates football.

Altogether, my personal experiences continually inspire me to support others in my own modest way. Looking back on my time at school in Nigeria, for instance, I could see that there was inadequate guidance and resources for public secondary school students to think about further education.

So I co-founded The Ganglion Initiative in 2017 to provide guidance, mentorship and scholarship opportunities. We now have NGO status and have reached over 13,000 students across 30 Nigerian public schools and online.

“Our ambition is to help build a continent where all African youths can access the opportunities they need to become solution providers.”

You are working in fundamental science. How does that compare with medicine?

It can sometimes feel very different. In medicine, if somebody comes to you with a complaint, you might be able to give them a medication or do an operation, and sometimes you get results almost instantaneously.

In science things can be a bit drawn out. You have an idea. You discuss the idea. You refine the idea. You do the first experiment. It doesn’t work. It takes maybe six months to first see your idea come together, and that can be deeply gratifying in a unique way.

I think the privilege of being able to work in both medicine and science is the opportunity to zoom in and zoom out from time to time, delivering care to the person right in front of you but also being able to think of the big picture of how you might contribute to the care of many people who you might never meet.

I am also grateful to be getting my scientific training at a great place. My supervisor, Dr Maike De La Roche, is an inspiration. She’s a truly kind person, really committed to everyone’s success, and the culture within the lab is great. The CRUK Cambridge Institute is also very supportive and well resourced. I feel that this is one of the best places to do cancer research.

What are your hopes for the future of cancer?

I think cancer will continuously become a disease that’s manageable, and I hope ultimately curable. My generation is coming into the field at the point where there are so many possibilities for achieving success against cancer, with so many tools available.

It’s still incredibly challenging but we’re at the precipice where a lot of things are coming together to be able to scale efforts. I think that in the not-so-distant future, we will get to a point when people experience cancer just like any other liveable disease, like asthma or diabetes, and still be able to reach their full potential. But we must make sure that this progress is truly global.

Oluwasegun Afolaranmi is a Gates Cambridge Scholar in the Cancer Research UK Cambridge Institute and a postgraduate student at Homerton College.

Published: 15 July 2024

Interview and words: Zoe Smith
Design: Alison Fair
Photography: Nick Saffell
Editor: Louise Walsh

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