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The International Atomic Energy Agency (IAEA) has a long history of supporting successful cancer diagnosis and treatment programmes in the developing world using radiation medicine through its Department of Technical Cooperation (TC) and Division of Human Health (NAHU). Building on this experience, IAEA/PACT and its partners are developing multidisciplinary cancer capacity building projects called PACT Model Demonstration Sites (PMDS) in all WHO regions. In Latin America, the PMDS is Nicaragua [Press Release on collaboration between the country and IAEA/PACT], where WHO's Regional Office for the Americas (AMRO)/Pan American Health Organization (PAHO) plays the leading role as a PACT Partner.
Over the course of five years, IAEA/PACT, WHO and other partners will assist the national authorities in the design, funding, implementation and evaluation of PMDS projects focusing on country specific priorities. They will provide technical expertise and support government efforts in resource mobilization for the implementation of the national cancer control programme, with emphasis on improving cancer registration, educating and training personnel, introducing prevention and early detection programmes, expanding or improving treatment facilities and services, including radiotherapy, establishing palliative care, and supporting cancer societies and NGOs. For information on general focus of PMDS click here ».
Nicaragua has 5.7 million people. In 2002 there were an estimated 5 000 new cases of cancer (Globocan 2002). Nicaragua has a single cancer treatment centre, the Centro Nacional de Radioterapia in Managua. Patient demand for cancer therapy far exceeds available services. Cancer prevention, registration, early detection, palliative care and civil based cancer society are either limited or not well developed.
Organize, coordinate and report on imPACT review mission; coordinate preparation of imPACT report and PACT Model Demonstration Site (PMDS) project work plans; coordinate interagency collaboration and resource deployment and mobilization during PMDS project execution.
The National Cancer Control Plan has been finalized with support from PAHO/WHO. A National Committee for Cancer Prevention & Control was established in 2008 and working groups have been formed in the areas of palliative care, human resources training & research, treatment, civil society, advocacy and communication, information systems (cancer registration), cervical cancer, breast cancer and paediatric cancer. In the area of cancer registration, Austin Samaritans & the Texas Department of State Health Services are working with health personnel to help develop the cancer registry (training of registrars, provision of computers with CanReg4, and manuals). The aim is to develop the registry by 2010 to increase national coverage.
Activities in prevention and early detection are ongoing, such as TV radio-novel on cervical and breast cancer and radio interviews with cancer experts. Use of VIA for the early detection of cervical cancer has increased, and training on VIA and cryotherapy has already been conducted in the SILAIS of Matagalpa, Jinotega, and Nueva Segovia. There are now 25 units for the treatment of pre-cancerous lesions in the entire country. PATH, UICC and other NGOs are actively working in cervical cancer prevention (FastHPV Test).
The new PACT-donated Equinox Cobalt 60 machine (through MDS Nordion/Best Theratronics) is now installed at the Centro Nacional de Radioterapia. The official launch ceremony was held on 12 March 2009 and was attended by the Minister of Health.
Palliative Care Guidelines are finalized and the first workshops in palliative care for health professionals were held in 2008 and 2009. Training on palliative care has been conducted in 6 hospitals in Managua. The purchase of oral morphine is being facilitated by the WHO Country Office.
Following the signing of the WHO/IAEA Joint Programme on Cancer Control, IAEA/PACT and its partners, together with Nicaraguan counterparts, will coordinate the formulation of interagency work plans on strengthening all areas of cancer control, each agency according to its mandate and areas of competence. PACT, in coordination with IAEA internal stakeholders, will support national counterparts in implementing work plans and developing proposals for funding. Having already secured resources for the Nicaragua PMDS, PACT will continue its fundraising efforts to help the country mobilize the additional resources needed to implement the PMDS.
Improved cancer survival rate; increased access to treatment for cancer patients; organized screening; earlier detection of cervical cancer with improved opportunity for and delivery of curative treatment; improved public awareness of and knowledge about cancer early detection and its prevention; enhanced palliative programme; and expansion of radiotherapy centres.
PACT works with WHO Headquarters, WHO Regional Office for the Americas (AMRO)/Pan American Health Organization (PAHO), WHO Country Office, IARC (WHO), American Cancer Society (USA), Best Medical International (USA/Canada), International Network for Cancer Treatment and Research (INCTR), International Union Against Cancer (UICC), MDS Nordion (Canada), Program for Appropriate Technology in Health (PATH) (USA) and the US National Cancer Institute (NCI). PACT hopes to involve the Open Society Institute (OSI) and others, especially the private sector.
For more information on Nicaragua, please contact Ms Maria Villanueva.
