Supporting comprehensive cancer control programmes

IAEA and cancer control

Under Article II of it statute, the IAEA's mandate is to seek to accelerate and enlarge the contribution of atomic energy to peace, health and prosperity throughout the world. Anchored by its strong technical expertise, the IAEA has acquired unrivalled experience in the delivery of radiotherapy, diagnostic imaging and nuclear medicine procedures to developing countries over the past 30 years. Providing assistance in all relevant aspects, including planning, training, econometric analysis, implementation, radiation protection, safety and security, the IAEA supports the safe, effective and sustained implementation of radiotherapy and nuclear medicine services ¹.

Supported by such essential programmatic and laboratory contributions, the IAEA's technical cooperation programme has already delivered over $200 million of radiotherapy and nuclear medicine projects since 1980. In recent years, the funding of activities in this area has reached nearly $15 million annually. Supplemented by cancer-related scientific and technical activities carried out under the regular programmes of the Department of Nuclear Safety and Security and the Department of Nuclear Sciences and Applications, this technical assistance has enabled many countries to establish safe and effective diagnostic and radiotherapy capabilities to provide higher quality treatment to at least a portion of their cancer patients. However, there remain more than 30 countries worldwide with no capacity to provide radiotherapy and still more countries with limited services where the life-saving impact of radiotherapy is not realized because the patients present for treatment with cancers too far advanced for curative therapy.

With a cancer epidemic looming in developing countries, the existing infrastructure is far from adequate to respond to the growing demand. At the same time, the IAEA recognizes that the public health benefit from its cancer-related activities can only be maximized if planned and coordinated within the context of national cancer control strategies. Investments in cancer control need to be made by national governmental and non-governmental bodies and other international organizations to enhance capacity across the continuum of cancer control, including surveillance, prevention, early detection and diagnosis, clinical, surgical and medical oncology, as well as cancer policy analysis and formulation, advocacy and management. Other challenges, such as infrastructure gaps in education and training of professionals, and community-based civil society action to combat cancer must also be addressed. In affluent countries, comprehensive national cancer control programmes — including prevention and early detection, coupled with a judicious mixture of treatment such as surgery, radiotherapy and chemotherapy — now result in increased health awareness and prevention, and the cure of 45% of all cancers. When cure is no longer possible, palliative care is available to all patients to alleviate suffering. Developing countries deserve the same!

Beyond radiotherapy...

In response to the developing world's growing cancer crisis, the IAEA established the Programme of Action for Cancer Therapy (PACT) in 2004 to realize fully the public health impact obtained through technology transfer in radiation therapy and nuclear medicine. PACT was launched as an IAEA initiative, but its vision is for a global public-private partnership and fund to confront the cancer crisis, including the formation of a joint programme on cancer control with the World Health Organization (WHO). This joint programme will allow close collaboration with WHO and other key international health organizations through a coordinated global response in developing strategies and specific plans for working with low and middle income (LMI) Member States in the design and implementation of comprehensive cancer control programmes.

PACT presents ambitious long-term goals for the next 20 years. These principal goals are:

1. To build a global public-private partnership of interested organizations committed to addressing the challenge of cancer in LMI Member States in all its aspects;
2. To mobilize resources from charitable trusts, foundations, and others in the public and private sectors to assist LMI Member States to develop and implement their radiation medicine capacities within a national cancer control programme (NCCP); and
3. To ensure the effective and sustainable transfer of radiation medicine technologies or knowledge to all LMI Member States where unmet needs exist.

In the short term, the IAEA is working through PACT with WHO and other partners to raise cancer awareness on a global scale, assess needs in individual countries or regions and develop successful demonstration projects that will attract donors to support these life-saving initiatives to help sustain and replicate positive outcomes.