Building Sustainable Cancer Control Capacity and Infrastructure in Developing Countries Presentation

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Building SustainableCancer Control Capacity and
Infrastructurein Developing Countries
Presentation to IAEA Seminar for Diplomats6-7
Feb 2007Massoud SamieiHead, PACT Programme
Office

• Programme of Action for Cancer Therapy (PACT)

Contact pact_at_iaea.org and Web
http//www-naweb.iaea.org/pact/
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Access to Radiotherapy
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A PACT with Developing Countries

• PACTs primary goal is to enable low and middle
  income countries to
• introduce or expand existing infrastructure and
  capacity in radiotherapy, in a sustainable manner
• improve or accelerate widespread access to
  effective radiotherapy services as an essential
  part of multidisciplinary cancer care

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Expanding Global Radiotherapy Access

• Expanding radiotherapy access will not
  achieve maximum clinical or public health value
  without paying attention to the following facts
• 70-80 of all patients treated with radiotherapy
  in low and middle income nations today are
  palliated because of late detection
• Radiotherapy is being employed to palliate
  potentially curable patients if they had been
  detected earlier
• Without simultaneous expansion of prevention
  efforts, any radiotherapy investment will be
  overwhelmed by demand as the cancer burden expands

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Maximize the Impact of Interventions including
Radiotherapy through Balanced Investments across
the System
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Cancer Control Objectives

• Prevent currently preventable cancer one third
  of all cancers
• Cure currently curable cancers another third of
  all cancers
• Reduce unnecessary pain and suffering in all
• This is current state-of-the-art cancer control
  that does not exist in most developing countries

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PACTs Basic Strategy

• To move the Agencys cancer-related programmes to
  a public health model where our radiotherapy
  intervention is integrated into a broad cancer
  capacity building effort that exploits prevention
  and early detection synergies to maximise the
  public health impact of treatment investments

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Resource Mobilization
Data Collection and Needs Assessment
Joint Programme Design
Joint Proposal Development
Partnership Building
Fundraising
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Implementation Strategy

• Joint Global Efforts for
  New Money
• To formulate a framework for PACT within a
  multidisciplinary programme strategy to secure
  critically needed alliances in order to drive
  forward programme development and fundraising
  through the implementation of specific pilot
  projects
• Implementation in several stages

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Stages of PACT Implementation

• Comprehensive cancer control needs assessment
  with partners (imPACT reviews)
• Establish Pilot Projects through PACT Model
  Demonstration Sites and use them for incremental
  fundraising
• Regional cancer training networks for capacity
  building
• Move towards a global alliance and fund

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Stage 1 imPACT Review

• imPACT (integrated missions of PACT) is a
  multi-disciplinary national needs assessment of
  all aspects of cancer
• imPACT is multi-stakeholder, involving national
  authorities and public-private partners working
  with PACT (WHO and others)
• Outcome
• National Cancer Strategy
• Action Plans
• PACT Model Demonstration Sites

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Stage 2 PACT Model Demonstration Sites (PMDS)

• Establish PMDS projects in each of the six WHO
  regions
• Albania, Nicaragua, Sri Lanka, Tanzania, Vietnam,
  Yemen
• Areas of Activity
• Cancer Control Planning
• Knowledge Transfer and Multidisciplinary
  Education and Training
• Programme Evaluation
• Society Building
• Cancer Registration
• Prevention
• Early Detection and Diagnosis
• Treatment
• Palliative Care
• Fundraising

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Stage 2 Objectives of PMDS

• Develop multidisciplinary cancer capacity
  building projects
• Illustrate feasibility and value of an
  interagency cancer control alliance
• Complement RT expansion with investments in
  cancer registration, prevention, early detection,
  palliation, and civil society
• Demonstrate to donors the value of
  multi-disciplinary cancer capacity building
• Use PMDS projects as a basis for fundraising
• Create policy, and raise donor and public
  awareness until regional/global initiatives can
  be funded
• Leverage successful PMDS execution with major
  donors for regional fundraising for larger scale
  efforts
• Cooperate with Member States to establish centres
  of competence and excellence

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Stage 3 Regional Capacity Building

• Lack of adequate human resources is a critical
  bottleneck which
• Leads to suboptimal utilization of existing
  radiotherapy facilities and delivery of cancer
  public health services
• Constrains ability to expand services locally and
  nationally
• Puts new investments at risk due to retirement or
  migration
• Limits establishment of other regional treatment
  centres
• Need to create and accelerate multidisciplinary
  regional cancer training networks
• Use South-South and North-South mentoring

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Stage 3 Regional Capacity Building

• Deploy modern IT tools and rely on existing
  recognised centres
• Create national and regional self-sufficiency
  (centres of competence/excellence)
• Train multidisciplinary personnel for replacement
  personnel as well as creation/expansion of
  facilities
• Develop new facilities and tools for RT and other
  cancer training as needed
• Serve as regional hubs or centres of excellence
  for multidisciplinary cancer training among
  neighbours
• Use as a basis for regional/global fundraising
  initiatives

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PACT By Region

• Africa (AFRO EMRO)
• Potential Centres of Excellence or Mentors
  Morocco, Egypt, Ghana, South Africa, Algeria,
  Tunisia, Tanzania
• imPACT and First Executions Tanzania, Ghana
• Assistance Requests Received Cameroon, Niger,
  Senegal, Kenya, Eritrea
• Asia (WPRO, SEARO EMRO)
• Potential Centres of Excellence or Mentors
  India, Thailand, Jordan, Iran, Syria,
  Philippines, Singapore, Australia, Japan, Israel,
  New Zealand, Rep Korea
• imPACT and First Executions Sri Lanka, Vietnam
• Preliminary imPACT Yemen
• Assistance Requests Received Afghanistan, Syria

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PACT By Region

• Latin America (PAHO)
• Potential Centres of Excellence or Mentors
  Brazil, Colombia, Mexico, Argentina, Cuba, Peru,
  Uruguay, Chile, Canada, United States
• imPACT and First Executions Nicaragua
• Preliminary imPACT Peru
• Assistance Requests Received Bolivia, El
  Salvador, Colombia, Costa Rica, Panama, Dominican
  Republic, Haiti, Venezuela
• Europe
• Potential Centres of Excellence or Mentors
  Czech Republic, Greece, Poland, Hungary, Monaco,
  Germany, Russia, Spain, Sweden, France, UK
• imPACT and First Executions Albania
• Preliminary imPACT Georgia, Montenegro
• Assistance Requests Received Moldova,
  Uzbekistan, Kyrgyzstan, Romania

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Nobel Peace Prize Institutes

• Special 5-day events in three regions to
• Draw the attention of society to why
  comprehensive cancer control is so essential for
  enhancing the effectiveness of cancer treatment
  by radiotherapy
• Encourage the planning for and investments in
  Regional Cancer Training Institutes
• Participation of policy makers and professionals
• Multidisciplinary cancer lecturers

Next Event 23-27 April in Buenos Aires
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PACT 2007-2009 Plans

• Consolidate partnerships
• Execution of 3 PMDS (Albania, Nicaragua,
  Tanzania)
• Initiate another 3 PMDS (Sri Lanka, Vietnam and
  Yemen)
• Solicit equipment, products and services
  donations
• Fundraising campaign for PMDS
• Proposals on cervical and breast cancer
• Sub-Saharan regional capacity building proposal
  UK
• Cancer Therapy for Africa EU
• Individual country and donor matching

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Summary of Resources 2005-07

• Over 2.4 million by IAEA Member States
• US NCI 200,000 in-kind
• OPEC Fund 500,000 Grant approved
• Up to 3 new Theratron cobalt machines MDS Nordion
• One new Bhabhatron cobalt from India
• Pledge for 13Mev cyclotron from KIRAMS Korea
• Offer of Cost-Free staff/experts for PACT

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PACT Expected Outcomes

• Placing cancer on global health agenda
• Building strategic public-private partnerships
• Encouraging integrated national cancer control
  plans and programmes
• Raising new funding for cancer care programmes
  including radiotherapy services
• Promoting affordable cancer therapy for everyone
• Developing regional cancer training networks
• Moving towards a global alliance and fund to
  fight cancer

PACT
pact_at_iaea.org
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More Information

• pact_at_iaea.org
• and
• http//www.iaea.org/PACT/