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Programme of Action for Cancer Therapy (PACT)
Building Sustainable
Cancer Control Capacity and Infrastructure
in Developing Countries
Presentation to IAEA Seminar for Diplomats
6-7 Feb 2007
Massoud Samiei
Head, PACT Programme Office
Contact: [email protected]
and
Web: http://www-naweb.iaea.org/pact/
Access to Radiotherapy
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A “PACT” with Developing Countries
• PACT’s 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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PACT’s Basic Strategy
• To move the Agency’s 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
Partnership
Building
Data Collection
and Needs
Assessment
Joint
Programme
Design
Joint
Proposal
Development
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
International Network for Cancer Treatment and
Research
Tata
Memorial
Centre
Private
Sector
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Stages of PACT Implementation
1. Comprehensive cancer control needs
assessment with partners (imPACT reviews)
2. Establish Pilot Projects through PACT Model
Demonstration Sites and use them for
incremental fundraising
3. Regional cancer training networks for capacity
building
4. Move towards a global alliance and fund
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Stage 1: imPACT Review
• imPACT (integrated missions of PACT) is a multidisciplinary 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
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•
•
•
•
•
•
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:
[email protected]
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More Information:
[email protected]
and
http://www.iaea.org/PACT/
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