Embed Size (px)
Citation preview
Building SustainableBuilding SustainableCancer Control Capacity and InfrastructureCancer Control Capacity and Infrastructure
in Developing Countriesin Developing Countries Presentation to IAEA Seminar for DiplomatsPresentation to IAEA Seminar for Diplomats
6-7 Feb 20076-7 Feb 2007
Massoud SamieiMassoud SamieiHead, PACT Programme OfficeHead, PACT Programme Office
Programme of Action for Cancer Therapy (PACT)Programme of Action for Cancer Therapy (PACT)
Contact: [email protected]
Web: http://www-naweb.iaea.org/pact/
2
Access to RadiotherapyAccess to Radiotherapy
3
A “PACT” with Developing CountriesA “PACT” with Developing Countries
• PACT’s primary goal is to enable low and middle PACT’s primary goal is to enable low and middle income countries to:income countries to:
introduce or expand existing introduce or expand existing infrastructure infrastructure and capacity in radiotherapyand capacity in radiotherapy, in a sustainable , in a sustainable mannermanner
improve or accelerate widespread access to improve or accelerate widespread access to effective radiotherapy serviceseffective radiotherapy services as an essential as an essential part of multidisciplinary cancer carepart of multidisciplinary cancer care
4
Expanding Global Radiotherapy AccessExpanding Global Radiotherapy Access
Expanding radiotherapy access will not achieve Expanding radiotherapy access will not achieve maximum maximum clinical or public health valueclinical or public health value without paying attention to the without paying attention to the following facts:following facts:
70-80%70-80% of all patients treated with radiotherapy in low and of all patients treated with radiotherapy in low and middle income nations today are middle income nations today are palliated palliated because of late because of late detection detection
Radiotherapy is being employed to Radiotherapy is being employed to palliate potentially palliate potentially curable patientscurable patients if they had been detected earlier if they had been detected earlier
Without simultaneous expansion of Without simultaneous expansion of prevention effortsprevention efforts, any , any radiotherapy investment will be overwhelmed by demand as radiotherapy investment will be overwhelmed by demand as the cancer burden expandsthe cancer burden expands
5
Maximize the Impact of Interventions including Radiotherapy through Maximize the Impact of Interventions including Radiotherapy through Balanced Investments across the SystemBalanced Investments across the System
115
6
Cancer Control ObjectivesCancer Control Objectives
PreventPrevent currently preventable cancer – one third of all currently preventable cancer – one third of all cancerscancers
CureCure currently curable cancers – another third of all currently curable cancers – another third of all cancers cancers
ReduceReduce unnecessary pain and suffering in allunnecessary pain and suffering in all
This isThis is current state-of-the-art cancer controlcurrent state-of-the-art cancer control thatthat does not exist in most developing countriesdoes not exist in most developing countries
7
PACT’s Basic StrategyPACT’s Basic Strategy
• To move the Agency’s cancer-related To move the Agency’s cancer-related programmes to a programmes to a public health modelpublic health model where our where our radiotherapy intervention is integrated into a radiotherapy intervention is integrated into a broad cancer capacity buildingbroad cancer capacity building effort that effort that exploits exploits prevention and early detectionprevention and early detection synergies synergies to maximise the public health impact of to maximise the public health impact of treatment investmentstreatment investments
8
Resource MobilizationResource Mobilization
Fundraising
Data CollectionData Collectionand Needsand Needs
AssessmentAssessment
Joint Joint Programme Programme
DesignDesign
Joint Joint Proposal Proposal
DevelopmentDevelopment
PartnershipPartnershipBuildingBuilding
9
Implementation StrategyImplementation Strategy
• Joint Global Efforts for Global Efforts for “ “New MoneyNew Money” ”
• To formulate a framework for To formulate a framework for PACT within a PACT within a multidisciplinary multidisciplinary programmeprogramme strategy to secure strategy to secure critically needed critically needed alliancesalliances in in order to drive forward order to drive forward programme development and programme development and fundraisingfundraising through the through the implementation of specific implementation of specific pilot pilot projectsprojects
• Implementation in several Implementation in several stagesstages
I nternational Network for Cancer Treatment and Research
Tata Tata MemorialMemorial
CentreCentre
Tata Tata MemorialMemorial
CentreCentre
PrivateSector
PrivateSector
10
Stages of PACT ImplementationStages of PACT Implementation
1.1. Comprehensive cancer control needs Comprehensive cancer control needs assessment with partners (assessment with partners (imPACT reviewsimPACT reviews))
2.2. Establish Establish Pilot ProjectsPilot Projects through through PACT Model PACT Model Demonstration SitesDemonstration Sites and use them for and use them for incremental fundraisingincremental fundraising
3.3. Regional cancer training networksRegional cancer training networks for capacity for capacity buildingbuilding
4.4. Move towards a global alliance and fundMove towards a global alliance and fund
11
Stage 1:Stage 1: imPACT ReviewimPACT Review
• imPACTimPACT ( (integrated missionsintegrated missions of PACT) is a multi- of PACT) is a multi-disciplinary national needs assessment ofdisciplinary national needs assessment of all aspects of all aspects of cancercancer
• imPACTimPACT is is multi-stakeholder, involving national multi-stakeholder, involving national authorities and public-private partners working with authorities and public-private partners working with PACT PACT (WHO and others)(WHO and others)
• Outcome:Outcome:
• National Cancer StrategyNational Cancer Strategy
• Action PlansAction Plans
• PACT Model Demonstration SitesPACT Model Demonstration Sites
12
Stage 2:Stage 2: PACT Model Demonstration Sites (PACT Model Demonstration Sites (PMDSPMDS))
• Establish PMDS projects in each of the six WHO regions:Establish PMDS projects in each of the six WHO regions: Albania, Nicaragua, Sri Lanka, Tanzania, Vietnam, YemenAlbania, Nicaragua, Sri Lanka, Tanzania, Vietnam, Yemen
• Areas of Activity:Areas of Activity: Cancer Control PlanningCancer Control Planning Knowledge Transfer and Multidisciplinary Education and Training Knowledge Transfer and Multidisciplinary Education and Training Programme EvaluationProgramme Evaluation Society Building Society Building Cancer Registration Cancer Registration Prevention Prevention Early Detection and Diagnosis Early Detection and Diagnosis TreatmentTreatment Palliative Care Palliative Care FundraisingFundraising
13
Stage 2:Stage 2: Objectives of Objectives of PMDSPMDS
• Develop multidisciplinary cancer capacity building projects Develop multidisciplinary cancer capacity building projects • Illustrate feasibility and value of an interagency cancer control Illustrate feasibility and value of an interagency cancer control
alliance alliance • Complement RT expansion with investments in cancer registration, Complement RT expansion with investments in cancer registration,
prevention, early detection, palliation, and civil societyprevention, early detection, palliation, and civil society• Demonstrate to donors the value of multi-disciplinary cancer Demonstrate to donors the value of multi-disciplinary cancer
capacity buildingcapacity building• Use PMDS projects as a basis for fundraisingUse PMDS projects as a basis for fundraising• Create policy, and raise donor and public awareness until Create policy, and raise donor and public awareness until
regional/global initiativesregional/global initiatives can be funded can be funded• Leverage successful PMDS execution with major donors for Leverage successful PMDS execution with major donors for
regional fundraisingregional fundraising for larger scale efforts for larger scale efforts• Cooperate with Member States to establishCooperate with Member States to establish centres of centres of
competence and excellencecompetence and excellence
14
Stage 3:Stage 3: Regional Capacity Building Regional Capacity Building
• Lack of adequate human resources is a Lack of adequate human resources is a critical critical bottleneckbottleneck which: which:• Leads to suboptimal utilization of existing radiotherapy facilities and Leads to suboptimal utilization of existing radiotherapy facilities and
delivery of cancer public health servicesdelivery of cancer public health services
• Constrains ability to expand services locally and nationallyConstrains ability to expand services locally and nationally
• Puts new investments at risk due to retirement or migrationPuts new investments at risk due to retirement or migration
• Limits establishment of other regional treatment centresLimits establishment of other regional treatment centres
• Need to create and accelerate multidisciplinary Need to create and accelerate multidisciplinary regional regional cancer training networkscancer training networks
• Use South-South and North-South mentoringUse South-South and North-South mentoring
15
Stage 3:Stage 3: Regional Capacity BuildingRegional Capacity Building
• Deploy modern IT tools and rely on existing recognised centresDeploy modern IT tools and rely on existing recognised centres
• Create national and regional self-sufficiency Create national and regional self-sufficiency (centres of (centres of competence/excellence)competence/excellence)
• Train multidisciplinary personnel for replacement personnel as Train multidisciplinary personnel for replacement personnel as well as creation/expansion of facilitieswell as creation/expansion of facilities
• Develop new facilities and tools for RT and other cancer Develop new facilities and tools for RT and other cancer training as neededtraining as needed
• Serve as Serve as regional hubsregional hubs or or centres of excellencecentres of excellence for for multidisciplinary cancer training among neighboursmultidisciplinary cancer training among neighbours
• Use as a basis for regional/global fundraising initiativesUse as a basis for regional/global fundraising initiatives
16
PACT By RegionPACT By Region
Africa (AFRO & EMRO)Africa (AFRO & EMRO)Potential Centres of Excellence or Mentors: Potential Centres of Excellence or Mentors: Morocco, Egypt, Ghana, South Morocco, Egypt, Ghana, South
Africa, Algeria, Tunisia, TanzaniaAfrica, Algeria, Tunisia, Tanzania
imPACT and First ExecutionsimPACT and First Executions: Tanzania, Ghana: Tanzania, Ghana
Assistance Requests ReceivedAssistance Requests Received: Cameroon, Niger, Senegal, Kenya, Eritrea: Cameroon, Niger, Senegal, Kenya, Eritrea
Asia (WPRO, SEARO & EMRO)Asia (WPRO, SEARO & EMRO)Potential Centres of Excellence or Mentors: Potential Centres of Excellence or Mentors: India, Thailand, Jordan, Iran, Syria, India, Thailand, Jordan, Iran, Syria,
Philippines, Singapore, Australia, Japan, Israel, New Zealand, Rep KoreaPhilippines, Singapore, Australia, Japan, Israel, New Zealand, Rep Korea
imPACTimPACT and First Executionsand First Executions: Sri Lanka, Vietnam: Sri Lanka, Vietnam
Preliminary imPACT: Preliminary imPACT: YemenYemen
Assistance Requests ReceivedAssistance Requests Received: Afghanistan, Syria: Afghanistan, Syria
17
PACT By RegionPACT By Region
Latin America (PAHO)Latin America (PAHO)
Potential Centres of Excellence or Mentors: Potential Centres of Excellence or Mentors: Brazil, Colombia, Mexico, Brazil, Colombia, Mexico, Argentina, Cuba, Peru, Uruguay, Chile, Canada, United StatesArgentina, Cuba, Peru, Uruguay, Chile, Canada, United States
imPACTimPACT and First Executionsand First Executions: Nicaragua: Nicaragua
Preliminary imPACT: Preliminary imPACT: PeruPeru
Assistance Requests ReceivedAssistance Requests Received: Bolivia, El Salvador, Colombia, Costa Rica, : Bolivia, El Salvador, Colombia, Costa Rica, Panama, Dominican Republic, Haiti, VenezuelaPanama, Dominican Republic, Haiti, Venezuela
EuropeEurope
Potential Centres of Excellence or Mentors: Potential Centres of Excellence or Mentors: Czech Republic, Greece, Poland, Czech Republic, Greece, Poland, Hungary, Monaco, Germany, Russia, Spain, Sweden, France, UKHungary, Monaco, Germany, Russia, Spain, Sweden, France, UK
imPACTimPACT and First Executions:and First Executions: Albania Albania
Preliminary imPACT: Preliminary imPACT: Georgia, MontenegroGeorgia, Montenegro
Assistance Requests ReceivedAssistance Requests Received: Moldova, Uzbekistan, Kyrgyzstan, Romania: Moldova, Uzbekistan, Kyrgyzstan, Romania
18
Nobel Peace Prize InstitutesNobel Peace Prize Institutes
• Special 5-day events Special 5-day events in three regions to:in three regions to:
• Draw the attention of society to why Draw the attention of society to why comprehensive comprehensive cancer control is so essential for enhancing the cancer control is so essential for enhancing the effectiveness of cancer treatment by radiotherapyeffectiveness of cancer treatment by radiotherapy
• Encourage the planning for and investments in Regional Encourage the planning for and investments in Regional Cancer Training InstitutesCancer Training Institutes
• Participation of policy makers and professionalsParticipation of policy makers and professionals• Multidisciplinary cancer lecturersMultidisciplinary cancer lecturers
Next Event: 23-27 April in Buenos AiresNext Event: 23-27 April in Buenos Aires
19
PACT 2007-2009 PlansPACT 2007-2009 Plans
• Consolidate partnershipsConsolidate partnerships
• Execution of 3 PMDS Execution of 3 PMDS (Albania, Nicaragua, Tanzania)(Albania, Nicaragua, Tanzania)
• Initiate another 3 PMDS Initiate another 3 PMDS (Sri Lanka, Vietnam and Yemen)(Sri Lanka, Vietnam and Yemen)
• Solicit equipment, products and services donationsSolicit equipment, products and services donations
• Fundraising campaign for PMDSFundraising campaign for PMDS
• Proposals on cervical and breast cancerProposals on cervical and breast cancer
• Sub-Saharan regional capacity building proposal UKSub-Saharan regional capacity building proposal UK
• Cancer Therapy for Africa EUCancer Therapy for Africa EU
• Individual country and donor matchingIndividual country and donor matching
20
Summary of Resources 2005-07Summary of Resources 2005-07
• Over Over $2.4 million$2.4 million by IAEA Member States by IAEA Member States
• US NCI $200,000 in-kindUS NCI $200,000 in-kind
• OPEC Fund $500,000 Grant approved OPEC Fund $500,000 Grant approved
• Up to 3 new Theratron cobalt machines MDS Up to 3 new Theratron cobalt machines MDS NordionNordion
• One new Bhabhatron cobalt from IndiaOne new Bhabhatron cobalt from India
• Pledge for 13Mev cyclotron from KIRAMS KoreaPledge for 13Mev cyclotron from KIRAMS Korea
• Offer of Offer of Cost-FreeCost-Free staff/experts for PACT staff/experts for PACT
21
PACT Expected OutcomesPACT Expected Outcomes
PACT:PACT:
PACT:PACT:
• Placing cancer on global health Placing cancer on global health agendaagenda• Building strategic public-private Building strategic public-private partnershipspartnerships• Encouraging integrated national Encouraging integrated national cancercancer control plans and programmes control plans and programmes• Raising new Raising new funding for cancer care funding for cancer care programmes including radiotherapy programmes including radiotherapy servicesservices• Promoting affordable cancer therapy Promoting affordable cancer therapy for everyonefor everyone• Developing Developing regionalregional cancer training cancer training networksnetworks• Moving towards a Moving towards a global alliance global alliance and fundand fund to fight cancer to fight cancer [email protected]
