PACT

A Partnership to
Fight Cancer in Developing Countries

J.P. Cayol
Programme Officer, PACT

WHO/IAEA Coordination and Planning Meeting with Asia & Pacific Member States
under IAEA Regional Project RAS/6/060
- 29 June – 1 July 2009, Vienna, Austria -
 Cancer as World’s #1 Killer by 2010

Cancer is not a “rich” but rather a

“poor
poor”” country disease:
Ü 55% of all cancer patients
Ü Cancer incidence: + 30% by
2020
Ü 75% of cancer deaths

11.5 million deaths

annually by 2030

Children with cancer, Tanzania 2

Cancer Kills More People than AIDS,
Malaria & TB Combined

10 AIDS, TB, Malaria

49
9.
Cancer
Total Cancer Deaths (millions per year)

88
7

6.
83
6
5.

5
29
4.

85
4
3.
3

15
2.
2

0
2008 2015 2030
Low--Middle Income Countries,
Low
WHO 2008 3
 IAEA & Cancer:
“Atoms for Peace, Health and Prosperity”
Ü IAEA: International Atomic Energy Agency
Agency;; global focal
point for nuclear cooperation
Ü Nuclear “watchdog
watchdog”” but also technical cooperation to
fight poverty
poverty,, sickness
sickness,, pollution and other MDGs
Ü Decades building radiotherapy capacity (for cancer
treatment) in developing countries

IAEA building, Vienna 4

 IAEA & Cancer:
Expenditure on Cancer Projects

EUROPE
$46 million

ASIA and the

PACIFIC
$42 million

AFRICA
LATIN AMERICA $60 million
$47 million

INTERREGIONAL
$7 million
TOTAL EXPENDITURE
* These figures do not include IAEA’s corresponding overhead costs. $202 million

1980--2008
1980 5
 IAEA & Cancer:
Access to Radiotherapy in the World

6
 IAEA & Cancer:
2005 Nobel Peace Prize

Ü 2005 Nobel Peace Prize to

IAEA and its DG

Ü Creation of the “IAEA Nobel

Cancer and Nutrition Fund”
Fund”
with the IAEA's € 525,000
share of the Prize

Ü Fund used to initiate PACT

training programmes in
cancer care IAEA DG Mohamed ElBaradei and Amb. Yukiya Amano, Chairman of
IAEA Board of Governors, at the Prize Award Ceremony

7
 IAEA & Cancer:
From Radiotherapy to PACT
2004 WHO calls for global action to fight the cancer epidemic
sweeping through developing countries
2005 IAEA responds and establishes PACT to address full spectrum
of cancer control, using radiotherapy as an anchor
2006 PACT Model Demonstration Sites (PMDS) established in
Albania, Nicaragua, Sri Lanka, Tanzania, Vietnam & Yemen
2007 High level cancer control meetings Africa, Latin America
2008 US$ 23 million mobilized
to date by PACT
2009 WHO
WHO--IAEA Joint Programme
on cancer control
formally signed

Press Release WHO-IAEA, May 2009

8
 PACT:
Its Mission
Ü To raise awareness and funds to
fight cancer in developing countries
Ü To forge partnerships with global
cancer experts including WHO,
Ministries of Health, NGOs
Ü To work with developing countries
to implement National Cancer
Control Programmes (NCCP)
Ü To accelerate IAEA’s assistance to
build infrastructure and capacity in
radiotherapy

The technology and skills already exist

to treat and often cure cancer.
People in developing countries
deserve access to them. 9
 PACT:
Basic Strategy
Ü Move the IAEA’s cancer-
cancer-related
programmes to a public health
model
Ü Integrate radiotherapy into
National Cancer Control
Programmes
Ü Focus on prevention and
early detection to
maximise public health
benefit of investments in
treatment
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 PACT:
Priority Interventions
PACT experience in developing countries shows
urgent need for:
Screening: Cervical Radiotherapy to Palliative Care for
and Breast Treat and Cure Late Stages

Photos left to right: PMDS Albania, Nicaragua, Vietnam

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 PACT:
Approach to Cancer Control

Based upon WHO model 12

 PACT:
Building Partnerships

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 PACT:
Three Stages of Implementation
1. Comprehensive cancer control needs assessment
(imPACT Review)
Review )
2. Establish PACT The FUTURE
Model Demonstration
Sites (PMDS) to drive
forward fundraising and
programme
development
3. Regional cancer
A Global alliance
training networks for
and Fund for cancer
capacity building
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 PACT’s Implementation:
imPACT Review (stage 1)
Ü Multi
Multi--disciplinary needs assessment of a country’s cancer
control capacity
Ü Multi
Multi--stakeholder, involving
national authorities and
public--private partners
public

OUTCOMES:
ü Detailed national cancer
profile
ü Assessment of current
cancer control capacity
ü Recommendation for imPACT Review, Vietnam 2006

actions

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 PACT’s Implementation:
Focus on PMDS (stage 2)

Multidisciplinary cancer capacity building projects in each of

the six WHO regions: Albania
Albania,, Nicaragua
Nicaragua,, Sri Lanka,
Lanka,
Tanzania,, Vietnam
Tanzania Vietnam,, Yemen
ü Cancer Control Planning ü Early Detection and Diagnosis
ü Society Building ü Treatment
ü Cancer Registration ü Palliative Care
ü Prevention ü Fundraising
ü Programme Evaluation ü Knowledge Transfer, Education, Training

PMDS workshop,
Sri Lanka 2008

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 PACT’s Implementation:
Regional Capacity Building (stage 3)

Medical oncologists
Surgeons
Radiation oncologists
Radiotherapy physicists
Radiation therapy technologists
Radiation safety experts
Nurses

17
 PACT’s Implementation:
Regional Cancer Training Networks (stage 3)
Ü Provide comprehensive and multidisciplinary training

Ü Optimize use of RT facilities & expand services

Ü Train local/regional health professionals to replace

those who leave

Ü Develop a Cancer Control International Mentorship

Network to facilitate institutional exchange in training &
research

Ü Create a Virtual Cancer Control University to facilitate

access and exchange of information in RT and cancer
control

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 PACT in the Regions:
Latin America (AMRO)

Ü Potential Centres of Excellence

or Mentors:
Brazil, Colombia, Mexico, Argentina, Cuba,
Peru, Uruguay, Chile, Canada, United States
Ü imPACT and first
implementations:
Nicaragua
Ü Preliminary imPACT: Peru
Ü Assistance Requested:
Bolivia, Colombia, Costa Rica, Cuba,
Dominican Republic, El Salvador, Guatemala,
Haiti, Honduras, Panama, Uruguay,
Venezuela
Ü Donors:
Norway, United States, France, OPEC Fund, Treating a cancer patient with radiotherapy,
Nicaragua
MDS Nordion

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 PACT in the Regions:
Africa (AFRO & EMRO)
Ü Potential Centres of Excellence or
Mentors:
Morocco, Egypt, Ghana, South Africa, Algeria,
Tunisia, Tanzania
Ü imPACT and first implementations:
Tanzania
Ü Preliminary imPACT:
Ghana, Madagascar, Morocco
Ü Assistance Requested:
Algeria, Angola, Botswana, Burkina Faso,
Cameroon, Cape Verde, Eritrea, Kenya, Libya,
Malawi, Mali, Mauritania, Mauritius, Namibia,
Niger, Nigeria, Senegal, Sierra Leone, Sudan,
Uganda, Zambia, Zimbabwe
Ü Donors:
Canada, France, India, Monaco, Norway, USA,
OFID, MDS Nordion
Cancer patients between treatments, Tanzania

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 PACT in the Regions:
Europe (EURO)
Ü Potential Centres of Excellence
or Mentors:
Czech Republic, Greece, Poland, Hungary,
Monaco, Germany, Russia, Spain, Sweden,
France, UK
Ü imPACT and first
implementations:
Albania
Ü Preliminary imPACT:
Georgia, Moldova, Montenegro
Ü Assistance Requested:
Armenia, Azerbaijan, Bosnia and
Herzegovina, Kazakhstan, Kyrgyzstan,
Romania, Uzbekistan
Radiotherapy machine donated through PACT before installation
Ü Donors: in Albania

Hungary, Norway, Poland, United States,

OPEC Fund, MDS Nordion

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 PACT in the Regions:
Asia (WPRO, SEARO & EMRO)
Ü Potential Centres of Excellence or
Mentors:
India, Thailand, Jordan, Iran, Syria,
Philippines, Singapore, Israel, New Zealand
Ü imPACT and first
implementations:
Sri Lanka, Vietnam, Yemen
Ü Preliminary imPACT:
Syria
Ü Assistance Requested:
Afghanistan, Indonesia, Iraq, Malaysia,
Mongolia, Papua New Guinea, Palestinian
Authority, Philippines
Ü Donors: Chemotherapy ward, Yemen
Australia, India, Japan, New Zealand,
Norway, Rep Korea, MDS Nordion

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Saving lives …

…lessening suffering
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For more information:

pact@iaea.org
http://cancer.iaea.org

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