PACT for PERU meeting by pengtt


									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

Access to Radiotherapy

  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
  improve or accelerate widespread access to
   effective radiotherapy services as an essential
   part of multidisciplinary cancer care

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
  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

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

          Cancer Control Objectives
 Prevent currently preventable cancer – one third of all
 Cure currently curable cancers – another third of all
 Reduce unnecessary pain and suffering in all

 This is current state-of-the-art cancer control that
  does not exist in most developing countries

          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

              Resource Mobilization

Partnership    Data Collection      Joint       Joint
 Building       and Needs        Programme    Proposal
                Assessment         Design    Development


              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   International Network for Cancer Treatment and
  projects                                                        Memorial

• Implementation in several                                                           Private

      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
4. Move towards a global alliance and fund

           Stage 1: imPACT Review

• imPACT (integrated missions of PACT) is a multi-
  disciplinary national needs assessment of all aspects of
• 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

 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

              Stage 2: Objectives of PMDS

• Develop multidisciplinary cancer capacity building projects
• Illustrate feasibility and value of an interagency cancer control
•   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

    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

      Stage 3: Regional Capacity Building

•   Deploy modern IT tools and rely on existing recognised centres
•   Create national and regional self-sufficiency (centres of
•   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

                         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

Potential Centres of Excellence or Mentors:
   India, Thailand, Jordan, Iran, Syria, Philippines, Singapore, Australia, Japan, I
   srael, New Zealand, Rep Korea
imPACT and First Executions: Sri Lanka, Vietnam
Preliminary imPACT: Yemen
Assistance Requests Received: Afghanistan, Syria

                       PACT By Region

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

             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

     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
• One new Bhabhatron cobalt from India
• Pledge for 13Mev cyclotron from KIRAMS Korea
• Offer of Cost-Free staff/experts for PACT

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

  More Information:



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