PACT for PERU meeting by pengtt

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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: pact@iaea.org
                                                      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


                                                     3
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


                                                                  4
Maximize the Impact of Interventions including Radiotherapy through
              Balanced Investments across the System




                                                                      55
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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    Data Collection      Joint       Joint
 Building       and Needs        Programme    Proposal
                Assessment         Design    Development




                         Fundraising



                                                           8
              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
                                     Research
                                                                    Tata
  projects                                                        Memorial
                                                                   Centre

• Implementation in several                                                           Private
                                                                                      Sector
  stages

                                                                                                9
      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


                                                    10
           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

                                                         11
 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


                                                                       12
              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



                                                                               14
      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, I
   srael, New Zealand, Rep Korea
imPACT and First Executions: Sri Lanka, Vietnam
Preliminary imPACT: Yemen
Assistance Requests Received: Afghanistan, Syria


                                                                                   16
                       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
Europe
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
                                                                             17
        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


                                                             19
     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          PACT:
  • 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
    PACT:
  networks
  • Moving towards a global alliance
  and fund to fight cancer                pact@iaea.org

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  More Information:


     pact@iaea.org

          and

http://www.iaea.org/PACT/




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