Page 0043

national policies and plans. Further drivers for raising

awareness and global commitment to fight cancer in LMICs

include the Global Action Plan for the Prevention and

Control of NCDs 2013-2020, endorsed by the 66th World

Health Assembly in May 2013, and the World Health

Organization (WHO) Global Monitoring Framework, agreed

by consensus at a formal meeting of WHO Member States in

November 2012. The Global Action Plan establishes costeffective

and affordable interventions on NCDs, including

cancer, - the "best buys" - for all Member States and the

Global Monitoring Framework sets nine voluntary targets

and 25 indicators to monitor the global action on NCDs.

These political declarations and high-level commitments

are built on a decade of significant efforts from the

international community, civil society and governments on

building awareness on cancer control in LMICs. As a result,

an increasing number of countries are approaching the UN

system with requests for technical support to strengthen

capacity in cancer control. WHO is the international agency

within the UN system responsible for health and provides

leadership and advice on the evidence-base for international

action on prevention and control of NCDs, including cancer.

Additional UN agencies have been actively involved in

supporting LMICs. This is the case of the International

Atomic Energy Agency (IAEA), that acts under its mandate to

"accelerate and enlarge the contribution of atomic energy to

peace, health and prosperity throughout the world" (3). The

IAEA approach is predicated on the fundamental role that

radiation medicine plays in cancer diagnosis, treatment and

palliative care.

The global efforts for building awareness on cancer

prevention and control in LMICs - including civil society and

government involvement in information and early detection

campaigns - have led to higher demand for effective and

quality cancer diagnosis and treatment services, in which the

IAEA provides unique support and expertise.

The Programme of Action for Cancer Therapy

(PACT)

The IAEA through its Technical Cooperation (TC) and Human

Health (NAHU) Programmes has been providing support for

the enhancement of radiation medicine capacity for cancer

in LMICs for the past 40 years. Over the past four decades,

the IAEA has delivered cancer-related assistance totalling

more than US$ 260 million to low- and middle-income

Member States, with financial and in-kind support from

Member States, donors and partners. The IAEA assistance

has been primarily facilitated through the procurement of

equipment and training the workforce in imaging diagnosis,

nuclear medicine and radiotherapy. Currently, the IAEA

supports over 130 projects in cancer diagnosis, management

and treatment.

Building on the evidence that a substantial burden of

cancer can be prevented and cancer mortality can be

significantly decreased if the provision of adequate

treatment services and early detection of cancers are

addressed simultaneously, different approaches designed to

actively prevent, cure or manage cancer have emerged.

These approaches are best known as cancer control and

range from prevention through early detection, diagnosis

and treatment to palliative care.

In view of the above, the IAEA created the Programme of

Action for Cancer Therapy (PACT) in 2004. PACT's objective

is to build strategic partnerships with pre-eminent

organizations, such as WHO, IARC and the Union of

International Cancer Control (UICC) in order to leverage the

effectiveness of radiation medicine services in LMICs by

integrating them within a comprehensive cancer control

approach. Through PACT, the IAEA is combining its expertise

in radiation medicine with the experience of WHO and other

international partners to deliver comprehensive cancer

control to the places that need it most.

Assessing the need and targeting support to priority

areas

WHO recommends that planning in cancer control should

start with a needs assessment of all aspects of the cancer

continuum in the country, in order to implement evidencebased

strategies adapted to the country's specific context

(4). In line with this principle, the IAEA through PACT offers

its Member States a tool, known as integrated mission of

PACT (imPACT Review), to assess the status of cancer

control plans and activities and the readiness to develop and

implement a long-term radiation medicine infrastructure

and capacity-building plan (5).

The IAEA through its Technical

Cooperation (TC) and Human Health

(NAHU) Programmes has been

providing support for the enhancement

of radiation medicine capacity for

cancer in LMICs for the past 40 years

CANCER MANAGEMENT

CANCER CONTROL 2015 41

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