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