Steps to Sustainable Cancer Treatment

Senior representatives from four African IAEA Member States – Chad, Eswatini, Liberia and Sierra Leone – came to Vienna last week to develop planning and funding proposals for the establishment of the first radiotherapy facilities in their countries. The meeting was hosted by the IAEA as part of a phased approach to increase cancer services in low and middle income countries.

“Establishing a country’s first radiotherapy facility is very complex. The IAEA is on hand to support Member States to plan and implement each step so that cancer services have both an immediate and long-lasting beneficial effect for patients,” said Shaukat Abdulrazak, Director for IAEA’s Technical Cooperation regional division for Africa. “Where countries have not yet secured the necessary funding, the bankable documents being developed at this meeting will be indispensable when approaching potential donors and development banks.”

The IAEA has recently conducted comprehensive reviews of cancer control capacities – imPACT Reviews – in the four countries, which highlighted the need to establish radiotherapy facilities as part of a coordinated national approach to address cancer.

The participants, drawn from government ministries and national hospitals, each outlined their cancer control plans and where the country needs to go from there. IAEA experts then worked with each participant to build plans detailing the infrastructure, training and equipment requirements for their national radiotherapy facility. Once complete, these documents can be used to approach potential donors and funding institutions.

“This meeting has helped us progress designs for a highly specialised cancer facility, not a regular medical centre. This underlines the importance of robust planning from the start,” said Winnerford Richards, Assistant Chief Architect at Liberia’s Ministry of Public Works. “I am receiving input from my colleagues at the Ministries of Health and Finance, who agree what cancer services are needed and what should be added to the proposal. We can then translate this into a design for a cancer centre which suits our needs and will benefit patients for years to come.”

Training staff for the future

Cancer is a global issue. While over a million people in Africa develop the disease each year, according to the International Agency for Research on Cancer, diagnostic and treatment services are severely limited. Some 28 countries in Africa have no radiotherapy services, which is essential for treatment.

“Our President recognises that cancer is creating a huge burden for the country. His flagship project looks to make radiotherapy publicly available by 2023,” said Frank Kosia, radiologist and focal point for the Ministry of Health and Sanitation in Sierra Leone. “This high-level commitment speeds up Government approvals for the new radiotherapy centre, but the project’s urgency requires the plan to ensure medical staff are trained when facility becomes operational. This is a big challenge.”

Improving the skills of medical staff was a common concern. “While we have secured funding for a new comprehensive cancer centre in the public sector, this did not include training the highly specialised staff required. We must raise these funds,” said Fatima Hagger, Medical Oncologist at the Hôpital de la mère et de l’enfant in Chad’s capital, N’Djamena. “This is a very limiting factor, because the centre will open in around three years and it will take this time to qualify all the staff we need.”

IAEA assistance and support

The IAEA has supported Member States for over 60 years with knowledge, skills and equipment so that Governments can detect and treat cancers earlier and save more lives.

“I have been collecting cancer-related information for a long time to plan our first centre. This meeting has helped link it all together,” said Velephi Joana Okello, Deputy Director of Health Services at Eswatini’s Ministry of Health. “It’s all become clear to me now – how many machines we will need, the skills and number of qualified staff we require, and how much it will all cost.”

Luis Longoria, acting Director of IAEA’s Programme of Action for Cancer Therapy, agreed. “For Member States these plans create a complete picture of what is needed and its cost; for donors they provide the justification and reassurance of the feasibility and sustainability of these urgently needed facilities,” he said.

In concluding the meeting, Neil Jarvis from the IAEA’s Division for Africa, emphasised the need to keep the momentum going to ensure that bankable documents are finalised and approved so that work on establishing the radiotherapy centres and staff training can commence as soon as possible. Patients will then receive the lifesaving care they need in their own country.