IAEA International Atomic Energy Agency First Global Forum on Medical Devices IAEA / PACT Advisory Group IAEA / PACT Advisory Group Increasing access to radiotherapy Increasing access to radiotherapy in low in low - - resource countries (AGaRT) resource countries (AGaRT) Professor Graeme Morgan Consultant - PACT Programme Office
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IAEA / PACT Advisory Group Increasing access to radiotherapy in low-resource countries
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IAEAInternational Atomic Energy Agency
First Global Forum on Medical Devices
IAEA / PACT Advisory Group IAEA / PACT Advisory Group
Increasing access to radiotherapy Increasing access to radiotherapy
in lowin low--resource countries (AGaRT)resource countries (AGaRT)
Professor Graeme MorganConsultant - PACT Programme Office
IAEA
The Burden of Cancer
IAEA 3IAEA PACT July 2008 3
� Forge strategic partnerships with international organisations, private sector and NGOs
� Develop Joint Programme with WHO
� Mobilise new resources
� Make technologies more suitable and affordable
3
International Network for Cancer Treatment and
Research
Tata MemorialCentre
Tata Tata MemorialMemorialCentreCentre
PrivateSector
PrivateSector
: An IAEA Umbrella Programme
improving cancer survival indeveloping countries
IAEA
���� WHO - IAEA PACT programme
PACT = Programme of Action for Cancer Treatment
• National Cancer Control Programme• Education • Prevention• Screening• Diagnosis – Radiology, Nuclear medicine, Pathology• Treatment – Surgery, Radiotherapy, Chemotherapy• Palliative Care• Cancer Registry
PACT Model Demonstration SitesVietnam Sri LankaYemen AlbaniaTanzania Nicaragua
IAEA
Why Radiotherapy ?
• Over 50% of cancer patients need radiotherapy
• Need for radiotherapy greater in LMIC as most
patients are late stage or palliative
Barton 2006
• Surgery or chemotherapy
are not a substitute for
radiotherapy in most cases
0.58Bladder
0.46Corpus uteri
0.58Cervix uteri
0.83Breast
0.60Prostate
0.76Lung
1.00Larynx
0.68Stomach
0.80Oesophagus
0.78Oral cavity
Proportion recommended for RT
Selected sites
0.58Bladder
0.46Corpus uteri
0.58Cervix uteri
0.83Breast
0.60Prostate
0.76Lung
1.00Larynx
0.68Stomach
0.80Oesophagus
0.78Oral cavity
Proportion recommended for RT
Selected sites
IAEA
Composition
• Users from developing countries
• International Organisations: IAEA, WHO, IEC, World Bank
• Scientific and professional societies
• Manufacturers of diagnostic and radiotherapy equipment
Advisory Group on increasing
access to Radiation Therapy: AGaRT
Objective
• Increasing access to radiotherapy in low and middle income countries
• Complete, integrated solutions for radiotherapy which are affordable, safe, reliable, effective and suitable for low-resource settings
IAEA 7
IAEA’s Overall Goal
Cooperate with its Member States 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 and NCCP
This doesn’t mean machines alone! There’s more
emphasis on trained professionals and quality of radiation and clinical services
This doesnThis doesn’’t mean machines alone! Theret mean machines alone! There’’s more s more
emphasis on trained professionals and quality of emphasis on trained professionals and quality of
radiation and clinical servicesradiation and clinical services
IAEA 8
Basic Radiotherapy Clinic: ~ $3 - 5MEssential Equipment and Staffing
Buildings: ����$0.7 - 1.0M• A megavoltage bunker
• A shielded room for simulator
• A high dose rate brachytherapy (HDR) bunker
• A mould room, dosimetry planning/physicist room etc