Plans are well underway to build a national cancer centre in Djibouti - the first of its kind in a country that currently has no access to radiotherapy, a life-saving treatment estimated to help in approximately 50 per cent of all cancer cases. Djibouti's Ministry of Health invited experts from the International Atomic Energy Agency (IAEA), the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) to conduct a comprehensive cancer assessment imPACT Review in the country in October 2023.
"Introducing radiotherapy is a top priority for our government," said Ahmed Robleh Abdilleh, Minister of Health for Djibouti, "as it will reduce unnecessary deaths from cancer and enable our citizens to avoid having to travel abroad to receive the life-saving treatment they deserve."
Out of Djibouti's population of one million, it has been estimated that over 750 new patients were diagnosed with cancer and over 500 people died from the disease in the year 2020 alone (GLOBOCAN - IARC). These numbers are expected to increase by 70-80 per cent in the next twenty years due to delays in diagnosis and limited treatment options within the country. However, they are only estimates because the country does not currently have a population based cancer registry in place to provide reliable data - something experts from the mission pointed out as a priority action area. "A comprehensive health information system is essential for the government of Djibouti to be able to plan, monitor and evaluate the success of different cancer control strategies and take informed decisions," confirmed Renee Van de Weerdt, Representative for the WHO Djibouti office.
Following data gathering and desk review, eight specialists from the IAEA, WHO and IARC travelled to Djibouti to assess the situation first hand. Experts were fielded from institutions based in Algeria, Egypt, Morocco, Senegal and Sudan underscoring the importance of regional cooperation in addressing pressing health priorities.
At the start of the mission, experts from the IAEA, WHO and IARC met with WHO country representative Renee Van de Weerdt to be briefed on priorities for the visit. (Photo: IAEA)
During the mission, the team visited different hospitals and research institutions and also met several partner organizations. "This visit was an opportunity to focus not only on what the IAEA can bring to cancer patients in Djibouti," said Adeline Djeutie, Programme Management Officer at the IAEA, "but also to explore synergies with other cancer fighting organizations in the country."
Staff in the WHO regional and country office are presently working on a governance roadmap for noncommunicable diseases (NCD). "In order to achieve the best health outcomes for Djiboutians, cancer care efforts need to be integrated within a broader NCD agenda and framework," said Lamia Mahmoud, Regional Advisor for the WHO Regional Office for the Eastern Mediterranean. The team also met the United Nations Population Fund (UNFPA) - currently carrying out a breast and cervical cancer screening programme in the country - and the Djibouti National Scientific Research Centre (Centre National de la Recherche Scientifique), which provides screening services for women for cervical and breast cancer.
"Each individual organization brings its own strengths when it comes to supporting the Djibouti Ministry of Health in its battle against cancer," said Lisa Stevens, Director of the IAEA's Programme of Action for Cancer Therapy, "but it is only together that we can hope to win this fight."
In 2022 the IAEA launched the Rays of Hope initiative to help bridge the gap in cancer care in low-and-middle-income countries. In 2020, over 700 000 people in Africa died of cancer. Over 70 per cent of the population in Africa does not have access to radiotherapy. This is largely because of the enormous lack of radiation medicine equipment and specialists trained in radiotherapy in the region.
In conclusion of the imPACT Review mission, IAEA, WHO and IARC experts met with the Djiboutian Ministry of Health to share preliminary findings and flag the most urgent priorities to be addressed. (Photo: IAEA)
Looking forward in cancer diagnostics and treatment with IAEA support
The government of Djibouti can count on IAEA support for establishing the new radiotherapy centre in the form of specialised training for medical personnel, expertise and guidance for construction and launch, and for sourcing and installing new equipment as part of the Rays of Hope initiative. In addition, the IAEA is helping the country to formulate an adequate legal framework and build the regulatory infrastructure needed to ensure regulatory control and the safe use of ionising radiation. Key personnel have been trained and further tailored assistance is anticipated in this area.
