Enabling people to access quality radiotherapy treatment and diagnostic medical imaging services are crucial steps in the fight against cancer, a disease estimated to cause up to 16 million deaths and 30 million new cases in the next two decades. Around half of all cancer patients require radiotherapy, and almost all of these require medical imaging for diagnosis and treatment planning.
The burden of cancer is particularly heavy in low- and middle-income countries where 70 per cent of global deaths related to cancer, occur. These countries typically receive only around five per cent of the global spending on cancer care.
In recognition of the cancer care imbalance, one year ago IAEA Director General Rafael Mariano Grossi announced the IAEA's "Rays of Hope - Cancer Care for All" initiative, to help low- and middle-income countries establish and improve access to radiation-based medical technologies, such as diagnostic radiology, nuclear medicine and radiotherapy services. The initiative was launched on the eve of an African heads of state summit in the Ethiopian capital Addis Ababa, together with Senegal's President Macky Sall, the Chairperson of the African Union. Of the African Union's members, more than 20 countries do not have a single radiotherapy machine.
Since the launch of Rays of Hope, more than 50 countries have already expressed interest in participating in the initiative, and in June last year six countries pledged over 9 million euro in support of it. To date, a total of 37 million euro have been pledged. These funds and commitments have enabled the IAEA to work more closely with a first wave of seven countries where equipment and training needs have been assessed to increase access to affordable, quality radiation medicine services within a comprehensive cancer control system.
Through Rays of Hope, Kenya will receive two linear accelerators at its regional centres in Nakuru and Mombasa. Linear accelerators are used for external beam radiation treatment. "The two linear accelerators will expand our capacity to treat more cancer patients, while reducing waiting times associated with the high demand for services at these centres," said Mary Nyangasi, Head of the National Cancer Control Program at the Ministry of Health in Kenya. "This of course has a direct impact on improving treatment outcomes with better chances of survival since we anticipate it will eliminate delays in starting radiotherapy treatment."
In addition to Kenya, Rays of Hope is on the ground in Benin, Chad, the Democratic Republic of Congo, Malawi, Niger and Senegal, where the IAEA is partnering with governments to procure radiotherapy, diagnostic radiology, and nuclear medicine equipment; train personnel in its safe and effective use, and develop action plans and resource mobilization strategies to sustainably address gaps in access to cancer care.
The initiative complements the IAEA's six decades of supporting cancer care, including its cooperation with the World Health Organization (WHO) to improve capacities in cancer management and establish safe, secure and effective radiotherapy, radiology, and nuclear medicine facilities around the world. Based on sustainability, it contributes to the fulfilment of the United Nations' 2030 Agenda and Target 3.4 of its Sustainable Development Goal 3 - Good Health and Well-Being - which aims to reduce by one third premature deaths from non-communicable diseases, such as cancer.
Strength in partnerships
The IAEA is forging new partnerships with governments, international financing institutions, the private sector and professional organizations to help save lives and address the disproportionate burden of cancer.
"Joining the Rays of Hope initiative is very meaningful - not only because we recognize the strength of this flagship initiative, which lies in its comprehensive approach, tackling the cancer challenge in a holistic way, but also because of the tangible impact it has in the lives of cancer patients," said Ambassador Pirkko Hämäläinen, Resident Representative of Finland to the IAEA. Finland is one of 10 countries that has pledged funds in support of the initiative.
Israel, which provides ongoing support to the IAEA's work on cancer, has also joined the Rays of Hope Initiative. "This will make a real difference for countries in need of improving their cancer care capacities," said Ambassador David Nusbaum, Resident Representative of Israel to the IAEA. "By joining the donor coalition for Rays of Hope, we hope this sends an important signal to others to commit to this cause and help address the growing gap in access to cancer care in a sustainable way."
In December last year, through Rays of Hope the IAEA launched a multilateral partnership with 11 leading global organizations in the field of cancer care, to strengthen its support to countries, particularly in the areas of capacity building in radiation oncology, medical physics and diagnostic imaging, nuclear medicine and to facilitate cooperation in research, quality assurance, training and delivery of radiotherapy.
A comprehensive, sustainable approach
Rays of Hope combines several elements, from legislation and infrastructure to equipment, training and quality control, into a set of interventions that build on and complement one another for maximum impact. Rays of Hope is also promoting the establishment of 'anchor centres' - regional centres that will help build educational and research infrastructure for neighbouring countries, improving access to cancer care and providing access to radiation medicine in their region where and when it is needed.
To help guide policymakers, programme managers and clinical care providers in establishing and developing cancer treatment facilities, the IAEA and WHO last year issued a strategic document, Setting up a Cancer Centre: A WHO-IAEA Framework.
"Rays of Hope has a strong emphasis on sustainability of cancer care," said May Abdel-Wahab, Director of the IAEA Division of Human Health. "Our partnerships with professional societies, the Anchor Centres, and this flagship document is a valuable tool in the planning and implementation of cancer centres, providing guidance on setting up different levels of cancer services within individual cancer centres." The goal is to improve the level of cancer services through a stepwise approach, providing context and requirements for specific services.
"The response from donors and partners to Rays of Hope is encouraging," said Lisa Stevens, Director of the IAEA Division of the Programme of Action for Cancer Therapy. "Many private sector entities are also awaiting the articulation of the gaps in countries to be able to join forces to address and ensure equitable delivery of cancer care."
