World Health Assembly Boosts Medical Imaging Capacity

An IAEA-initiated commission - the first comprehensive global assessment of medical imaging-related needs and resources across the globe - has provided an impetus for a recent World Health Assembly resolution. Adopted by consensus in May, the resolution titled "Strengthening Medical Imaging Capacity" recognizes how vital medical imaging is for diagnosing and treating diseases, injuries and other health conditions.

"This landmark resolution is a crucial tool to realise effective universal health coverage that includes imaging," reflected Adriana Velazquez Berumen, former Team Lead of Medical Devices and In Vitro Diagnostics at the World Health Organization (WHO). "It will significantly impact efforts to tackle the rising burden of cancer and other communicable and non-communicable diseases around the world."

As part of its efforts to address the growing cancer burden, the IAEA developed a concept note for a Lancet Oncology Commission - a global public good that provides data and recommendations to support better policy and change practice - and convened a kick-off meeting in 2018. Inviting 27 of the world's leading medical societies and organizations to join forces, the Commission examined access to an essential component of care: medical imaging. Through its human health programme , the IAEA collected data on equipment availability, workforce personnel, and procedure variety and built the IAEA Medical Imaging and Nuclear Medicine (IMAGINE) Global Database . As part of its primary data sources, IMAGINE drew on the information provided by national, regional and global professional societies and organizations within medical imaging and nuclear medicine.

The resulting analysis - published in 2021 as the Lancet Oncology Commission on Medical Imaging and Nuclear Medicine - revealed stark global disparities. At the same time, it highlighted the substantial health and economic benefits which could be realised by expanding access. Scaling up imaging alone could not only avert 2.5 million of the 76 million projected cancer deaths between 2020 and 2030 but also yield lifetime productivity gains of US$ 1.23 trillion - a net return of nearly US $180 for every dollar invested, they found. Doing so alongside a comprehensive scale-up of treatment and care quality could increase these figures to nearly 10 million lives saved and $2.66 trillion gained.

"The Lancet Oncology Commission provided a compelling evidence base for action for healthcare professionals and policymakers worldwide," said Hedvig Hricak, chair emeritus of the Department of Radiology at Memorial Sloan Kettering Cancer Center and joint lead author. "Its message is clear: the time to act is now!"

In that vein, the medical imaging commission's three lead authors formed a 10-member group which included the IAEA, the International Society of Radiology and the World Federation of Nuclear Medicine and Biology to support global efforts towards a dedicated resolution.

"I thank the work of the [various] Lancet Oncology commissions on medical imaging and nuclear medicine , cancer in sub-Saharan Africa , radiotherapy and theranostics and global surgery," Theophile Olivier Bosse, First Counsellor in the Permanent Mission of the Republic of Cameroon to the United Nations Office and other international organizations in Geneva - said during a 25 March webinar organized by members of that group. "For many countries around the world including those in Africa, [medical imaging] will represent a considerable qualitative leap forward," he emphasized, adding: "A new era is opening up for the health systems of a fragile continent beset by a number of health threats."

Following the proposal of a draft resolution by Cameroon, several countries - including Armenia, Burkina Faso, Brazil, China, Ethiopia and Thailand - co-sponsored the text while consultations were coordinated by WHO's medical devices team lead. During its 156th session in February, the World Health Organization's Executive Board decided to recommend the draft's adoption by the 78th World Health Assembly. At its annual session in May, the Assembly subsequently adopted the resolution.

Under the terms of the resolution, the Assembly urges countries to promote access to medical imaging by implementing appropriate policies, strategies, programmes, norms and standards. Within their national contexts and circumstances, countries are to promote sustainable investments in imaging equipment, infrastructure, maintenance and quality management systems. Among other actions, they are also urged to strengthen training and education of a health workforce, ensure affordable and equitable access, and consider including medical imaging technologies within their national lists of devices for benefit packages or reimbursement schemes.

"To support the implementation of the imaging and diagnostics resolutions, the IAEA has joined the Global Diagnostics Coalition ," noted May Abdel-Wahab, Director of the IAEA Division of Human Health and joint lead author of the Lancet Oncology Commission on Medical Imaging and Nuclear Medicine. Launched during a side event at the Assembly as a WHO-managed network, the Coalition serves as a collaborative platform to provide strategic direction and coordinate global efforts. "Through its human health programme , the IAEA will continue to provide its technical expertise and experience towards supporting countries in realizing safe, effective and high-quality medical imaging for all," Abdel-Wahab emphasized.