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Improving cancer control in developing countries

19 November 2010 -- Three-quarters of cancer deaths occur in developing countries where the resources needed to prevent, diagnose and treat cancer are severely limited. As a result WHO and the International Atomic Energy Agency (IAEA) have created a Joint Programme on Cancer Control focusing on the needs of developing countries.

Transcript of the podcast

Veronica Riemer: You're listening to the WHO Podcast and my name is Veronica Riemer. In this episode we look at cancer care in the developing world.

Veronica Riemer: Cancer is a leading cause of death worldwide, killing nearly eight million people a year. Yet about one-third of these lives could be saved if cancer is detected and treated early. Screening programmes to identify early cancer, such as mammography for breast cancer, and "pap smears" for cervical cancer are now available in many countries. However, three-quarters of cancer deaths occur in developing countries where the resources needed to prevent, diagnose and treat cancer are severely limited or nonexistent.

The International Atomic Energy Agency (also known as IAEA) and the World Health Organization have come together to produce a Joint Programme on Cancer Control, which focuses on the needs of developing countries. Dr Margaret Chan, WHO's Director-General explains what the IAEA brings to this programme:

Dr Margaret Chan: For public health, the complexity of cancer control increased enormously following the shift of the disease burden from wealthy to less affluent societies. As IAEA has brought to world attention, some 30 developing countries, including 15 in Africa, do not possess even a single radiation therapy machine. In some African countries, only 20% of patients survive cancers, such as cervical cancer, that are highly curable elsewhere in the world. IAEA offers unparalleled expertise in radiation medicine, a vital component of cancer diagnosis and treatment. For an agency that received the Nobel Peace Prize in 2005, I find this a truly noble, peaceful use of nuclear energy.

Veronica Riemer: The problem is most severe in sub Saharan Africa, where 80 percent of the continent’s one billion inhabitants live without proper access to basic radiotherapy and related cancer services. The IAEA calls on manufacturers of diagnostic and radiotherapy technologies to produce equipment that’s more affordable and suitable for the challenging conditions in the developing world. Massoud Samiei is the Head of the Programme of Action for Cancer Therapy (PACT) at the IAEA.

Massoud Samiei: The main problem is that countries do not have the resources to buy the equipment. The cost of equipment currently is high and is not within the budget available to many ministries of health. And even if they have plans, they will not be able to acquire all the equipment they need.

Veronica Riemer: The IAEA is encouraging manufacturers to simplify their designs, to make equipment more affordable, and more suitable to the conditions of developing countries.

Massoud Samiei: Currently, a complete package for a developing country would cost three, four million dollars in terms of equipment required to set up a radiotherapy clinic. We have now asked them to try and think about a one million dollar package. A package that would include all the essential equipment and components but will cost only one million dollars, at today’s prices.
And I am very pleased that we have received positive offers from at least two manufacturers who are looking into such a package and very soon they are hoping to put that in the market.

Veronica Riemer: Dr Olola Oneko is a gyneocologist working at the Kilimanjaro Christian Medical Centre, a teaching hospital in Moshi, Tanzania. The hospital offers a screening service with a new method called VIA (visual inspection with asetic acid) which means that the disease can be detected much earlier. However, once detected, the hospital has no radiation therapy and is therefore unable to offer further treatment.

Dr Olola Oneko: In our hospital in Moshi, we would like to have radio therapy units, so that our women don't travel long distances in order to access health. We see very many women suffering for cervical cancer. After detection, we send them to Dar es Salam, Ocean Road hospital where they get radio therapy. But unfortunately most of them cannot access Ocean Road because of costs transport from Moshi, where I work, to Dar es Salam is very far, it is about seven hours bus drive. This means that most of the people are not able to pay transport. They don't simply go there, and in fact they may come back to our hospital, may die in the hospital or at home.

Veronica Riemer: Dr Olola Oneko went on to explain that having technology means nothing without well-trained and motivated staff to use it.

Dr Olola Oneko: We still need resource people which at the moment we don't have, we need oncologists, cancer specialists which we don't have, we need technicians. The way forward is to first of all have units in our countries, in our teaching hospitals. These radio therapy units would function for example, as training oncologists and through that we think that we would manage cervical cancer much better than what we are seeing today.

Veronica Riemer: Adriana Velazquez from WHO's Department for Diagnostic Imaging and Medical Devices explains how WHO and the IAEA, are working together with governments, the medical device industry and health professionals to develop cost-effective solutions for the treatment and prevention of cancer.

Adriana Velazquez: Earlier this year WHO launched a survey to identify, among other things, which countries lack medical devices, specifically equipment to treat and prevent cancer. We need to make sure that this equipment is really accessible and available to all those in need. Appropriate to the health care setting, doesn't matter if it is a country or city hospital and affordable to all those who provide the care. But the International Atomic Energy Agency (IAEA) is not the only organization which is collaborating with WHO. We have agreed with the International Organization of Medical Physics, to provide training to health personnel in the best use of this very important equipment.

Veronica Riemer: This is one more area where WHO and partners are working together to develop training and mentoring networks, and innovative public-private partnerships to improve public health.

That's all for this edition of the WHO podcast. If you would like more information about cancer screening and treatment there are links on the transcript page of this podcast. For the World Health Organization, this is Veronica Riemer in Geneva.

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