Programme of Action for Cancer Therapy (PACT) Building Partnerships to Fight the Cancer Epidemic General Conference PACT Event 20 September 2012 International Atomic Energy Agency
Why partnerships are needed? Cancer affects us all, and it is not a health problem limited to high income countries! 40% of all cancer deaths can be prevented Cancer killed nearly 8 million people in 2008, almost 5 million in less developed regions Sources: WHO, GLOBOCAN (2008)
Inequity in access to radiotherapy. Despite the needs in LMI countries, access to cancer care is very limited (and not only to radiotherapy) Radiotherapy programmes offered by the are an essential part of the treatment of cancer There is a shortfall of over 5 000 radiotherapy machines in developing countries Source: -DIRAC (2010)
Complementing core expertise Partnerships WHO Headquarters, Regional and Country Offices and IARC (Joint Programme 2009) Key international cancer control organizations (INCTR, UICC, ) Several national cancer institutes and centres (US-NCI, INCa, ) Private sector, foundations
One of PACT s Main Objectives Resource Mobilization
Advocating for Cancer Control: to place cancer on the global agenda (NCDs) and radiation medicine as an important component of cancer treatment Advocacy and outreach
Assessing National Cancer Control Needs Integrated missions of PACT (impact) Multi-disciplinary, multi-stakeholder (involving national authorities,, WHO regional and country offices, partners) Unique tool Outcomes: Assessment of current cancer control capacity Recommendations for action to Ministry of Health Identification of projects for funding
impact Review Process Official request by Ministry of Health Prioritization and selection (PPO, NAHU, TC, NSRW, WHO and other partners) WHO/ Self-Assessment and Comprehensive Desk Study Preparation and implementation of impact Review Mission Report to Minister of Health impact Follow-up
Global impact implementation Received impact Review [47, by end 2012]
impact in Africa Received impact Review [22, by end 2012] 22 of 41 TCAF recipient Member States have received impact Review
impact in Asia and Pacific Received impact review [10, by end 2012] 10 of 34 TCAP recipient Member States have received impact Review
impact in Latin America Received impact review [8, by end 2012] 8 of 23 TCLA recipient Member States have received impact Review
impact in Europe Received impact review [7, by end 2012] 7 of 31 TCEU recipient Member States have received impact Review
Contributors to impact Average cost of impact Review is estimated at US $50 000 PACT has relied upon multiple funding sources to implement impact: Since 2010, contributions from the United States through the Peaceful Uses Initiative have supported implementation of 12 impact Review missions (by end 2012) as well as follow-up missions to seven PMDS Czech Republic, France, Monaco, New Zealand and Spain have contributed to impact Korea Nuclear International Cooperation Foundation (KONICOF) TC regional projects
The Impact of impact Thanks to your contributions, impact has provided 47 countries with: Knowledge that empowers development of a comprehensive national cancer control plan and programme A tool to establish cancer control priorities and activities Foundation on which to build projects for possible funding
Showcasing Synergy in Cancer Control PACT Model Demonstration Sites (PMDS) Promote comprehensive national cancer control approach Demonstrate success through synergies between international partners and national authorities for comprehensive cancer control Enable resource mobilization and replication in other Member States 8 PMDS Albania, Ghana, Mongolia, Nicaragua, Sri Lanka, Tanzania, Vietnam, Yemen
Member States or other entities decide to donate through PACT Donor Member State/Entity Expressed interest in supporting specific region or Member State(s) or an area of cancer control PACT Presentation of relevant projects identified by recipient Member States as an outcome of impact and TC programme Agreement between the Donor, the recipient Member State(s) and the ; acceptance of donation Recipient Member State(s) Project implementation
OFID Supports Albania through PACT
A Creast Cancer Project is Submitted to the OPEC Fund for International Development What was the process? impact mission conducted in Albania in 2006, needs and priorities in cancer control assessed Major problem in Albania: Breast Cancer (most common cancer in women) but NO strategy In collaboration with IARC and WHO, workshop organized in Tirana to discuss strategy for breast cancer control As a result, a Breast Cancer Project was developed by Albanian counterparts, in collaboration with WHO Country and Regional Offices, and submitted to OFID
The project: New Model for Raising Breast Cancer Awareness Decision to train professionals in the area of diagnosis and treatment, as part of the project Identification of a centre for training: Centro di Riferimento Oncologico, Aviano, Italy Training of primary healthcare professionals Information materials developed and distributed to the population Cancer survivor network established
The project: New Model for Raising Breast Cancer Awareness Project outcome: 15+ professionals trained abroad Capacity to train health care professionals Project has begun to attract donors: - Order of Malta - United Nations Population Fund (UNFPA) Expected outcome: Increase in number of patients diagnosed earlier, and therefore survival and quality of life
Some projects supported by OFID through PACT Nicaragua: Early Detection, Diagnosis and Treatment of Cervical and Paediatric Cancers in Women and Children Tanzania: Increased Access to Palliative Care Services for Cancer Patients Vietnam: Advancing Cancer Control in Vietnam
Member States or other entities decide to donate through PACT Donor Member State/Entity Expressed interest in supporting specific region or Member State(s) or a specific area of cancer control PACT Presentation of relevant projects identified by recipient Member States as an outcome of impact and TC programme Agreement between the Donor, the recipient Member State(s) and the ; acceptance of donation Recipient Member State(s) Project implementation
Support from the Principality of Monaco for Strengthening Palliative Care in Mongolia Last year, Monaco expressed interest to support Mongolia through PACT A project was presented by Mongolia based upon the impact findings Review of project proposal on strengthening palliative care services (Ministry of Health, NLO, National Cancer Center, WHO Country Office, NAHU, PPO) PPO submitted the project to Monaco Trilateral Agreement (, Mongolia, Monaco) Transfer of funds and project implementation before end of the year
Support from the Principality of Monaco for Strengthening Palliative Care in Mongolia What will be the benefit for the cancer patients of Mongolia? The Palliative Care Department of the National Cancer Center (NCC) Mongolia will be equipped and upgraded with modern medical devices Health professionals trained abroad as trainers Doctors and nurses from provincial and district level will be trained at the NCC Provision of quality palliative care in 21 provinces and 9 districts More than 3000 cancer patients will have access to palliative care
Other Examples of Support from Member States Spain to Nicaragua: Strengthening cervical and breast cancer diagnosis at the Hospital Bertha Calderon Czech Republic to Moldova: impact review and workshop on advancing comprehensive cancer control Monaco to Niger: Establishment of a Radiotherapy Centre India to Vietnam, Sri Lanka and Namibia: Donation of Co60 radiotherapy machines
Member States Supporting a Specific Region During the 55 th General Conference, Korea expressed interest to support Asia and Pacific Member States through PACT Indonesia, Mongolia, Sri Lanka and Vietnam presented project proposals PPO coordinated the review of project proposals Acceptance of projects by Korean Institute of Radiological and Medical Sciences (KIRAMS) (2012) 23 health professionals in the area of radiation medicine and cancer control will be trained plus several will benefit from the expert training in own country Other example: Institut National du Cancer (INCa, France) to Francophone Member States
Support from United Nations Women s Guild (UNWG) to Paediatric Cancer Patients UNWG committed to the welfare of needy children throughout the world Review and submission of project proposals received from PMDS (PPO) Projects supported to date: Nicaragua (waiting room) Mongolia (playground) Tanzania (paediatric beds) Sri Lanka (blood gas analyser)
% of global burden of disesase Health workforce - Training Needs Human resources development is key to implement cancer control plans 35 30 25 20 Africa South-East Asia Western Pacific Distribution of health workers by level of expenditure and burden of disease (as per WHO regions) 15 Europe Americas 10 5 Eastern Mediterranean 0 0 5 10 15 20 25 30 35 40 45 % of global workforce Size of the dots is proportional to total health expenditure Source: WHO (2006)
In-kind contribution to training needs US National Cancer Institute PACT assists with candidate selection / logistics/ follow up Need to increase in kind contribution for training in: Radiation Medicine, Prevention, Early Detection, Palliative Care, Cancer Information, Cancer Control Planning
Private sector support to shortage of cancer professionals Virtual University for Cancer Control (VUCCnet) Funding (US $5.5 million): Roche African Research Foundation US Government Member State Consortia Aim: To increase regional capacity to educate and train workers in cancer control role diminishes over time
expenditure on TC cancer-related projects (1980-2011) Despite the s efforts, the needs can not be covered Other options have to be explore by Member States EUROPE $60million ASIA and the PACIFIC $55 million LATIN AMERICA $65 million AFRICA $76 million INTERREGIONAL $7 million TOTAL EXPENDITURE 33 * These figures do not include s corresponding overhead costs. $263 million
Supporting the development of bankable documents on cancer control (1/2) Decision by Government (Ministry of Finance, Health ) to engage in soft loan(s) for funding its cancer control activities Initiation of a project proposal or draft bankable document and request for support Member State PACT Inputs from existing documents on status of Member State s radiation medicine activities (Country Cancer Profile, impact report, completed/active TC projects) (PPO, TC, NAHU, NSRW) Technical review of radiation medicine (including safety) component (NAHU, NSRW) Liaison with external partners (WHO, others) for technical review of non radiation medicine components (PPO)
Supporting the development of bankable documents on cancer control (2/2) PACT Specialist support in resource mobilization and design of bankable documents (PPO) Liaison with development banks (PPO, TC) Member State Submission of bankable document to development bank(s) for funding Project implementation ( technical guidance)
Ghana Bankable Document impact mission 2005 Development of comprehensive proposal Building Comprehensive Cancer Control Capabilities in Ghana Stakeholder meeting in Vienna in 2008 to finalize the bankable document (TC, NAHU, PPO, Ghana, WHO) Submission of bankable document to OPEC Fund for International Development (OFID) and the Arab Bank for Development in Africa (BADEA) Written support by Director General Long term development loans obtained from BADEA (US $6.5 million) and OFID (US $7 million) to strengthen Ghana s radiotherapy and nuclear medicine capacity Ghana pledged complementary funds for cancer registration, prevention, early detection and palliative care
Islamic Development Bank (IDB) > two years joint efforts identifying common interest of IDB and and advocating for the needs for cancer control in Africa (PPO, TC) Identification of 11 common Member States in Africa with needs for financial support in cancer control Joint High Level Seminar in September 2012 at IDB HQ (, IDB, Organisation of Islamic Cooperation (OIC), 9 Member States, OFID, Saudi Development Fund) 8 Member States expressed Government s decision to present a bankable document to IDB IDB and agreed to join efforts and liaise with partners (WHO, others) IDB, OIC, OFID and SDF to list cancer control as a priority Conclusions
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