Challenges of accessible radiotherapy in developing countries

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Published: 7 Jan 2015
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Nelly Enwerem-Bromson - Director, International Atomic Energy Agency

"It's just not acceptable in the twenty-first century that whether you get to live or die depends on an accident of birth," says Nelly Enwerem-Bromson of the IAEA.

Speaking to ecancertv at the UICC World Cancer Congress 2014, she describes the current challenges of bringing radiotherapy to developing countries and ensuring its global accessibility.

PACT supports our member states; we’re a UN agency so member state based and driven. So we support our member states in fighting cancer, that’s the simple answer, how we do so is by harnessing resources and partnerships and bringing together the various stakeholders and trying to have a co-ordinated approach to ensuring that countries have access to radiotherapy, diagnostic imaging and radiotherapy. So that’s basically what we do. The mandate of the agency, of course, is… we’re thought of as the nuclear watchdogs, that’s what we’re best known for and most people associate the IAEA with Iran and DPR Korea but we have actually a huge programme in health and cancer particularly. I think that there are over a hundred people, in one way or another, working in cancer.

Everybody in the general public would assume that everybody has got radiotherapy; tell us the facts.

Unfortunately not. I’m actually a cancer survivor and I have dual citizenship, one of which is a country in Europe and the other one a country in Africa and I always say the only reason why I’m alive today is probably because I happened to be living in the European country and not the African country and therefore was diagnosed early and had adequate treatment. That’s just not acceptable in the 21st century that whether you get to live or die depends on an accident of birth. There are over 36 countries worldwide that have absolutely no access to radiotherapy, nothing, nothing at all. So that’s what we do, we try to support those countries in getting access to radiotherapy but doing so, not just plonking a radiotherapy unit in the country but making sure that that is part of a comprehensive cancer control programme where there are robust registries that enable us to know what the incidence of the disease is and where it’s located and in what areas and what types; that there is a national cancer control plan that we align behind and that is country driven and that the country has ownership of; that there is adequate prevention and screening and detection, early detection, and then treatment, treatment that is surgery; there are three pillars, as you know, surgery, chemotherapy and radiotherapy, and palliative care. So we need to make sure that everything is in place, that all of the different components are harmonised and that radiotherapy is part of a… that we look at it in terms of strengthening the health system, that it is a component of a strong robust health system because we believe that that’s the only way to address the issue in a sustainable manner.

The size and the enormity of the problem is so great that I don’t think we’re going to be able to address it with what we have today and conventional ways of doing so. So we need to strive for innovative financing, I think that’s key, innovative partnerships and innovative technologies to address the issue. That’s what PACT is about, trying to co-ordinate a global response. We work with lots of partners, banks, private sector, NGOs, because we are all needed and we all have an important role to play and it’s a complementary role because the issue is complex and huge and daunting and we need to save lives.