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Expanding Cancer Control: IAEA, WHO and PAHO Support Colombia


During the course of the imPACT Review, staff at 21 health provider institutions across Colombia were interviewed by experts from the IAEA, WHO and PAHO. (Photo: L. Loaiza)

Cancer is currently the second leading cause of mortality in Colombia and is a significant public health challenge, placing a high economic burden on the health system. Estimates from the International Agency for Research on Cancer’s (IARC) Global Cancer Observatory indicate that the number of cancer cases and deaths in Colombia will increase by about 40 per cent by 2030 and almost 50 per cent by 2040.

From 21 to 25 November, a team of 11 international experts in all areas of cancer prevention and control arrived in Colombia from various countries in Latin America and the Caribbean, for an imPACT mission coordinated and conducted by the IAEA jointly with the World Health Organization (WHO) and Pan American Health Organization (PAHO).

Travelling 11 000 kilometers within the country, the interdisciplinary team visited eight public and 11 private hospitals, and met with close to 100 local actors to explore existing geographical and economic inequalities in access to cancer care services. After gathering their findings, the team met with the Ministry of Health and Social Protection to share their recommendations. To collect as much evidence and as many testimonies as possible, the review experts also carried out interviews with health provider institutions and public health administrators at both national and local level, using online questionnaires, focus groups, individual interviews and regional workshops covering Colombia’s five regions, from as early as July this year, with the support of 21 national experts appointed by Colombia’s Ministry of Health.

“This review has aimed to identify opportunities to improve quality and has contributed to strengthening the equity of cancer services by providing the information required for action planning and evaluation,” said Nubia Bautista, Deputy Director of Non-Transmissible Diseases in the Ministry of Health and Social Protection. "This imPACT Review has endeavored to capture Colombia's geographical, cultural and socioeconomic diversity. Despite the country’s expansive human and technological capacities, there are communities in Colombia that have limited access to cancer prevention, diagnostic and treatment services and facilities, including ancestral communities, isolated communities and migrant communities.”

The objective of imPACT Reviews is to conduct a participatory analysis of the capacities and needs of a country’s national healthcare system in the areas of cancer prevention and control. Colombia requested its first imPACT Review in 2011, and on the review recommendations launched its Ten-Year Cancer Control Plan in 2012. The November 2022 follow-up imPACT review was launched at the request of the Ministry of Health and Social Protection, which sought a comprehensive assessment of the country’s cancer control capacities by a team of IAEA, WHO and PAHO experts.

The interviews and discussions were conducted using online questionnaires, focus groups, individual interviews and regional workshops covering Colombia’s five regions. (Photo: G. Venegas)

To reduce inequity in access to services in specific regions and population groups, particularly remote regions of the country, ancestral communities and migrant populations, the imPACT Review experts proposed the development of a coordinated care model, including strategies such as extramural care, the use of telemedicine and the use of appropriate technologies.

The imPACT Review identified other major gaps in the provision of cancer control services that need to be resolved to promote equitable access to cancer prevention and control services. The Review report stated that an early detection programme would be needed to reduce the number of cancer cases presenting at an advanced stage. It also detailed information systems for cancer surveillance with which to enhance the national cancer registry that tracks data related to cancer patients and survivors.

"The imPACT mission was successful in that the vision of carrying out the mission with a view to the territories and coverage in remote areas was very well received and is in line with the vision of the new government," said Juan Pablo Parra, National Liaison Officer for technical cooperation with the IAEA in Colombia, noting the mission’s focus on cross-cutting issues, including indigenous and remote communities.

“Undoubtedly, there is still a long way to go before we can ensure that the entire Colombian population has an equal opportunity to prevent cancer, and to improve the quality of life of cancer patients,” said Carolina Corcho, Minister of Health and Social Protection. "We need to reach all Colombians and we need to provide the best service we can without any discrimination, be it geographical or socioeconomic. All in all, we are working to transform and build an inclusive, predictive and preventive health system, capable of responding to existing gaps.”

imPACT Reviews provide governments and their partners with a baseline situation analysis and a set of recommendations to guide cancer control planning and investments across the cancer control spectrum, from prevention to palliative care. Since 2005, the IAEA has conducted over 100 imPACT Reviews in its member countries.

Unequal access to cancer control and care services in underserved, rural and remote communities was an added focus of the imPACT Review. (Photo: G. Saporiti/IAEA)

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