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Strengthening Oncological Services in Tajikistan, with a Growing Focus on Women’s Cancers

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Young doctors at the Republic Oncology Research Centre. (Photo: O. Pellet/IAEA)

Each year, medical professionals at Tajikistan’s Republic Oncological Scientific Centre (RCCO) must contend with nearly 6,000 new cases of cancer, of which approximately 70% might be treatable through radiotherapy. To ease the burden placed on the RCCO and to expand access to cancer therapy, an ongoing IAEA technical cooperation (TC) project is working toward the enhancement of radiotherapy services at the RCCO and the inauguration of a new radiotherapy centre in the country’s northern Sughd Province. Dazhu Yang, Deputy Director General (DDG) and Head of the Department of Technical Cooperation, visited Tajikistan in June to meet with high level officials and to observe the progress of the projects which are working toward the expansion and enhancement of radiotherapy services in the country.

Beginning in 2014[1], a series of IAEA projects have been implemented to strengthen the quality of cancer services in Tajikistan. Through its technical cooperation programme, the IAEA has supported the procurement of radiotherapy equipment, while simultaneously delivering training in the latest dosimetry, safety and quality management methods.

Tajikistan is the second most mountainous country in the world—as a result of its unique geography, gaining access to healthcare services has traditionally been very challenging for those living outside of the capital, far away from the country’s only radiotherapy facility at the RCCO.

 “Technical cooperation projects in the area of human health represent close to 25 percent of the TC programme and, following projects related to food and agriculture, account for the highest disbursement of TC funds. The majority of these health projects focus on the fight against cancer,” explained DDG Yang. “The new radiotherapy department, awaiting inauguration later this year, represents a milestone in Tajikistan’s efforts to expand access to cancer therapy, but more work is required if we are going to overcome the challenge of access.”

Enhancing and Expanding Services

Reflecting the challenge of access, a new project[2] was launched in 2018 to support Tajikistan’s efforts to build and equip a new radiotherapy department at the Sughd Regional Oncological Centre in Khujand, approximately 300 kilometres from the capital.

“The main problem is distance, accommodation and fees, which places a heavy burden on the Northern population,” explained Ilkhom Mirsaidov, National Liaison Officer for Tajikistan. “For the time being, radiotherapy services are only available at the Republican Oncological Scientific Centre—however, the equipment [at the RCCO] was temporarily out of operation due to heavy patient loads. Once the radiotherapy unit is operational in Khujand, it will contribute to decreasing the load and increasing access.”

As the radiotherapy department in the Sughd Regional Oncological Centre is entirely new, the IAEA has provided support from the outset. In addition to the procurement of major equipment—such as a new teletherapy treatment unit, a conventional simulator and a treatment planning system—the IAEA purchased quality assurance equipment, radiation survey meters and dosimeters, and arranged fellowships and scientific visits to facilitate training in modern technologies and treatment modalities. Additionally, a series of expert missions were launched to advise Tajik counterparts on the set-up and commissioning of the new equipment.

Moreover, five TC Fellowships in the area of radiotherapy were organized by the Agency—with the support of Armenian counterparts at the National Centre of Oncology in Yerevan—to ensure that a team of well-qualified nurses was in place to staff and support the Khujand radiotherapy centre upon its inauguration.

Future Focus on Women’s Cancers

Building on these efforts, the Deputy Director General discussed proposals for a new four-year project for the 2020-2021 TC programme cycle, which would be expected to help enhance diagnostic radiology services and to place greater emphasis on women’s cancers. Breast cancer is the most common female cancer worldwide, and cervical cancer also has a high incidence rate. In Tajikistan, according to the International Agency for Research on Cancer, breast cancers account for almost 20 percent of all cancers in women. 

Since May 2019, the Tajik counterparts have been working on the design of a project to support diagnostic imaging in oncology. Under this proposed project, the design and development of a Women’s Cancer Diagnostic and Treatment Centre has been planned, and is expected to be housed within the existing RCCO facility in Dushanbe, in addition to long term fellowship training and imaging equipment to help address the country's cancer burden.   

[1] TAD6006, ‘Providing Radiotherapy Services in the Sugd Regional Cancer Centre’

[2] TAD6007, ‘Strengthening the Central and Northern Oncology Centres’

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