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World Cancer Day: COVID-19’s Impact on the Fight Against Cancer

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Director General, Rafael Mariano Grossi, at World Cancer Day

IAEA Director General Rafael Mariano Grossi talked about the importance of ongoing support to deveoping countries to ensure adequate cancer care in face of the pandemic. (Photo: D. Calma/IAEA)

Inequality is present in most aspects of life, but in the global fight against cancer the stark difference between industrialised countries and developing nations in their ability to diagnose and treat the disease, is a matter of life and death. Most new cancer cases today occur in low- and middle-income countries, and COVID-19 has further strained the capacities of health infrastructure. Strengthening these health systems is key in the global fights against both cancer and COVID-19.

Marking this year’s World Cancer Day on 4 February, the IAEA held a panel discussion, exploring the impact the COVID-19 pandemic has had on cancer care globally and the support provided by the IAEA to radiotherapy practitioners worldwide. Panelists called for more and urgent action to address the wide gap in diagnosis and therapy access between developed and developing countries.

“This event is an opportunity to be reminded of where we are in our continuous efforts; we can’t stop for a single minute in fighting cancer,” said IAEA Director General Rafael Mariano Grossi in his opening remarks. Speaking from IAEA Headquarters in Vienna to a global audience online, Grossi explained that COVID-19 stretched national medical services, disrupted supply chains and put up numerous other barriers to cancer patients seeking the urgent care they needed. He highlighted that a recent IAEA survey found that in March-April 2020, diagnostic procedures fell on average by more than half in the 72 countries surveyed.

The IAEA supports national governments in using nuclear science and technology to better diagnose, treat and manage cancer. It also helps countries in procuring equipment, training medical professionals and secure resources from donors. The pandemic has not stopped the IAEA in providing support in these areas.

Voices for action

Cancer is the second leading cause of death worldwide, responsible for one-in-six fatalities in 2018 and taking the lives of 9.5 million people. COVID-19, a highly transmissible virus, has to date infected over 103 million people globally, and killed 2.24 million. Tackling cancer in the shadow of COVID-19 has been a priority for the IAEA, which has been cooperating with the World Health Organization to provide assistance around the world.

Speaking first in the day’s panel discussion, May Abdel-Wahab, Director of the IAEA’s Division of Human Health highlighted the importance of radiation medicine in the modern management of cancer patients and shared how the IAEA is promoting and developing radiation medicine in Member States in light of the COVID-19 pandemic.

“Radiotherapy has been an optimal treatment option during the COVID-19 pandemic for cancer patients because it does not compete for in-demand hospital resources such as intensive care unit beds and is amenable to treatments with shorter regimens of radiation, thus minimizing exposure to patients and medical personnel,” she said. “The IAEA has supported medical professionals working in radiation oncology, nuclear medicine and radiology practices through guidance documents, webinars and publications to ensure the continuity of these essential services.”

While in the last 5 years, there has been an increase of around 5 per cent in the number of radiotherapy centres globally, still more than 70 countries have no radiotherapy machines at all — 28 of them are in Africa.

Lisa Stevens, Director of the IAEA’s Programme of Action for Cancer Therapy (PACT), shared how the Agency is supporting countries in cancer control and resource mobilisation for cancer activities under the current circumstances. “In spite of the pandemic, we were able to support three Member States in reviews of their cancer control activities and thirteen Member States held meetings with international experts to review progress and ongoing needs identified in previous imPACT Reviews. We also were able to continue to mobilize financial resources to support cancer activities.”

Belgium highlights partnership on novel educational initiatives and fighting cervical cancer

International coordination and support are critical to helping developing countries address the challenges involved in building cancer care capacities for cancer control, said Ghislain D'Hoop, Belgium’s Ambassador to Austria and Permanent Representative to the international organizations in Vienna. 

He highlighted Belgium's contributions to enhance education and training in nuclear medicine and radiotherapy. Belgium has supported the development of e-learning modules, guidance documents and software platforms implemented through the Human Health Programme of the IAEA to support continued education and facilitate broad access to professional information. "These initiatives are of fundamental importance during the Covid pandemic, where physical meetings and trainings are limited," D'Hoop said.

He also highlighted the country's successive contributions to the UN Joint Global Programme on Cervical Cancer Prevention and Control, supporting activities in Morocco and Tanzania, which included developing e-learning modules on image-guided brachytherapy for cervical cancer. "Despite the Covid challenges, activities must and can be implemented to continue the fight against cancer," he said.

Belgium & France provide 160 000 euros for cancer care in Niger

D'Hoop announced that his country and France will be allocating EUR 160 000 to an IAEA project advancing cancer care in Niger. “Every day is cancer day and we do well to remind ourselves of the millions that fight cancer. Imagine fighting both COVID and cancer in these uncertain times. We must act, and indeed the IAEA is acting,” D’Hoop said.

An IAEA project supported by Belgium and France will send a physician from Niger for training in Algeria — contributing to filling the gap of qualified cancer care professionals in the country and helping to ensure sustainability of care control efforts.

“The support to Niger is a good example of two countries of the North pulling their resources together to help a country in the South through South-South cooperation,” said France’s Permanent Representative to the United Nations in Vienna, Xavier Sticker.

Morocco and fighting cancer in Africa

The patterns and often the causes of cancer in developing countries differ from those in high-income countries. This is particularly noticeable in cervical cancer, which kills 300 000 women each year, of whom 90 per cent are in developing countries — these differences are often due to fewer Human papillomavirus (HPV) vaccinations, a lack of effective screening programmes, and limited treatment options. Interventions are needed across the entire cancer control continuum to reduce cervical cancer incidences in developing countries.

Azzeddine Farhane, Ambassador of Morocco to Austria and Permanent Representative to the United Nations in Vienna, is the President of the 64th session of the IAEA General Conference and in his statement he explained why his country has chosen to make cervical cancer in Africa a priority.  

“Nineteen out of the top twenty countries with cervical cancer incidences are in Africa, and 268 million women aged fifteen and above are at risk of developing cervical cancer. Morocco is proposing a resolution for the 65th IAEA General Conference to collectively address this issue by gathering all stakeholders and putting forward the role of nuclear technologies in the fight against cervical cancer on the Agency’s agenda,” he added.

Responding to cancer and COVID-19, Farhane also explained how his country had been working with the IAEA and other African countries in a 'triangular cooperation' approach. The IAEA through Technical Cooperation Projects, has supported Morocco in South-South cooperation by organising training workshops and courses in Morocco for hundreds of Moroccan and African participants — highlighting that 43 Moroccan experts were also sent by the IAEA to other African countries.

Farhane also said his country has received crucial equipment from the IAEA, such as RT-PCR kits, reagents, PPE and mobile X-ray machines and that 231 Moroccans had participated in courses organised by the IAEA abroad.

Indonesia’s experience

Soehartati Gondhowiardjo, radiation oncologist and senior consultant at the Cipto Mangunkusumo National General Hospital Jakarta, Indonesia, described how the COVID-19 situation has impacted access to cancer care, and how  her country benefitted from IAEA support during these difficult times. (Photo: IAEA)

Bringing insights from her role as a radiation oncologist and senior consultant at the Cipto Mangunkusumo National General Hospital Jakarta, Indonesia, Soehartati Gondhowiardjo described how the COVID-19 situation has impacted access to cancer care, specifically to radiotherapy in Indonesia. “The IAEA’s comprehensive e-learning platforms have been a very useful tool to provide technical resources to health professionals on the ground, and reduce confusion during the pandemic,” she said. Describing a swathe of virtual tools and programmes provided by the Agency, Ms Gondhowiardjo said the IAEA’s Asia-Pacific Radiation Oncology Network (ASPRONET) allowed her to connect with counterparts in the region and enabled them to learn from one another’s experience. “These tools allow oncologists across Member States discuss common difficulties and determine the best solutions for solving cancer cases.”

The IAEA will continue to work with countries globally to address cancer and will later this month hold its first large international conference of the year: The International Conference on Advances in Radiation Oncology (ICARO-3). Gathering leading experts from around the world, ICARO-3 will review best practices in radiotherapy and discuss the future potential of technological, medical physics and molecular/biological innovations using the most advanced breakthroughs of nuclear and nuclear derived science and applications. Learn more about and register for ICARO-3, here.

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