Opening Address to the Conference on Quality Management and New Techniques in Radiation Medicine
Distinguished Guests, Delegates, Friends,
Let me join my colleague, Mr. Burkart, in extending a warm welcome to all of you who are attending this Conference. I am impressed by the level of attendance, which speaks of the relevance of the topics that you will be discussing in the coming days.
As you know, the IAEA has over the past three decades assisted developing Member States in building capacity and establishing infrastructures in nuclear science and technology. The Agency has often played and indispensable role in these countries, by transferring isotope and nuclear technologies that have applications in industry, human health, agriculture, water management and other sectors.
In this regard the issues of quality management and new techniques in radiation medicine are of great importance for the Agency´s Technical Cooperation Programme. Nuclear applications in human health, the majority of which are in the field of radiation medicine, constitute the single largest technical area in which Member States request support, representing roughly a third of the total resources allocated from the Technical Cooperation Fund in each one of the four regions: Africa, Asia and the Pacific, Europe and Latin America.
Practically all our Member States, regardless of their level of social and economic development, have expressed the need to incorporate new diagnostic and treatment modalities that involve the use of radiation. These may vary from the establishment of basic radiology and radiotherapy services to support the provision of secondary level of care in resource deprived environments, up to the deployment of technological innovations based on high-speed computer systems that operate with digitally processed information and sophisticated means of display and interpretation, which require by their very complex nature an advanced level of infrastructure development and highly trained human resources.
One of the difficult issues we must constantly deal with is how to ensure that the Agency´s support in any field, including that of radiation medicine, actually contributes to the achievement of sustainable development. Our Technical Cooperation Strategy has established a basic tenet to guide us in establishing, in partnership with Member States, the best way to allocate our scarce financial and human resources in response to their multiple requests for support, the so-called central criterion. A project meets the central criterion if it addresses an area of real need in which there is a national programme enjoying strong government commitment; it must either produce a tangible socio-economic benefit in an area in which nuclear technology holds a comparative advantage; or clearly support the creation of an enabling environment for the use of nuclear technologies (such as safety infrastructures or energy planning). The central criterion thus embraces the government´s commitment to sustaining the benefits of technical cooperation activities. The mere existence or availability of a new technology cannot by itself justify its introduction in a given country: by promoting its transfer and adoption we must consciously contribute to effective capacity building, and through this, to equitable and sustainable human development.
In the area of human health we face particular challenges when considering the application of the Central Criterion to identify priority areas for technical cooperation. There are many different ways of determining a country´s public health priorities: other competent global authorities such as the World Health Organization have deployed substantial resources for defining useful criteria and effective methods for establishing population health needs. A snapshot of the burden of disease in any given country, regardless of its level of development, will show many competing illnesses and conditions, with varying prevalence or impact on overall mortality and discapacity, and with differing potential for cost-effective treatment or prevention. No matter how many resources are made available for improving the health of any given population, the totality of potential demands can never be met: the needs are literally infinite and the available means will always be insufficient.
As I have indicated, our technical cooperation strategy strives to promote tangible impact by contributing directly in a cost-effective manner to the achievement of the major sustainable development priorities of each country. In the case of human health, and particularly with regard to the area of radiation medicine, in which the level of financial and human resource investment is quite high, we must ask ourselves the following questions when defining our Agency´s role in supporting the transfer of emerging high end technologies to our less developed Member States that have many competing development priorities:
- Should we or can we put a hold on such transfer until basic human health needs for the total population have been met?
- How can we assess what is relevant and appropriate in terms of adapting new technologies in the health sector?
- What implications does technology transfer have for health equity and for establishing health system priorities?
- What does this imply for the work of an Agency such as the IAEA which mainly supports developing countries in acquiring those relatively advanced technologies?
We have a number of tools for improving the relevance of our technical cooperation in health: through the use of various instruments such as the Country Programme Frameworks, Thematic Planning and others, we can work together with Member States and other partners in establishing clear guidelines and criteria to conduct work in these areas. With our country-level health sector counterparts, we need to define long term work plans that include the development of human resources and the strengthening of the health system, joining forces with other relevant partners who can bring to bear their complementary expertise and support. In this vein, I particularly look forward to the outcome of the discussions from the panel in session 7 on Technology Relevant to Needs, to the organization of which we have been happy to contribute.
I believe that ancient wisdom continues to be a good source of orientation in our post-modern times, and one maxim by Hippocrates, the father of Medicine, continues to be valid even in this most technological of ages: First, do no harm. Let us strive to do good, not harm, and to ensure that our efforts for making new technologies available to all the citizens of the world contribute in the best possible way to the principles of equity, justice and human development.