Identifier
Created
Classification
Origin
09UNVIEVIENNA145
2009-04-06 15:37:00
UNCLASSIFIED
UNVIE
Cable title:  

IAEA/PACT: IRAQ BEGINS CONSULTATIONS ON NATIONAL CANCER

Tags:  EAID PREL IAEA TRGY TBIO AORC IZ 
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PP RUEHWEB

DE RUEHUNV #0145/01 0961537
ZNR UUUUU ZZH
P 061537Z APR 09
FM USMISSION UNVIE VIENNA
TO RUEHC/SECSTATE WASHDC PRIORITY 9249
RHMCSUU/DEPT OF ENERGY WASHINGTON DC PRIORITY
RUEAUSA/DEPT OF HHS WASHDC PRIORITY
INFO RUEHII/VIENNA IAEA POSTS COLLECTIVE
RUEHGB/AMEMBASSY BAGHDAD 0096
RUEHGV/USMISSION GENEVA 0871
UNCLAS UNVIE VIENNA 000145 

SIPDIS

STATE FOR IO/T, ISN/MNSA, ISN/RA

E.O. 12958: N/A
TAGS: EAID PREL IAEA TRGY TBIO AORC IZ
SUBJECT: IAEA/PACT: IRAQ BEGINS CONSULTATIONS ON NATIONAL CANCER
THERAPY PROGRAM

REF: A) 08 UNVIE 541; B) 08 UNVIE 556
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Summary
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UNCLAS UNVIE VIENNA 000145

SIPDIS

STATE FOR IO/T, ISN/MNSA, ISN/RA

E.O. 12958: N/A
TAGS: EAID PREL IAEA TRGY TBIO AORC IZ
SUBJECT: IAEA/PACT: IRAQ BEGINS CONSULTATIONS ON NATIONAL CANCER
THERAPY PROGRAM

REF: A) 08 UNVIE 541; B) 08 UNVIE 556
--------------
Summary
--------------


1. (U) In spring 2008, Mission provided, through the Embassy
Baghdad
Health Attache's office, an IAEA Program of Action for Cancer
Therapy (PACT) "imPACT" questionnaire, which the Iraqi Ministry of
Health and the Ministry of Science and Technology completed in
August 2008. PACT subsequently produced an analysis of nuclear
applications for cancer therapy, based on the GOI's responses.
During the 2008 IAEA General Conference, Msnoffs participated in a
meeting with the Iraqi Delegation and PACT to clarify short,
medium,
and long-term needs and assistance PACT might provide in Iraq.
Mission conveyed general U.S. support for PACT, but made no
commitments related to this project, though Iraqi interlocutors
pressed for such assistance. Instead, the next step discussed was
the GOI's need to delineate a concrete timeline, strategy, and cost
estimate for donors to consider. PACT offered assistance in
formulating a project package for donors. After months of inaction,
Iraq recently sent two experts from the Ministry of Health to Vienna
for March 30-April 4 consultations with PACT. The Iraqi experts hope
to create a short, medium, and long term plan to take back to
Baghdad for approval and eventual roll-out to potential donors.


2. (U) Action Request: Mission requests preliminary guidance on how
to
respond to Iraqi/PACT expectations that the U.S. will help fund this
project
either monetarily or through in-kind contributions. More detailed
guidance will be needed once the GOI completes its plan. We would
also
welcome thoughts from colleagues at Embassy Baghdad regarding where
these ideas might fit into USAID Iraq's strategic planning or any
other on-going USG efforts in cancer therapy. From a Vienna
perspective, a key benefit of this dialogue is the catalyst it
provides for enhanced interaction between the IAEA Secretariat and
IAEA board member Iraq. End Summary and Action request.

--------------
Major Issues
--------------


3. (U) As described in ref A, PACT is the IAEA's highly regarded
program to make nuclear medicine for cancer treatment available in
developing countries. The first stage in a PACT-Member State
partnership is the completion of an imPACT questionnaire. The
questionnaire provides a baseline of the cancer therapy
infrastructure in a country and the problems that remain to be
addressed. The Iraqi Ministry of Health and the Ministry of
Technology and Science worked together on the questionnaire and
submitted the responses below to PACT Director Massoud Samiei in
August 2008. Per ref B, the questionnaire revealed a number of
problems associated with current Iraqi cancer therapy practices and
capacity to treat patients.


4. (U) PACT's initial analysis focused on assessing urgent actions
that can be taken to improve the situation for cancer patients in
Iraq in the short-term. However, the security situation in Iraq and
lack of funding are major obstacles. Missonoff reconfirmed in early
March 2009 that PACT's analysis, per ref B, still holds. The major
issues that need to be addressed are:

- Iraq has only two cancer centers, with a third one in the north
that Ministry of Health officials claim they cannot access due to
political tension. The centers have three "functioning" teletherapy
machines for a population of approximately 29 million. Because of
the lack of treatment capacity, plans for additional radiotherapy
centers should be a priority. In order to do this, the national
cancer control committee should conduct a feasibility study that
provides a plan for expansion of centers based on patients' needs.

- Because of antiquated equipment, patients often wait six to 12
months for radiotherapy which means that only palliative treatment
is given. Upgrading teletherapy equipment and training professionals
to use the equipment properly is needed urgently. According to
PACT, this could be done in parallel to the feasibility study for
the expansion of centers.

- Three existing cobalt machines currently in use in Baghdad are
also in need of refurbishment. According to Iraqi and PACT
information, the sources utilize aged cobalt-60 which leads to very
long treatment times of low quality. PACT advises that the machines
be taken out of commission and the sources replaced. This of course

is predicated on the security situation allowing for transport of
sources, material, and personnel. The refurbishment should also
include installation of a cancer treatment simulator, dosimetry
equipment, QA/QC kits, and computerized treatment planning
software.

According to PACT, the Iraqis need to provide a list of prioritized
plans for immediate short term action (such as replacing the
radioactive sources, initiating a national cancer control plan,
upgrading cancer registries, regulating supply cancer medicine,
etc),and a list for longer-term actions in order to attract donors
and keep their own inter-agency focused on the issue.

--------------
MARCH 2009 PACT-IRAQI
CONSULTATIONS
--------------


5. (U) The Iraqi Ministry of Health, after six months of not
moving on this issue, caused in part by difficulties in obtaining
visas, has sent two clinical oncologists to Vienna for consultations
with PACT on how to assemble a short/medium/long-term cancer therapy
program. Consultations began on March 30 with IAEA health experts
and will continue throughout the week with relevant IAEA offices.
Dr. Mahdi Al-Saraj from the Baghdad Medical Center stressed the need
for new sources (cobalt 60) for the three existing machines and
requested USG assistance in this regard. [NOTE: Mission will report
on full request for removal septel. END NOTE] Al-Saraj also noted
the lack of training and the need to institute short and long-term
training for technicians and oncologists. Al-Saraj did not have a
clear idea of next steps with respect to promotion of a national
cancer therapy program to potential donors because the Ministry of
Health has not been in close contact with the Ministry of Foreign
Affairs on this issue. Missionoff encouraged Iraqi interagency
coordination and possible outreach by the Iraqi IAEA Governor on the
margins of the June Board of Governors meeting to attract donor
funding or services.

--------------
COMMENT
--------------

(U) Comment: Mission recommends USG adopt a supportive posture
toward IAEA/PACT cooperation with Iraqi authorities in charting and
implementing a plan. PACT involvement would ensure that GOI plans
provide for due safety and security protections on radiological
sources at cancer centers. While the security situation will
regulate the pace of implementation, the potential contribution
this
partnership could make to health and science in Iraq is consistent
with broader U.S. assistance to Iraq reconstruction. A forthcoming
U.S. approach would also be helpful to our effort to work with Iraq
as a member of the IAEA Board of Governors and would further our
interest in constructive IAEA-GOI relations.

SCHULTE