Identifier
Created
Classification
Origin
09UNVIEVIENNA150
2009-04-07 11:23:00
UNCLASSIFIED
UNVIE
Cable title:  

IAEA BUDGET: PROGRAM OF ACTION FOR CANCER THERAPY (PACT)

Tags:  ETTC KNNP MNUC PREL SOCI TRGY EAIO 
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PP RUEHWEB

DE RUEHUNV #0150/01 0971123
ZNR UUUUU ZZH
P 071123Z APR 09
FM USMISSION UNVIE VIENNA
TO RUEHC/SECSTATE WASHDC PRIORITY 9267
RHMCSUU/DEPT OF ENERGY WASHINGTON DC PRIORITY
RUEAUSA/DEPT OF HHS WASHDC PRIORITY
INFO RUEHII/VIENNA IAEA POSTS COLLECTIVE
RUEHLM/AMEMBASSY COLOMBO 0047
RUEHDR/AMEMBASSY DAR ES SALAAM 0029
RUEHHI/AMEMBASSY HANOI 0049
RUEHMU/AMEMBASSY MANAGUA 0001
RUEHYN/AMEMBASSY SANAA 0052
RUEHGV/USMISSION GENEVA 0873
UNCLAS UNVIE VIENNA 000150 

SIPDIS

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

E.O. 12958: N/A
TAGS: ETTC KNNP MNUC PREL SOCI TRGY EAIO
SUBJECT: IAEA BUDGET: PROGRAM OF ACTION FOR CANCER THERAPY (PACT)
HIGH PRIORITY FUNDING NEEDS 2009-2011

REF: A) 08 UNVIE 539; B) 08 UNVIE 541; C) UNVIE 65

--------------------------
Summary and Action Request
--------------------------

UNCLAS UNVIE VIENNA 000150

SIPDIS

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

E.O. 12958: N/A
TAGS: ETTC KNNP MNUC PREL SOCI TRGY EAIO
SUBJECT: IAEA BUDGET: PROGRAM OF ACTION FOR CANCER THERAPY (PACT)
HIGH PRIORITY FUNDING NEEDS 2009-2011

REF: A) 08 UNVIE 539; B) 08 UNVIE 541; C) UNVIE 65

--------------
Summary and Action Request
--------------


1. (U) The IAEA's Program of Action for Cancer Therapy (PACT)
expertise in radiotherapy to assist developing Member States to
design comprehensive National Cancer Control Plans (NCCP). PACT
looks to the U.S. as one of its main supporters and would welcome
USG funding or cost-free expertise during its three year planning
cycle for 2009-2011. To date, PACT has mobilized more than USD 22
million applied to cancer control efforts in developing countries
and more than 40 IAEA Member States have requested imPACT reviews,
the first stage in PACT's assessment of cancer incidence in a
particular country. PACT has seven program/funding priorities
ranging from conducting cancer-policy workshops, to providing
equipment and creating regional cancer therapy networks. The U.S.
is the leading state supporter of PACT, contributing USD 300,000 in
seed money, USD 500,000 in 2006, and over USD 365,000 in cost-free
experts from 2004-2006.


2. (U) In parallel with deliberations over the IAEA 2010-2011
regular budget, in which PACT would command enhanced but still
modest funding, Mission requests guidance to respond to PACT
2009-2011 extrabudgetary funding priorities and staffing requests.

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What has PACT achieved?
--------------


3. (U) For more than 30 years, the IAEA has worked with Member
States to build diagnostic and therapeutic radiotherapy capacity.
In 2004, responding to the World Health Organization's (WHO) call
for action to address this issue, the IAEA established PACT with a
mission to use the IAEA's expertise in radiotherapy to assist
developing Member States to design comprehensive National Cancer
Control Plans (NCCP). NCCPs address the entire cancer spectrum,
from prevention to palliation, maximizing public health return from
investments in radiotherapy and technology. PACT executes its
mission through partnerships with the WHO, the International Agency
for Cancer Research (IARC),International Union Against Cancer

(UICC),International Network for Cancer Treatment and Research
(INTCR),American Cancer Society (ACS),the American National Cancer
Institute (NCI) and national cancer institutes in Argentina,
Algeria, Brazil, Egypt, France, Morocco, Philippines, South Africa,
Thailand, and the United States.


4. (U) Six PACT Model Demonstration Sites (PMDS) in Albania,
Nicaragua, Tanzania, Sri Lanka, Vietnam, Yemen, and Ghana have
received long-term development loans from international
organizations for cancer control after obtaining initial seed money
from PACT. Donor states and organizations have endorsed PACT's
partnership approach, which seeks to maximize public-private funding
and expertise. To date, more than USD 22 million has been mobilized
and applied to cancer control efforts in developing countries and
more than 40 IAEA Member States have requested imPACT reviews, the
first stage in PACT's assessment of cancer incidence in a country.
(NOTE: The U.S. was the leading member state in recognizing and
supporting PACT, contributing USD 300,000 in seed money, USD 500,000
in 2006, and over USD 365,000 in cost-free experts from 2004-2006.
END NOTE)

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Programming/Funding Priorities
--------------


5. (U) PACT Director Massoud Samiei recently outlined to potential
donors countries seven projects that PACT will focus on from
2009-2011:

-- The first project, to conduct two Policy-Level Cancer Awareness
Seminars per year, is designed to raise awareness and broaden
understanding among policy and decision-makers of the importance of
national cancer control strategies, the fundamental role of
radiotherapy, and its implications for developing national policies
and strategies. The seminars are intended to produce plans of action
for selected countries in the regions where the seminars are held
and to improve their capacity for cancer treatment. The required
funding for this project is $240,000 per annum. For 2009 the
seminars will be help in Africa and Asia.


-- The second project develops Baseline Data Collection Criteria,
Outcome Indicators and Monitoring and Evaluation Methodology for
PACT Model Demonstration Sites (PMDS). PMDS is ongoing in Albania,
Nicaragua, Sri Lanka, Tanzania, Vietnam, and Yemen; under this
project PACT would add another six countries. PMDS projects ensure
that countries sustainably implement appropriate cancer therapy
programs by anchoring such programs to comprehensive national cancer
control plans and strategies. The main objective is to develop
methodology, allowing PMDS initiatives to be objectively evaluated;
a necessary first step in demonstrating success, especially to
donors and host governments. Because such complex interagency
cancer control efforts have never before been measured, new and
adequate methodologies are required. PACT would work with the WHO
under its joint cooperation agreement to ensure that evaluations of
projects are conducted appropriately by medical experts. The
required funding for this project is $160,000 per annum. PACT wants
to start immediately on the field research, country visits,
analytical work, development of materials and reporting, and
implementation of evaluations in up to 12 countries.

-- The third project for PACT's Regional Cancer Training Networks
and establishment of a Virtual University for Cancer Control (VUCC),
focuses on education and training of staff locally and regionally to
advance cancer care capacity in countries. Through its
public-private partnerships and close collaboration with the IAEA
Program Office for Human Health (NAHU),PACT would like to create
regional centers of excellence (the first one would be in Africa)
and online learning tools. Required funding is USD 700,000 over
three years, which includes field visits by external cancer training
and educators, reporting, development of terms of reference for the
establishment of Regional Cancer Training Networks, definition of
VUCC content and IT requirements, development or adaptation of
training material for distance learning for specialists involved in
cancer diagnosis and treatment, support for the establishment of
national radiation oncology and nuclear medicine graduate courses in
up to 25 locations in Africa, Asia, and Latin America, and various
consultancies and expert assignment during implementation of the
project.

-- The fourth programming priority is to recruit a full-time Health
Economist at the P-5 level. This expert would provide cancer
economic studies and cost-effective analysis for cancer treatment
including radio therapy programs. The PACT Program Office has
developed a concrete plan to conduct such studies in support of PMDS
projects currently underway in Albania, Nicaragua, Sri Lanka,
Tanzania, and Yemen. The required funding is USD 220,000 per annum.
The appointment would be for 2-3 years starting in 2009.

-- The fifth programming priority is the recruitment of a Public
Health Specialist with experience in non-communicable diseases, at
the P-5 level. This expert would coordinate the recently signed
WHO-IAEA Joint Program and assist with imPACT Reviews (see para 6,
below). The overall objective of the WHO-IAEA Joint Program is to
strengthen the development and implementation of comprehensive
national cancer control programs, including development of cancer
therapy capacity, with special emphasis on low- and middle income
countries. The required funding is USD 220,000 per annum. The
appointment would be for two years starting in 2009.

-- The sixth project entails the purchase of a High Dose Rate (HDR)
brachytherapy for PMDS Sri Lanka at the General Teaching Hospital
(Cancer Unit) in Karapitiya, Galle (southwestern province). A
critical short-term need for Sri Lanka is the installation of a new
HDR machine and training of a radiotherapy technologist (RTT). Sri
Lanka is one of the six PACT Model Demonstration Sites and this
effort complements past and on-going IAEA radiotherapy investments
with critically-needed development of capacity in cancer prevention,
early detection, registration, palliation, and civic society
activities. This project seeks to achieve the advancement of each
component area of cancer control through better alignment of
existing resource expenditure and augmentation of resources beyond
those currently available. According to PACT, these efforts are
especially important to Sri Lanka where cervical cancer accounts for
20 percent of female cancers, most with advanced cases at stage III
and above. The required funding for purchase of the machine,
installation and safety checks, and training of one radiotherapy
technologist and one medical physicist for three months at the Tate
Memorial Center in India is USD 450,000.

-- The seventh project is the establishment of a National Degree

Program in Radiation Therapy at the PMDS in Vietnam. This project
aims to kick-start the development of curriculum and training of
domestic radiation oncologists and medical physicists. According to
PACT, such an effort is critical in order to ensure that there is
sufficient human resource capacity to effectively utilize the new
technical equipment that will arrive in the country in the coming
years, and is considered a high priority high-impact short term
action. (NOTE: Australia is considering funding the training of 30
radiation therapy professionals and Austria is considering providing
six radiotherapy machines through bilateral programs. END NOTE)
The required funding is USD 200,000 per annum, with approximately
USD 100,000 supporting the training of 15 medical professionals and
the remainder used for degrees program development.

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New Partnership on the Block
--------------


6. (U) The WHO-IAEA Joint Program on Cancer Control, recently
signed by both agencies, is designed to strengthen the development
and implementation of comprehensive national cancer control program
(NCCPs),including the development of cancer therapy capacity, with
special emphasis on low to middle income countries. The Joint
Program's main areas of partnership are: 1) developing and enhancing
cancer registration and planning capacity; 2) strengthening support
to countries implementing measures to prevent cancer; 3) supporting
establishment and evaluation of early detection programs to ensure
timely diagnosis for curable cancers; 4) increasing access to
treatment; 5) increasing effective pain management and palliative
care; 6) promoting research and development; 7) building national
capacity for managing and evaluation national cancer control
programs; and 8) mobilizing resources. Initially, the Joint Program
will focus on full implementation of the PMDS in Albania, Nicaragua,
Sri Lanka, Tanzania, Yemen, and Vietnam. Depending on resource
availability, further demonstration sites may be developed.

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


7. (U) PACT continues to be one of the strongest IAEA programs that
delivers results in an area of global human health importance. The
model of public-private partnerships and proactive fundraising has
been successful, and major donors, including the U.S., continue to
call on the Agency to embrace the approach as a model for other
parts of its operation. Mission recommends USG consideration of the
PACT funding and staffing priorities for 2009-2011, specifically the
staffing requests either on the basis of establishing a new position
as PACT wants or as a CFE. On the project side, Mission recommends
working with PACT to identify a new PMDS country, with possible
on-going bilateral USG programs, which would dovetail nicely with a
USG/PACT initiative. We would welcome advice from USAID regarding
countries where such complementarities with U.S. programs might be
achieved.

SCHULTE