Health: The need to increase global coverage of nuclear medicine for cancer | Expert Network | future planet

Advances in the fight against cancer have yielded enormous benefits and saved millions of lives. Between 2000 and 2015, the probability of patients dying from the disease fell by 20% in high-income countries.

But this progress has eluded much of the rest of the world, deepening longstanding global inequalities. And the problem is going from bad to worse. Seven out of 10 people who will die of cancer in the next two decades will be from low- and middle-income countries, many of which lack even the basic tools to respond to the crisis. By 2040, cancer will have killed 11 million people a year in these countries.

In Latin America and the Caribbean, in 2020 there were about 1.5 million cases. By 2040, they are expected to increase by nearly a million, with annual deaths rising from 713,000 to 1.25 million. Likewise, Africa, which already has a cancer mortality rate 30% above the global average, will see an increase in cases in the coming decades.

Seven out of 10 people who will die from cancer in the next two decades will be from low- and middle-income countries

Changing that trajectory must become a major global priority. A profound epidemiological shift is underway, and it is in everyone’s interest to stay ahead of it. As improvements in quality of life lead to longer lives, deaths from cancer outnumber those from communicable diseases. In Africa, it kills more people than tuberculosis and at least as many as malaria. Since the end of 2019, six times as many Africans – and ten times as many Asians – have died from cancer compared to those who have been fatal victims of covid-19.

Health budgets have yet to reflect this change. In several low- and middle-income countries, funds to combat noncommunicable diseases are a small fraction of the total. With 23 African countries where there is not even a radiotherapy machine, more than 70% of the continent’s population does not have access to this treatment, despite the fact that more than half of the patients need it. In Africa, the annual per capita expenditure on radiotherapy is US$0.53 (0.48 euros); in North America, where radiotherapy needs are fully met, the figure is 35 times higher, and a similar comparison can be made with Europe.

In Africa, it kills more people than tuberculosis and at least as many as malaria. Since the end of 2019, six times more Africans have died from cancer compared to those who have been fatal victims of covid-19

Global cancer mortality reflects this inequality. In high-income countries, seven out of 10 children survive the disease, while the figure for Africa is less than three out of 10. In Latin America and the Caribbean, where more than 10% of cancer cases are found childhood, more children and adolescents die from this disease than from any other cause.

These inequalities do not have to persist. Investing in the fight against cancer can yield significant returns. Expanding and improving treatment, imaging, and quality of care could increase five-year survival rates tenfold in low-income countries, and more than double them in low- to middle-income countries. Increasing access to nuclear medicine (specialized radiology) and medical imaging services could prevent about 2.5 million cancer deaths globally by 2030, yielding global productivity gains equivalent to about €1.2 billion, a return net of 166 euros for each euro invested.

Increasing access to nuclear medicine could prevent nearly 2.5 million cancer deaths globally by 2030

Some readers may wonder why the head of the world’s leading nuclear proliferation watchdog is writing about the gap in the global fight against cancer. In fact, the International Atomic Energy Agency has a multifaceted mandate and was created to bring peaceful applications of nuclear science to those who need them. Since nuclear medicine plays a major role in the fight against cancer, one of our main tasks is to help member states make this technology available. From Niger to Uzbekistan, we’ve been helping countries expand their ability to tackle cancer for more than six decades.

While each country must determine its own priorities, the international community can and should play a valuable supporting role. Last month, the Director General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, and I committed to scaling up our organizations’ longstanding collaboration to help countries tackle cancer.

At the IAEA, we have thought a lot about how to do this, mapping the resources and needs around cancer in developing countries and calculating positive returns on investment in a variety of local settings. All of this motivated us to launch Rays of Hope, an initiative that brings together donor governments, technical and medical experts, international organizations, public financial institutions and the private sector. Together, all of them can help countries with little or no capacity to build the necessary infrastructure, acquire new equipment, support innovation and offer the necessary training. Furthermore, the countries that are most advanced in these areas can become regional references, helping to expand care and training in this field.

In times when the number of cancer cases is on the rise, standing still means going backwards. The covid-19 pandemic disrupted cancer care across the globe. In Africa and Latin America, the number of nuclear medicine procedures initially fell by 69% and 79%, respectively.

It is time for the authorities to reassess their priorities. This will help address a profound injustice and put us on the path to ensuring that the progress made in the fight against communicable diseases is not overshadowed by the rise of non-communicable diseases, particularly cancer.

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