Niger’s first public radiotherapy centre opens

After more than a decade of preparations supported by the IAEA, Niger commissioned its first public radiotherapy facility in 2021, marking an important milestone in the country’s fight against cancer.

Since treatments began in November last year, more than 15 cancer patients have been treated using cobalt therapy technologies at the National Cancer Centre (CNLC) radiation facility in the country’s capital, Niamey, said Malam Abari Moustapha, Director General of the CNLC.

There are nearly 10 000 new cancer cases in Niger every year, and more than 50 per cent of patients would benefit from radiotherapy as part of their treatment, including those diagnosed with breast, cervical and lung cancers, the most common types of cancer in the country.

“Particularly in Africa, where care is already limited, meeting the growing need for cancer services is an exceedingly complex endeavour. The launch of the CNLC facility, however, demonstrates that it can be done,” said Shaukat Abdulrazak, Director of the Division for Africa of the IAEA’s Department of Technical Cooperation. “Despite the added challenges imposed on the process by COVID-19, the IAEA remained in close contact with Nigerien counterparts to deliver the much-needed radiotherapy equipment and specialist training, and we plan to continue that close support.”

In Africa, 23 countries still do not have a radiotherapy machine, according to the IAEA’s Directory of Radiotherapy Centres. Niger is now no longer among them.

Before the radiotherapy machine was commissioned, no public cancer treatment services were available in Niger, except for limited chemotherapy services, which are complementary to radiotherapy, but do not replace it. While some patients were able to receive care abroad, the costs associated with international travel and treatment were prohibitive for most of the thousands of new cancer patients diagnosed each year.

Niger’s road to radiotherapy

Setting up a radiotherapy centre takes time, and the CNLC facility is no exception. Before establishing a radiotherapy centre, a country needs to put in place regulatory infrastructure for the safe and secure use of radioactive sources, including for the handling of these sources once they are no longer in use. Countries need to create the legal framework, establish a regulatory body and develop radiation protection expertise. The radiotherapy centre needs to be licensed by the regulatory body once its safety has been demonstrated. At the same time, the future staff of the centre needs to be trained and acquire expertise, often in a similar facility in another country.

Following expert missions and the construction of two bunkers to house and provide shielding for the radiotherapy machines, the IAEA organized training for 12 specialists, including radiation oncologists, medical physicists and radiotherapy technologists. In September 2020, the IAEA facilitated delivery of the facility’s final components in the midst of a COVID-19 pandemic related lockdown. In addition to capacity building activities and the procurement of equipment, the IAEA provided technical support for the licensing of the CNLC radiotherapy centre — a key component in the commissioning process.

“The IAEA contributed to the design of the centre’s building; facilitated the purchase, delivery and installation of equipment; and supported the basic and ongoing training of personnel,” said Minister for Public Health, Population and Social Affairs Idi Mainassara.

The Government has plans to continue developing the country’s public cancer services.

“Following the installation and operationalization of this cobalt machine, our plans for the extension of CNLC services will focus on the acquisition and installation of a linear accelerator (linac), on the establishment of brachytherapy and metabolic radiotherapy, and on further enhancing the training and capacities of our staff,” concluded Moustapha.