South–South Cooperation: Fostering Sustainable Solutions to Fight Cancer

When the IAEA began helping Zambia to formulate its national cancer control programme (NCCP) in 2021, radiation oncologist Kennedy Lishimpi joined experts from Egypt and South Africa, countries with advanced cancer control plans in place, to help draft his own country’s plan. Lishimpi, who serves as the Director and National Coordinator of Cancer Control Services in Zambia, is now paying it forward and leading a team of experts to help Sierra Leone with its own NCCP.

“The Zambian NCCP aims to reduce cancer incidence and is specific to the cancer burden of our country. The IAEA’s support has helped to shape the nation’s programme to build capacity for and transform cancer control in Zambia,” Lishimpi said. “Now we are able to contribute to Lesotho’s and Sierra Leone’s efforts and share our lessons learned.”

Global partnerships, including through South–South and triangular cooperation, are essential in fighting cancer and providing adequate treatment with sustainable solutions. South–South cooperation is the mutual exchange of knowledge and resources between and among countries in the Global South to meet development goals, while fostering self-reliance and ownership of activities. Triangular cooperation involves third parties, such as donor countries and organizations, that help facilitate South–South initiatives through funding and training.

“The IAEA facilitates the first interactions among countries that often develop into lasting institutional partnerships. These partnerships enable South–South cooperation to last beyond a specific point in time,” said Geraldine Arias de Goebl, Head of the Cancer Control Review and Planning Section at the IAEA. “With the support of the IAEA, many countries have established and continue to strengthen national policies and regional capacities in cancer control.”

The IAEA’s Programme of Action for Cancer Therapy (PACT), which was established in 2004, supports three areas in cancer control: assessment, planning and resource mobilization. The IAEA is currently supporting more than 20 countries in their comprehensive cancer control assessments and planning, and more than 100 countries are benefiting from cancer-related technical cooperation projects.

“In collaboration with the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), we identify local experts to assess the cancer control situation to help with planning. Typically, two to three experts from the same region with more advanced plans support the in-country experts,” Arias de Goebl said. Later on, as their own capacities are strengthened, those experts serve their peers in the region by sharing their experiences and knowledge with other countries. For example, experts from Cuba and Spain are supporting Paraguay with its NCCP, while, in Central Asia, the cancer team in Uzbekistan is benefiting from collaboration with Kazakhstan and the Russian Federation, among others.

In April and October 2021, the IAEA convened international experts who are helping countries to develop NCCPs to share good practices and challenges, including with regard to advancing NCCP advisory support virtually. “These workshops are part of a larger effort by the IAEA, through PACT, to strengthen South–South cooperation on cancer control, to create a knowledge sharing community within and across regions, and to expand the base of expertise available to support low and middle income countries in cancer control planning and governance,” said Arsen Juric, a PACT Programme Officer.

Assessment and action

To assess a country’s cancer control capacities, the IAEA conducts imPACT Reviews with experts from the region, in order to provide a baseline situation analysis and recommendations to guide cancer control planning and investments (read more here).

In November 2021, the IAEA, the WHO and the IARC completed a virtual imPACT Review to support Iraq. In cooperation with the Iraqi Ministry of Health, an international team of experts, including experts from Jordan and Türkiye, assessed Iraq’s cancer control capacities and needs, from registration and surveillance to diagnosis, treatment and palliative care. “During the review process, we identified capacity needs and the Iraqi medical specialists who would benefit from specific education and training,” said Juric, the coordinator of Iraq’s imPACT Review. “As a result of the Review, scientific visits were arranged to Jordan and Türkiye for Iraqi cancer specialists to observe the design and service delivery of oncology facilities, with regard to radiotherapy, radiology, medical physics and related safety dimensions.”

Regional platforms for cooperation

Under the auspices of the IAEA, four regional cooperative agreements — covering Africa, Asia and the Pacific, Latin America and the Caribbean, and the Middle East — bring together countries to identify priorities and collectively agree on projects to implement. As a result, these regions have strengthened cancer treatment and improved patient care and capacities through educational programmes.

In Africa, for example, Morocco is leading the fight against cervical cancer, which kills 300 000 women each year globally, of whom 90 per cent are in developing countries. “Out of the top 20 countries with cervical cancer incidences, 19 are in Africa, and 268 million women aged 15 and above are at risk of developing cervical cancer,” said Azzeddine Farhane, Ambassador of Morocco to Austria and Permanent Representative to the United Nations and other international organisations in Vienna, including the IAEA.

Taking a triangular cooperation approach to cervical cancer, Morocco has been working with the IAEA and other African countries. The IAEA has supported the North African country in organizing training workshops and courses for hundreds of Moroccan and other African participants to collectively address the cancer burden, as well as COVID-19. Furthermore, 43 Moroccan experts have been sent by the IAEA to other African countries for training.