How a new partnership can save more lives worldwide

The announcement on June 9, 2010, of a new partnership between the International Atomic Energy Association’s Programme of Action for Cancer Therapy (IAEA-PACT) at the Breast Health Global Initiative’s Global Summit on International Breast Health in Chicago came with great excitement and interest. How will the collaboration advance the worldwide fight against breast cancer? As communications liaison for the Global Summit, I was able to sit down with Dr. Massoud Samiei, head of the PACT Program Office, who answered some of the questions about what the partnership could mean to developing countries.

How did PACT select BHGI for this partnership?
Dr. Samiei: For us, it’s important when selecting a partner that they have a plan that fits our goals. BHGI’s focus on low-resource countries was important. They also met our primary goal of cancer control. There was a synergy between our two organizations: BHGI’s focus on breast cancer in developing countries, their reputation and their development of guidelines that are being adopted. Together, we have a better chance of succeeding. I’ve been meeting with Ben Anderson for the past three or four years; this close contact has helped us better understand each other.

At PACT, we need to bring in the right partners to implement complete cancer programs. Since we’re creating base programs in countries, we’re always looking for partners. BHGI is an important example of a partner that can deliver – providing concrete guidelines for planning and then delivering breast cancer control. Guidelines on their own are fine, but at the end of the day, someone must implement them.

As a program manager, I see we have all the theory, but when it comes to designing a program, many areas need much more detail. For example, in pathology, how many lab services are needed? You need to work in real conditions of low-resource countries to decide what works and what needs to wait until later stages.

Where do you see PACT being of greatest benefit in the partnership?
Dr. Samiei: As part of IAEA, are door openers at the highest levels, so we’re able to engage at the top levels of government. BHGI is exposed to the realities of countries at the institutional levels, and now also at the highest ministerial levels. We’re global, and BHGI will have exposure to more countries to get feedback from across the globe. In particular, we have eight pilot projects, PACT model demonstration sites: Albania, Ghana, Nicaragua, Tanzania, Sri Lanka, Mongolia, Vietnam and Yemen. The idea is for everyone who comes in to demonstrate what can be feasible and successful, what guidelines will work in our model sites. We’re expanding to another four countries, so the total will be 12 countries.

BHGI will participate as a partner in all of these to the extent that their resources will allow. Breast cancer is the highest priority in some of these sites, including Mongolia, Vietnam and also Nicaragua. BHGI has the chance to bring its guidelines and expertise to all of these countries.

Does PACT provide equipment to these areas?
Dr. Samiei: In these model countries, we include all of the areas. We do an assessment and recommend what is needed in terms of equipment, finances, outreach. Based on these recommendations, the countries develop an action plan. With those having breast cancer as a priority, imaging, pathology, treatment all have to be analyzed. BHGI would be a partner to advise ministries what is needed. Is mammography needed? Should we do mobile mammography? The recommendations are based on research and scientific evidence, not someone’s opinion. That’s a very valuable input to the programs we’re running. It must be scientifically advisable and credible. I need something with support, based on results. That’s what BHGI provides.

What are the next steps for the BHGI-PACT partnership?
Dr. Samiei: Immediate steps are to start joint activities in Ghana. We’d like to support the training course BHGI is doing there. This is a great opportunity to get together and link up. PACT has three cancer centers in Ghana, a $22 million program, in Kumasi, Accra and Tamale. One component is breast cancer diagnosis and treatment. We could benefit from working with BHGI and with the government to plan expansion of services.

The next step in our collaboration is to engage BHGI in PACT’s virtual network, VUCCnet. The program was launched recently, and the idea is to train and while keeping people at home. It’s designed to provide training, partially distance learning and partially continuing professional development. We need to offer content from providers, adopt curriculum that can be placed on a website and determine how much should be done in person. This can be extended to oncology, pathology, surgery, radiation oncology. We’d like this virtual university to deliver; we have lots of interested parties that the World Health Organization is supporting. BHGI is developing training materials for those delivering cancer care, so this is a valuable partnership.

The virtual network already has been launched in Ghana. The target countries are four now in pilot phase for VUCCnet: Ghana, Tanzania, Uganda and Zambia. The mentor countries used as support are Egypt and South Africa. We’re hoping to link with others and that BHGI will be a link to benefit us with distance learning as they have access to education in the U.S. to help us in our programs in Africa.

Virtual University in its first phase will take three years to implement in four countries. We will analyze capabilities in each of the countries and try to assess their needs. They will expand so they can train their own personnel and decide whether their own hospitals have the resources to do the training. We could have trainings for breast cancer treatment and diagnosis that BHGI could provide for Ghana and then other countries could adopt them for their trainings.

We could expand our collaboration to a regional basis for other countries. We could collaborate in other regions. If there is opportunity, we should join together. We are door openers, and BHGI has an important message: develop clear guidelines for low- and middle-resource countries. It’s a long-term goal, and certainly we should be able to take advantage of this agreement and go forward.